Roles and relationships
Families and their relationships
Normal family function
• Family is a social group whose members share common
values, occupy specific positions, and interact with each
other over time
Characteristics of normal family
– Family structure
– Family function
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FAMILY STRUCTURE
1. NUCLEAR FAMILY
• Members include adult man and woman, who are
married, and their children
• Members live under the same roof
2. EXTENDED FAMILY
• Members include the nuclear family as well as
grandparents, aunts, uncles, and cousins
• May or may not live under the same roof
• Often consists of three or more generations
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Family structure cont’d
3. SINGLE PARENT FAMILY
• Composed of one parent and one or more children
• Increasing due to high separation and divorce rates
4. BLENDED (STEP) FAMILY
– Members include children living with one birth parent
and one non birth parent, as well as the offspring of a
non birth parent
– Each member faces challenges of forming new
relationships
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Family structure cont’d
5. COHABITATED FAMILY
• Includes people living together without the formal or
legal bond of marriage
• Couples include:
– Men and women living together as trial marriage or as
an alternative marriage
– Gay or lesbian homosexual couples
• May include children
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cont’d...
6. COMMUNAL FAMILY
• Includes a number of members who share a common
bond such as religious affiliation, ideology, economic
needs, or situations such as attending college.
• Membership may be short-term
OTHER FAMILIES
Other family structures are commuter marriage (one
member may live away from the rest of family due to
leave for work or school), single adults living alone, etc
Some families adopt or care for children which are not
their own
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FAMILY FUNCTION
– Physical provision
– Economic provision
– Sexual intimacy/relation ship/
– Reproduction
– Education
– Socialization
– Nurturing or support
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Normal functional family pattern
• Meeting the family’s developmental tasks
• Guiding family members in accomplishing tasks
according to their age group
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Factors affecting normal family function
Culture, values and beliefs
Economic status
Lifestyle
Previous life experience
Coping and stress tolerance
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Altered family function
Potentials for altered function
Acute illness
Chronic illness
Traumatic experiences
Substance abuse
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Manifestations of altered family function
• Social isolation
• Family abuse and violence
• Separation and divorce
• Role strain
• Emotional problems in children
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ASSESSMENT
Subjective Data
• Functional pattern identification
Ask the client to tell you
– Who are the members of your family?
– How are the physical needs of food, shelter, health care,
etc met?
– What is the financial status of the family?
– What are the roles of different members?
– Who makes decisions in a family?
– Are members support each other? etc
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Subjective Data cont’d
• Risk identification
Ask for potential sources of stress in the family using the
following questions
– Are there any financial problems in the family?
– How healthy are other family members?
– Is there a history of alcoholism in your family?
– What other support system do you have?
– Are there relationship problems among members?
– Are there communication problems in the family?
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Subjective Data cont’d
• Dysfunction identification
Ask the client to tell you about the problems in the
family using the following questions
– Are you experiencing role strain?
– Describe the abuse you are experiencing
– How long have you been separated?
– What needs of your family are going unmet? etc
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Objective Data
• Observe family interactions and individual members’
behaviour
• Observe behavioural signs of dysfunction like labile
emotions, withdrawal, irritability, poor sleeping and
eating, inability to concentrate, and dependency
• Using physical ass’t techniques assess indicators of
physical abuse like injuries or bruises, enlarged liver
(sign of chronic alcoholism), signs of stress like weight
loss, fatigue, and impaired cognitive function, etc
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NURSING DIAGNOSES
• Altered family process
• In effective family coping: Disabling
• In effective family coping: Compromised
• Altered parenting
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NUSING INTERVENTIONS
Nursing interventions to promote family health and
function
– Identifying and reinforcement of family strengths
– Family support
– Anticipatory guidance (support plus teaching focusing on
what will happen rather than what has happend)
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... cont’d
• Help the family with problem solving
• Offer referrals
• Suggest family counselling as necessary
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