Concept About Family and Health Care

Afza.Malik GDA

Health Care and Concept of Family

Concept  About Family and Health Care

Family Theory and Research,Health Care Family,Category or Types of Theories,Like Exchange Theory and  Conflict Theory Assumes,Concept of Family in General,Family Development Theory,Double ABCX Model.

Family Theory and Research

    Family refers to any group whose members are related to one another through marriage, birth, or adoption. E. Burgess's (1926) description of a family as a unit of interacting personalities is still relevant to how families are viewed today. Because of the variety of family forms, theorists and researchers should provide their own definitions of family.

Health Care Family

    Nursing has long been interested in families as the context for individual members and has focused more recently on the family as a whole. Families have been a component of studies of psychiatric illness, caregiving, violence, adaptation to chronic illness in both children and adults, and cardiac conditions and other acute illnesses. 

    Family transitions, including grieving, transition to parenthood for adolescent mothers and married couples, and adaptation to divorce, remarriage, and stepfamilies, have also been studied. Nurses have published reports in major family journals as well as in nursing research and specialty journals and the new Journal of Family Nursing.

Category or Types of Theories

    Scholars from various disciplines have studied families, using diverse approaches. Theories presented here (except for stress theory) are based on descriptions provided by Klein and White (1996).

    The central focus in exchange theory is on the individual and what motivates his or her actions. Individuals are viewed as rational and self-interested, seeking to maximize rewards and avoid costs. 

    Individuals compare their own situation to others in the same circumstances and to others in different circumstances. In exchange theory the family is viewed as a collection of individuals. The family group is considered to be a source of rewards and costs for individual members. 

    Exchange theory could be used by nurse researchers to investigate the processes of family negotiation and problem solving.

Like Exchange Theory and  Conflict Theory Assumes

    Like exchange theory, conflict theory assumes that individuals are motivated by self-interest. Individuals compete for scarce resources, which include knowledge, skills, techniques, and materials. Resources provide a potential base for the exercise of power. 

    Conflict within the family is seen as the result of inequality of resources among individuals. Because conflict is both endemic and inevitable, a primary focus in the study of families is how they manage conflict.

    Concepts of symbolic interactionism include interaction patterns, meanings and definitions, symbols, sense of self, and role expectations. Socialization is the process by which individuals acquire the symbols, beliefs, and attitudes of their culture. 

    Individuals construct a sense of self and meanings for events and things through interactions with other people and with the environment. Role involves each person's adjusting behavior to what he or she thinks the other person is going to do. Children and adults have particularly significant interactions in the context of the family.     

    Likewise, roles that develop within the family are a crucial component of the individual's self-image.

Concept of Family in General 

    The family as a whole is the focus of family systems theory. All parts of the system are interconnected, and therefore, changes in one part of the system influence all other parts of the system. Subsystems are smaller units of the system, such as individuals and dyads. 

    Boundaries define who participates in the family and who participates in each subsystem. Boundaries exist between family members, between subsystems, and between the family system and the external environment. The degree of permeability of boundaries (open or closed) refers to the extent of impediments to the flow of information and energy. 

    A homeostatic system dynamically maintains equilibrium by feedback and control.The central concept in the ecological approach is adaptation. The child always develops in the context of family-type relationships, and that development is the outcome of the interaction of the person's genetic environment with the immediate family and eventually with components of the environment. 

    The individual is embedded in four nested systems. The microsystem is the immediate setting in which the person fulfills his or her roles, such as family, school, or place of employment. The mesosystem refers to the interrelations between two or more settings in which the developing person actively participates. 

    The ecosystem consists of external settings that do not include the person as an active participant but instead include systems (such as the legal system) that affect the person's immediate settings. Macrosystem refers to culture. Bishop and Ingersoll (1989) used the ecological framework in their research on the effects of marital conflict and family structure on self-concepts of children.

Family Development Theory

    Family development theory focuses on systematic changes experienced by families as they move through stages of their life course. Family stage is an interval of time in which the structure and interactions of role relationships in the family are noticeably distinct from other periods of time.     

Shifts from one family stage to another are called transitions. Family development theory emphasizes the dimensions of time and change. Using family development theory, Mercer, Ferketich, De-Joseph, May, and Sollid (1988) investigated the effect of stress on family functioning during pregnancy.

Double ABCX Model

    The double ABCX model is an extension of R. Hill's (1958) original ABCX family stress model, in which A refers to the stressor event and related hardships, B refers to resources, and C to perception of A (McCubbin & Paterson, 1983). The crisis, X (the amount of disruptiveness or disorganization), emerges from the interaction of the event, resources, and perception of the event. 

    The family's accumulation of life events and added stressors over time (Aa, pileup of demands) influences family adaptation both directly and indirectly through Bb (adaptive resources) and Cc, which is the perception of X, Aa, and Bb. J. Austin's (1996) study of family adaptation to childhood epilepsy is based on a modification of the double ABCX model.

    Research on families typically is an effort to test theoretical propositions or to develop theory. Although family research reflects different theoretical orientations, a common concern is the most appropriate unit of analysis. Is the concept of interest a property of the individual, dyad, or the family as a whole?     

For example, can families as a whole or only individual members perceive? Another recurring issue in family research is how to construct family variables if discrepant reports are provided by different members of the same family. 

    As family scholars address these problems, they can better explain the complexities of family life and ultimately provide guidance for intervention.


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