The family is the basic unit of care in community health nursing. It is an important social structure needed for reproduction and socialization. A family refers to a number of persons joined together by bonds of marriage, blood or adoption (Burgess, 1963). Freeman (1992) defined family as two or more persons who are joined together by bonds sharing emotional closeness and who identify themselves as being part of the family.
REASONS FOR HAVING THE FAMILY AS THE UNIT OF SERVICE
1. It is the natural and fundamental unit of any society. 2. It prevents, tolerates and corrects health problems within its membership. 3. Health problems of its members are interlocking.
4. It is the most frequent locus of health decisions.
5. It is an effective and available channel for much of the CHN effort. 6. It provides a crucial environmental force.
7. It validates and influences health efforts of CHN because of its interaction with the larger social system.
TYPES OF FAMILIES ACCORDING TO COMPOSITION
1. Nuclear/nuclear dyad 4. Blended
2. Multigenerational/extended5. Communal
3. Single-parent/incomplete6. Foster
GENERAL FUNCTIONS OF A FAMILY
1. Physical maintenance
2. Socialization of family members
3. Allocation of resources
4. Maintenance of order
5. Division of labor
6. Reproduction, recruitment and release of members
7. Placement of members into the larger society
8. Maintenance of motivation and morale
FAMILY HEALTH TASKS
1. Recognizing interruptions of health or development
2. Seeking health care
3. Managing health and non-health crises
4. Providing nursing care to the sick, disabled or dependent member of the family 5. Maintaining a home environment conducive to good health and personal development 6. Maintaining a reciprocal relationship with the community and its health institutions
NURSING PROCESS IN FAMILY HEALTH CARE
This involves a set of actions by which the nurse measures the status of the family, its ability to maintain itself as a system and a functioning unit, and its ability to resolve its problems in order to achieve health and well being among its members.
Assessment includes data collection through the use of initial data base, analysis or interpretation and problem definition or nursing diagnosis.
A. Data Gathering Methods and Tools
1. Observation – use of sensory capacities
2. Physical Examination – inspection, palpation, percussion, auscultation, measurement of specific body parts and reviewing body systems. 3. Interview – health history
B. Components of Initial Data base
1. Family Structure, Characteristics, and Dynamics
a. Members of the household and relationship
b. Demographic data
c. Place of residence of each member
d. Type of family structure
e. Dominant family members in terms of decision making on matters of health f. General family relationship/dynamics
2. Socioeconomic and Cultural Differences
a. Income and expenses – occupation, place of work, adequacy to meet the basic needs, family members who makes decisions about money b. Educational attainment of each member
c. Ethnic background and religious affiliation
d. Significant others
e. Relationship of the family to the community such as participation in activities 3. Home and Environment
a. Housing – adequacy of living space, sleeping arrangement, breeding places of vectors, accident hazards, food storage and cooking facilities, waters supply, toilet facility, garbage or refuse disposal, drainage system b. Kind of neighborhood
c. Social and health facilities available
d. Communication and transportation facilities
4. Health Status of each family member
a. Medical and nursing history – past and present illness b. Nutritional assessment –...