SAN BEDA COLLEGE OF MEDICINE Batch 2011

Topic: Family as the Unit of Care FCM 1

Lecturer: Dr. Mek Solana Nov. 12, 2007

DEFINITION OF THE FAMILY

THE FAMILY AS A VERY SPECIAL UNIT
Sociologic Viewpoint
• Enduring social form in which a person is 1. Lifelong involvement
incorporated
2. Shared attributes
Biologic Viewpoint • Genetics – physical/psychological
• Genetic transmission unit • Developmental – shared home,
lifestyle & social activities
Psychologic Viewpoint
• Matrix of personality development and the 3. Sense of belonging
most intimate emotional unit of society • Security/defense against potentially
hostile environment
Parsons & Bates, 1955 • Companionship
That social unit whose primary task are socialization of
children & stabilization of adult personalities 4. Societal expectations
• Sense of responsibility toward
Rogers, 1973
The family is a semi-closed system of actors occupying
member
inter-related positions defined by society of which the • Sense of responsibility toward others
family system is part as unique to that system with • Basis of affection/care
respect to the role content of the positions and to the
ideas of kinship relatedness 5. Built-in problems
• Generation gap
Murdock, 1965
• Dependence on members
The family is a social group characterized by common
residence, economic cooperation, and reproduction • Emotional attachment/involvement

Ransom and Vandervoot, 1973 6. The family endures in-spite of problems

Significant group of inmates with history & culture • Resource utilization
• Authority
Terkelson & Coworkers, 1980
A small social system made up of individuals related to • Individual sense of responsibility
each other,biologically or by reason of strong affections
and loyalty, that comprises a permanent household and
persists over decades. Members enter through birth, FAMILY STRENGTHS
marriage or adoption and leave by death; roles of
members change over time and through the history of 1. Ability to provide family’s needs
the group. • Physical – space management,
balanced meals, general health
UN
status
A group of people related by blood, marriages or
adoption, which live together in one household • Emotional – helping members
develop their capacity for sensitivity
to each other’s needs
THE FILIPINO FAMILY • Spiritual – sharing beliefs & cultural
Characteristics: values
• Closely knit • Cultural – sharing beliefs & cultural
• Bilaterally extended values
• Strong family orientation
• Authority based on age/seniority 2. Child – rearing practices and discipline
• Externally patriarchal, internally matriarchal • Capacity of parents to respect views
• High value on education of members on child rearing practices
• Predominantly Catholic(80% population) • If a Single Parent, the capacity of a
• Child centered single parent to be consistent and
• Average members is 5 effective in raising children
• Environmental stresses: economic, political,
3. Communication
urbanization & industrialization, health
problems • Ability to communicate and express
emotions verbally/non-verbally

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4. Support, Security & encouragement
• Capacity to provide with feelings of
security & encouragement
• Balance in pattern of family activities
5. Growth – Producing Relationships
• Ability to maintain & build
relationships in neighborhood
6. Responsible Community Relationships
• Capacity to assume responsibility
through participation in social,
cultural or community activities
7. Self-Help & accepting Help
• Ability to seek & accept help when
they need it
8. Flexibility of Family Functions & Roles
• Ability to “fill in” for one another
during times of illness/when needed
9. Crisis as a means of Growth
• Ability to unite & become supportive
during crisis/traumatic experience
10. Family Unity, Loyalty & Cooperation
• Ability to recognize & use family
traditions and rituals that promote
unity and pride
FAMILY HEALTH CARE
• Taking care of individuals on a one
by one basis
• Dealing with family as object of
management
• Influencing family members to
change factors affecting each
individual’s health
FAMILY AS THE UNIT OF CARE
1. THE FAMILY AS THE SOCIAL CONTEXT
FOR HEALTH CARE
• Transmission of
infectious/communicable
diseases
• Health behavior requirements in
the unit
• Resource utilization/source of
support
• Health and illness definitions
• Health decisions/approaches
and strategies
2. THE PATIENT’S PROBLEM IS THE
FAMILY’S PROBLEM
Doherty and McCubin, 1985: Important
ways in which the family plays a role in the
health of its members:
a. health promotion/maintenance and
illness/injury prevention
b. coping with stressful life events
c. family based health and illness
appraisal
d. family interaction and level of
functioning in response to specific
illness
e. help seeking or deciding on the
issue of seeking medical support
f. family adaptation/coping with illness
including care giving, strict
adherence to prescribe treatment
and lifestyle modification
3. THE FAMILY IS THE GREATES ALLY IN
THE PATIENT’S TREATMENT
• 90% of cases are
ambulatory/ out-patient
consultations with home
confinement/ prescriptions
4. PRESENCE OF THE FAMILY IN THE
INTERVIEW/CONSULTATION
• Family’s influence on the
patient’s personality,
values, beliefs, and
experiences
• Family’s influence on the
physician’s personality,
values, beliefs and
experiences
FAMILY STRUCTURE:
1. Nuclear
Members: parents & dependent children
Occupying separate dwelling not shared
with members of the family origin/orientation of
either spouse.
The household is economically dependent,
subsisting in the first instance from the
occupational earnings of husband/father.
2. Extended Family
• Unilaterally extended
• Bilaterally extended
Includes 3 generations; family centered;
lives together as a group & through its kinship
network provides support functions to all members
3. Single-Parent Family
• Children < 17 yrs. old living in a
family unit with a single parent,
another relative, or non-relative
• May result from loss of spouse by
death, divorce, separation, desertion
• Out-of-wedlock birth of a child
• From an adoption
• One parent is working outside the
Philippines (ocw, dhws etc.)
4. Blended Family
• Includes step-parents and step-
children
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 • Caused by divorce, annulment with
remarriage and separation
5. Communal/Corporate Family
• Grouping of individuals formed for
specific ideological or societal
purposes
• Considered as alternative lifestyle
for people who feel alienated from
the predominantly economically
oriented society
• Vary within social context
1. Highly formalized structure
e.g. Amish community in
Lancaster County Pennsylvania
2. Loosely knit group
e.g. Sta. Cruz mountains
near Boulder Creek California
BASIC AREAS OF FAMILY FUNCTION
1. Biologic
• Reproduction
• Child rearing/caring
• Nutrition
• Health maintenance
• Recreation
2. Economic
• Provision of financial resources
• Resources allocation
• Ensure financial security of member
3. Educational
• Teach skills, attitudes and skills
relating to other functions
4. Psychologic/ Affection
• Promotes natural development of
personality
• Offer optimum psychological
protection
• Promotes ability to form relationship
with people in family circle
5. Socio-Cultural
• Socialization of children
• Promotion of status and legitimacy
Transcribers: Ryan S. Marcelo
FAMILY RELATIONSHIP, INTERACTIONS &
EFFECTS ON HEALTH CARE
A. ORDINAL POSITION (DIFFERENCES IN
BEHAVIOURS)
1. First Born – generally persevering
• Serious
• More responsive to adults
• Achievement oriented
2. Middle Child - optimistic
• Sociable
• Aggressive
• Competitive
• Occasionally manipulative
3. Youngest - demanding
• Outgoing
• Occasionally narcissistic
• By nature are affectionate
B. PARENT – CHILD INTERACTION /
FAMILY RELATIONSHIP
C. FAMILY SOCIAL CLASS PATTERNS
1. Upper Class
• much more closely knit
• greater concern for maintaining for
family name & prestige
2. Middle Class
• believes in hard-work, initiative,
independence, responsibility,
economic security & self
improvement through education
3. Lower Class
• sees life as continual struggle for
survival
• resigned to a life of frustration and
defeat
D. FAMILY SET-UP
1. Democratic
• Parents respect child’s decision/idea
• Understanding & permissiveness
prevail
2. Authoritarian
• Unquestioned obedience conformity
to Parental guidance
• Pattern of punishment than praise
• Patients with Low self-reliance
• Suspicious adults
• Stand poorly in stressful situation
• Become hostile with pain/discomfort
Yrenne James H. Teodosio, PTRP
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