Definisi keluarga

Depend on the theoretical concern of the definer

Ex interaksionis, general system etc.
Badan sensus AS, orientasi tradisional

Keluarga terdiri dari orang yang bergabung bersama

oleh ikatan perkawinan, darah, atau adopsi yang
tinggal dalam satu rumah yang sama
Terbatas, aplikasi dan inklusivitasnya

 Whall, 1986 dalam Friedman, 2003

Self-identified group of two or more individuals whose

association is characterized by special terms, who may or
may not be related by blood line or low, but who function
in such a way that they consider themselves to be family
Family service America, dalam Friedman 2003
Two or more people joined together by bonds of sharing
and intimacy
Purposefully broad
sure way of determining is ask her/ him

Tipe keluarga, AS
Traditional family form
Nuclear family
Nuclear dyad
Step parent family
Single adult living alone
Three generation extended family
Middle aged or elderly couple
Extended kin network

Non traditional family form

Unmarried parent and child family
Unmarried couple and child family
Cohabiting couple
Gay/ lesbian family
Augmented family
nuclear or single parent + 1 unrelated persons
Commune family
> 1 monogamous couple with children
Foster family
Single/ two parents + foster children, may + own children

Tahap dan tugas perkembangan

keluarga

 9 tahap siklus kehidupan klg menurut Duvall dan Miller,

1985 dan McGoldrick,1989

- Klg tahap transisi: klg antara (the unattached young
adult)
1. Klg permulaan
2. Klg childbearing
3. Klg dg anak prasekolah
4. Klg dg anak sekolah
5. Kld dg anak remaja
6. Klg melepas anak dewasa
7. Klg usia pertengahan
8. Klg usia pensiun dan lansia

Klg tahap transisi: klg antara (the

unattached young adult)
20-an tahun, mandiri scr finansial, secara fisik meninggalkan klg asal,

not marriage yet

Pivotal transition, ignored as family client
Important : survei di AS makin byk, di INA?
Cornerstone to successive stage to follow
Marriage : with who, when?
Balance : ikatan klg dg kemandirian
Tgs perkembangan
Separating from family of origin, developing intimate peer
relationship, establishing work and financial independence
Health concern
Family planning, birth control, sexually transmitted disease, safe
sexual practice, HIV, Accidents, Hepatitis C, Suicide, Mental health
concerns, good health practice

Keluarga pemula
Stage of marriage, separate from family of origin,

intimate relationship
Di AS presentase menikah
, di INA?
Tgs perkembangan
Establishing a mutually satisfying marriage, Relating
harmoniously to the kin network, planning a family
(decision about parenthood)
Health concern
Family education and family planning, Prenatal
education and counseling

Klg chidbearing

Kelahiran bayi-anak umur 30 bulan

Transition to parenthood
Important but stresfull
Disequilibrium changes
family crisis inadequacy
in parenting and diasruption in marital relationship
Stressor : loss of personal freedom, less time and
companionship in marriage
Harder than marital adjustment
Mother fatigued psychologically and physically 3
burdens

Klg
chidbearing,
lanjtn
Tugas perkembangan
Setting up the young family as stable unit (integrating of
new baby into family), reconciling conflicting
developmental tasks and needs of various family members,
maintaining a satisfying marital relationship, expanding
relationship with extended family by adding parenting and
grandparenting roles
Health concern
Preparation for birth experience, transition to parenthood,
infant care, well-baby care, early recognition and
appropriate handling of physical health problem with
children, immunizations, normal growth and
development, safety measures, family planning, family
interaction, good health practices

Klg dg anak pra sekolah

Anak pertama + 2,5 tahun-5 tahun
Become 3-5 persons, more complex and differentiated
Busy and demanding for the parent
Preschool belajar kemandirian, achieve autonomy and

self-sufficiency
Di AS, > Single parent

Klg dg anak pra sekolah, lanjt

Tugas perkembangan

Meeting family members needs for adequate housing,

privacy, and safety; socializing the children, integrating
new child members while still meeting needs of other
children, maintaining healthy relationship within the
family (marital and parent-child) and outside the family
(extended family and community)
Health concern
Communicable disease of children, accident prevention
and home safety (e.g. falls, burn, poisoning), marital
relationship, sibling relations, family planning, growth and
development needs, parenting issues, child abuse and
neglect, good health practice

Klg dg anak sekolah

Anak 1 masuk sekolah, 5 th-pubertas, + 13 th
Usually reach max number
Busy years, children have own activities and interests

regarding live and school, parents work

Learning with child separation
Conforming with school and community standard

Klg dg anak sekolah, lanjt

Tgs perkembangan

Socializing the children, including promoting school

achievement and fostering healthy peer relations of
children, maintaining a satisfying marital relationship,
meeting the health needs of family members
Health concern
Health challenge to children (e.g vision, hearing,
speech), dental health, child abuse and neglect,
substance abuse, communicable disease, chronic
conditions, behavior problems, good health practices

Klg dg anak remaja

Anak 1 13 th-anak meninggalkan rumah (19-20 tahun)
Loosening family ties to allow greater freedom and

responsibilities
Most difficult, discussed and written about
> conflicts and turmoil
Need rule changing, limit setting, and role
renegotiation

Klg
dg
anak
remaja,
lanjt
Tgs perkembangan
Balancing of freedom with responsibility as teenagers
mature and become increasingly autonomous,
refocusing the marital relationship, communicating
openly between parents and children
Health concern
Accident (e.g. driving), sport injuries, drug and alcohol
misuse, birth control, unexpected pregnancies, sex
education, marital relationship, adolescent-parent
relations, good health practices

Klg
melepas anak usia dewasa
Anak 1 meninggalkan rumah ortu-sarang kosong, anak terakhir

meninggalkan rumah
Culmination years of children parenting, return to the original dyad
Family goal : reorganization of the family into a continuing unit while
releasing children
Tgs perkembangan
Expanding the family cycle to young adults including new family
member acquired by marriage of children, continuing to renew and
readjust in the marital relationship, assisting aging and ill parents of
the husband and wife
Health concern
Communication issues between parent and young adult, role
transitional for husband and wife, emergence of chronic health
problems, family planning for young adult, menopausal concerns,
effects associated with prolonged drinking, smoking, poor dietary,
practice, Wellness life style

Klg
ortu usia pertengahan
Anak terakhir meninggalkan rumah-pensiun atau

kematian salah satu pasangan

Changes in (better) marital relationship
Prime of live for family with increased satisfaction and
economic status, some generally difficult
Tgs perkembangan
Providing a health-promoting environment, sustaining
satisfying and meaningful relationship with aging parents
and children, strengthening the marital relationship
Health concern
Good health practice, marital relationship, communication
with and relating to children, in-laws, grandchildren, and
aging aprents, care giver concern, adjustment to
physiological changes of aging

Klg
pensiun
dan
usia lanjut
berakhir
1 pasangan lagi
meninggal

Pensiun 1 atau 2 pasangan, berlanjut 1 psg meninggal,

Lansia meningkat
Miserable Vs best years
Tgs perkembangan

Maintaining satisfying living arrangement, adjusting to a

reduced income, maintaining marital relationship,
adjusting to los of spouse, maintaining intergenerational
family ties, continuing to make sense out of ones existence
(life review and integration)
Health concern
Increasing functional disabilities, mobility impairment,
chronic illness, diminished physical vigor and function,
long-term care services, caregiving, social isolation, grief/
depression, cognitive impairment

Tingkat Keperawatan Keluarga

1. Family as context
Klg dipandang sbg konteks/ latar belakang klien atau

anggota klg
Perawatan berfokus terutama pada individu, klg fokus
sekunder
Klg mrpk klp primer yang penting bg klien, dpt sbg sumber
atau stressor
Tk keterlibatan klg dlm perawatan bervariasi (bagian dr
sistem dukungan sosial klien, renpra)
Dampak tangible dan sosioemosional klg thd klien
diperhatikan
Sesuai konseptualisasi teori keperawatan ttg peran klg
>> Spesialisasi lain memandang klg sbg lingk sosial yg
krusial dan sbr dukungan sosial yg utama

2. Family as Sum of Its Members

Klg dipandang sbg kumpulan indvd anggota klg
Latar utama adl setiap anggota klg, dilihat terpisah

bukan sbg unit yg berinteraksi

3. Family Subsystem as Client

Subsistem klg sbg fokus dan penerima perawatan
Dasar keperawatan klg interpersonal
Family dyads, triads, and other family subsystem as the

unit of analysis
Ex : Parent-child relationship, marital interaction,
caregiving issues, bonding attachments concerns

4. Family as Client
Seluruh klg sbg fokus perawatan
Klg sbg latar utama, individu anggota klg sbg ltr

belakang atau konteks

Klg dipandang sbg sistem yang berinteraksi
Fokus pd dinamika dan hubungan klg scr internal,
struktur dan fungsi klg, hubungan subsistem klg dg
keseluruhan klg serta klg dg lingkungan luar
Pd lingkup ini kontribusi keperawatan klg terbukti
Praktik keprwt lanjut

5. Family as Component of Society

Klg dipandang sbg subsistem dr sistem yg lebih besar,

komunitas, masyarakat
Institusi masyarakat dasar

Current Issues in FN
Praktik
Gap yang signifikan antara teori dan penelitian serta
praktik klinik yang sebenarnya
Kebutuhan untuk membuat FN lebih feasibel untuk
dimasukkan ke dalam praktik
Pergantian wewenang dan kendali dari pemberi yankes
kepada klg
Bgm bekerja lebih efektif dg klg yg berbeda secara kultur/
budaya
Globalisasi FN memunculkan kesempatan yang menarik,
baru bagi perawat klg

Pendidikan
Konten apa yang harus diajarkan pada kurikulum FN
Penelitian
Kebutuhan untuk meningkatkan penelitian intervensi
FN
Kebijakan
Kebutuhan bagi perawat klg u lebih terlibat dalam
membentuk kebijakan yang mempengaruhi klg