Family Wellness

Family A group of persons united by ties of marriage, blood or adoption; consisting of a single household; interacting and communicating with each other in their respective roles of husband and wife, mother and father, son and daughter, brother and sister, creating and maintaining a common culture (Burges and Locke 1960) A small social system made up of individuals related to each other by reason of strong reciprocal affections and loyalties and comprising a permanent household (Berman)

Family Semi-closed system of actors occupying interrelated positions defined by society of which the family system is a part as unique to that system with respect to role content of the positions and to the ideas of kinship relatedness. (Rogers)

Types of Families Nuclear- typically consists of a married man and women and their children Extended- linked together by virtue of kinship bond between parents and children and/or between siblings. Includes 3 generations- the family of procreation merges with the family of origin; can be unilateral or bilateral Blended- includes stepparents and stepchildren Communal- group of individuals who are formed for specific ideological or societal purposes.

The Family Systems Theory Minuchin (1978) Family is a continuous interlocking human relationship, organized in such a way that when there is a change in one family member, the other family members are affected Based on the following concepts: The family is more than a collection of individuals Families have repeating interaction patterns that regulate member behavior An individual’s symptoms may have a function within the family The ability of adapt to change is the hallmark of healthy family functioning There are no victims or victimizers in families

Family Structure Hierarchy- how power of authority is distributed in the family Boundaries- rules defining who participates in the subsystem and how they participate Coalition- relationship between atleast 3 people, where two people collude against the other Alliance- positive relationship between any two members of a system Role selection- unconscious assignment of roles to each family member

Family Process Enmeshment- occurs when boundaries are diffuse Disengagement- characterized by boundaries that are too rigid Triangulation- occurs when a third person is drawn into a two-pair system so as to diffuse anxiety or conflict Family patterns- ordered sequence of interaction that typify how families function

The Family Life Cycle Unattached young adult Newly married couple Family with young children Family with adolescents Launching family Family in later life

Family influence on health and impact on illness Genetic influence Crucial in child development Infectious disease spreads in the family Family factors affect morbidity and mortality The family is important in recovery from illness

Tools for Family assessment Family Genogram Family APGAR Family Circle Technique SCREEM Minuchin’s Family Map Family Lifeline

Family Genogram Uses: Quick overview of the interrelationships between family members As a way of looking at the family medical and psychosocial problems Tool for understanding the multigenerational family systems

Family APGAR Five item questionnaire designed to elicit the patient’s perception of the current state of his family relationships Adaptation-capability of the family to utilize and share inherent resources Partnership-sharing of decision making Growth- physical and emotional growth Affection- how emotions like love, anger, hatred are shared between members Resolve- refers to how time, space and money are shared

Medical factors affecting health Family Circle Technique SCREEM Social Cultural Religious Economic Educational Medical factors affecting health Brief, graphic method for disclosing, gathering, and discussing family dynamics as discussed by one or more family members

Family Health Care Plan Process which encompasses diagnostic, preventive, curative, and rehabilitative approach for whole family