COMMUNITY HEALTH NURSING LECTURE ST 2024-2025

CHN Lecture

1. The Family as a Client
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2. The family as client: assessment and diagnosis: objective

After completion the lecture the students enable to:
1.Define the FAMILY
2.Describe the roles and functions of the family
3.Describe the different types of families
4.To acknowledge why family is considered as the unit of
care
5.To recognize the developmental tasks and health tasks
of the family
6.Describe the decision making in the family
7.Enumerate and apply the different steps in Decision
Making
8.Discuss how to prepare for a home health care visit and
how to conduct the visit.
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3. The family as client: assessment and diagnosis: Introduction


Introduction
Working in a community setting generally
involves working with families. CHN must
there for understand the interactions and
dynamics of families so that they can provide
appropriate family assessment , planning,
intervention and evaluation
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4. The family as client: assessment and diagnosis: Introduction


Thus an understanding of family
dynamics and the context of the community
assists the nurse in planning care.
When family is the client, the nurse
determines the health status of the family
and its individual members, the level of family
functioning, family interaction family
strengths and weakness
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5. The family as client: assessment and diagnosis: Definition


Definition
Family is two or more persons related by
birth, marriage, or adoption who reside
together in a household.
Family is a structural unit composed of a man
and women who are married and have
children

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6. The family as client: assessment and diagnosis : Characteristics


Characteristics of the Family
Every family is a social system
Every family has a it’s own cultural values and
rules
It is the first social group to which the
individual is exposed
Every family has a structure
Every family have certain basic function
Every family moves through stages in its life
cycle
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7. The family as client: assessment and diagnosis : types

Types of Family Structure

 Nuclear family
 Extended family
 Commune family
 Family of origin
 Family of procreation
 blended family
 single parent family
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8. The family as client: assessment and diagnosis : Introduction


Function of the Family
a.Affection, love, care, an emotional support
b.Security
c.Identity
d.Affiliation
e.Socialization
f.Control
g.A sense of belonging and of history and place
h.Family rituals for rejoicing and grieving
i.Systems for earning money , supporting partners
and children
j.Sharing of labor, chores required to keep the
family running
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9. The family as client: assessment and diagnosis : Introduction


Characteristics of Healthy Family
1.Facilitative interaction among members
2.Enhancement of individual development
3.Effective structuring of relationship
4.Active coping effort
5.Healthy environment and lifestyle
6.Regular link with the border community
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10. The family as client: assessment and diagnosis : Introduction


Health Tasks of the Family
Recognizing interruptions of health or development.
Seeking health care
Managing Health and non- health crises
Providing nursing care to the sick, disabled and
dependent member of the family.
Maintaining a home environment conductive to good
health and personal development.
Maintaining a reciprocal relationship with the
community and health and institutions
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11. The family as client: assessment and diagnosis : Introduction


Importance of Family Health
1.Family as a unit of services
2.Effect of the family health on individual
health
3.Effect of family on community health
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12. The family as client: assessment and diagnosis : Introduction


Family Health Assessment
Assessing family health in a systematic
fashion require three tools:
1.Conceptual framework upon which to dbase
the assessment
2.A clearly defined set of assessment
categories for data collection
3.A method for measuring a family’s level of
functioning
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13. The family as client: assessment and diagnosis : Introduction


Conceptual frameworks
1.A conceptual framework is a set of
concepts integrated into meaningful
explanation that helps one interpret human
behavior or situations.
2.Three conceptual frameworks are
particularly useful in community health
nursing.
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14. The family as client: assessment and diagnosis : Introduction


1. Interactional Framework
Describes the family as:
unit of interacting,
personalities,
emphasize communication,
role,
 coping patterns and
decision-making process
( focus on internal relationship)
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15. The family as client: assessment and diagnosis : Introduction


2. Structual-Functional Framework
1.Describes the family as a social system
relating to other social systems in the
external environment, such as:
School
Work
Religion places
Health care system
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16. The family as client: assessment and diagnosis : Introduction


3. Developmental Framework

Studies family from lifecycle perspective
by examine members changes roles and tasks
in each progressive life cycle
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17. The family as client: assessment and diagnosis : Introduction


Family Developmental Tasks
1. Beginning family
Establishing a mutually satisfying marriage
Planning to have or not have children
2. Childbearing family
Having and adjusting to infant
Support needs of all three members

Renegotiating marital relationship

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18. The family as client: assessment and diagnosis : Introduction


3. Family with pre- school children
Adjusting to cost of family life
Adapting to needs of pre-school children to
stimulate growth and development
Coping and parental loss of energy and Privacy
4. Family with school age children
Adjusting to the activity of growing children
Promoting joint decision making between
children and parents.
Encouraging and supporting children’s
educational achievements
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19. The family as client: assessment and diagnosis : Introduction


5. Family with teenagers and young adults


Maintaining open communication among
members.
Supporting ethical and moral values within the
family.
Balancing freedom with responsibility of
teenagers.
Releasing rituals and assistance
Strengthening marital relationship.
Maintaining supportive home base young
adults with appropriate
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20. The family as client: assessment and diagnosis : Introduction


6. Post- parental family
Preparing for retirement
Maintaining ties with younger and older
generations.
7. Aging family
Adjusting to retirement
Adjusting to loss of spouse

Closing family house

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21. Data Collection Categories
A list of 12 data collection categories
1.Family demographic ( composition,
socioeconomic)
2. Physical environment
a. housing and the conditions inside, outside
and surrounding it
b. Any existing safety or environmental
hazards
c. The amount and quality or services available
d. Geography and climate
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22. The family as client: assessment and diagnosis :


3. Psychological and spiritual environment such as:
Mutual respect, support, promotion of
the members self-esteem
4. Family structure and roles include:
Family organization
Division of labor and allocation
Use of authority and power
5. Family functions refers to a a family’s ability to
carry out appropriate developmental tasks and
provide for it’s members needs
6. family values and beliefs influence all aspects of
family life, E.g making and spending money,
education, work and religion

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23. The family as client: assessment and diagnosis :


7. Family communication pattern include the
frequency and quality of communication with a
family and between the family and its
environment
8. Family decision-making pattern
9. Family problem solving
10. Family coping patterns , family support system,
responses to stressors
11. Family health behavior
12. Family social and culture pattern
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24. The family as client: assessment and diagnosis : assessment methods



Assessment Methods
1.Ecomap: is diagram of the connection
between a family and the other system in its
ecological environment or its A picture of
the family’s patterns.
Nurses can use an ecomap to identify:
a.Family resources that are present
b.Family needs
c.Conflicts
d.Connections that are present or absent
e.The balance or lack of balance between a
family's needs and the resources available
to the family

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25. The family as client: assessment and diagnosis

1.Genogram
A graphic picture of family history,
usually used over three or more
generation .
The genogram maps such
information as;
a.Relationships among family members
b.Important life events
c.Place of residence
d.Characteristics such as race, culture and
religious affiliations


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26. The family as client: assessment and diagnosis

Family assessment tools
Genogram
70 65 48 82
Lung heart car breast
cancer disease accident cancer
62 60
diabetes breast
cancer
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27. The family as client: assessment and diagnosis

3. Family Health Tree
A record of diseases that occur in a
family. It can be used to track:
a.Diseases that have genetic bases
b.Environmental diseases
c.Mental health disorders


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28. The family as client: assessment and diagnosis

There are two systems of nursing diagnosis
a.NA NDA system
Uses nursing diagnosis labels
b. Omaha system
Develop for community health nurses,
consist of:
1.Problem classification
2.Intervention
3.Problem rating scale for outcomes
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29. The family as client: assessment and diagnosis

Guidelines for family health assessment
Focus on the family as a total unit
Utilize goal-directed question
Allows adequate time for data collection
Combine quantitive data with qualitative data
Exercise professional judgement
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53. STEPS IN DEVELOPING
FAMILY NURSING CARE PLAN