Intro to fam med and FAMILY STRUCTURE AND FAMILY FUNCTION Flashcards
1
Q
why study family and community mendicine
A
- shows that HC that emphasizes PHC has better outputs
- better health outcome
- less hospitilization
- increased patient satisfaction
- lower costs
2
Q
Characteristics of Primary Health Care
A
› First contact accessibility
› Person-focused longitudinal care
› Comprehensiveness
› Coordination
3
Q
as both an academic discipline and clinical
specialty
● Included in basic medical education
A
FAMILY MEDICINE
4
Q
FAMILY MEDICINE
A
- ● One of the major rotations in medical postgraduate
internship - comprehensive and holistic care to individuals and families
› Integrates biomedical, behavioral, and social factors that
may affect individual’s health
5
Q
what is the basic social unit
A
family
6
Q
COMMUNITY MEDICINE
A
- concerned for a population or a group of people
7
Q
Community medicinde focuses on
A
epidemiology, screening, environmental health,
and others
● It focuses on:
› Health of community
› Concern with the promotion of health
› Prevention of disease and disability
› Rehabilitation through collective social action
8
Q
similarities of Fam and com med
A
- both clinical and public
- RHU and OPD
- educate public on health education
- public health activities under the city health officer
9
Q
is able to see patient in the context of
family, community, and society
A
› Family physician
10
Q
addresses peoples issues and at
the same is able to see the situation in the context of the
family and individual
A
Community physician
11
Q
PATHWAYS FOR SPECIALIZATION IN FAMILY
MEDICINE
A
- Traditional or Conventional Hospital-based Training- 3yrs
- Innovatice Practice based training- 4 -5yrs
12
Q
All doctors are expected to be
A
Five- Star Physicians
13
Q
distinct attitudes, skills, and knowledge
that qualify them to provide continuing and comprehensive
medical care, health maintenance, and preventive services
A
Five- Star Physicians
14
Q
Five- Star Physicians are
A
- Educator
- Counselor
- Manager
- Social mobilizer
- Researcher
15
Q
what is the scope of family medicine
A
scope of family medicine encompasses all ages, both
genders, each organ system, and every disease entity.
16
Q
focus of family physician
A
● Individual (patient-centered)
● Family (family-focused)
● Community (community-oriented)
17
Q
- analyze family pyschodynamics
- screem
- apgar
- family map
Identifying problems in the family that affects the patient
should also be addressed to have a better health
A
Counselor
18
Q
- researcher, decision making is based on evidence
- appraise medical literature
- evidence based
A
Researcher
19
Q
Empowerment of patients and families through:
- Health education and lifestyle modification
- Health promotion and disease prevention
- Early diagnosis and treatment
- Disability limitation, rehabilitation, and palliation
A
education
20
Q
make links and conncections - first contact last out should be - provide care womb to tomb - Refer cases appropriately to coordinate
A
Manager
21
Q
› Lead and actively participate in health policy-making
› Advocate patients’ rights and safety
› Mobilize communities towards worthy projects
A
Social mobilizer
22
Q
what is soap
A
Subjective
Objective
Assesment
Plan
23
Q
THE JOY OF FAMILY PRACTICE
A
- patients share there trust and
- provide better health care
24
Q
the center of 5 star physician
A
Health care provider
25
types of family structure
- Nuclear family
- extended fam
- blended fam
- single parent
- communal fam
26
- basic unit of fam
- married fam with children
- married fam no children
- widow/divorced and with children
Nuclear Family
27
Includes 3 generations
a. Family of procreation - parents and children
b. Family of origin - grandparents
› Could be unilaterally or bilaterally extended
one other memeber of the family
Extended Family
| › pertain to a
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› One or both parents have had a previous marriage
and possibly children from that marriage
› Includes step-parents and step-children brought
about by annulment, separation, and remarriage
Blended family
29
result from the loss of a spouse or death,
divorce, and separation
› May result from out-of-wedlock birth of a child or from
adoption
› May result from one parent working outside the
Philippines
Single parent family
30
of individuals which re formed for specific
ideological or societal purposes
› May not be related
› Share common resources and living arrangements
Communal family
31
Basic areas of function of family
- biologic
- economic
- educational
- psychological
- socio cultural
32
responsible for reproduction and
child-rearing to become contributing members of the
family
biological
33
family should prepare their children for life
› They should teach skills, values, and attitudes that
would equip their children to learn, work, form
friendships, and contribute to society
Educational
34
family should have the provision of adequate
financial resources and ensure the financial security
of its members
› Adequate financial resources, resources allocation,
financial security
Economic
35
family should promote natural development of
personalities, offer psychological protection for its
members, and promote ability to form relationships
within the family circle
Psychological /affection
36
The family should teach their children the values of
the society and share informations about culture and
beliefs
› Socialization of children
› Promotion of status and legitimacy
Socio cultural
37
is defined on the basis of structure
family
38
group of people related by blood, marriages, or
adoption, which live together in one household.” - United
Nations
Family
39
group of persons living under one roof and
| sharing the same kitchen and housekeeping arrangements.
household
40
1987 Philippines constitution
- sanctity of family institution
-
› Filipino family is the foundation of the nation
› Protects and promotes the right to ehealth of the people
41
as a basic autonomous social
| institution
Family
42
what is the foundation of the nation
Filipino Family
43
BY DIFFERENT VIEWPOINTS of family
Sociological
biological
psychological
44
WHY STUDY THE FAMILY?
● Psychosocial stress can occur within the family..
● Source of Social Support
● Transmission of infectious disease
● Health behaviour is acquired from the family
● Defines health and illness
● Makes health decisions
45
TWO PRINCIPLES
- Whatever illness that may best the patient will affect
the entire family in varying degree
- A triangular relationship exists and involves the
doctor, the patient, and the family, all providing inputs
and interaction that can be used in managing and
addressing the issues pertinent to the case.
› Therapeutic triad
46
WHAT IS FAMILY HEALTH CARE?
Taking care of all individuals in the family one by one
● Dealing with the family as object of management
● Influencing family members to change factors affecting
each individual’s health FAM
47
TYPES OF SET-UP
Democratic
Authoritarian
48
AUTHORITY PATTERNS
- Patriarchal
- matriarchal
- egalitarian
- within the family= age
49
authority outside the family
social class, professional status or official
| government affiliation, and ecclesiastical positions
50
ORDINAL POSITION
first born
second born
youngest
51
PARENT-CHILD INTERACTION
1. Rejecting Parent
- has an insecure, aggressive, nervous, and stubborn
child.
2. Submissive Parent
- has a careless and disobedient child.
3. Dominating Parent
- has an uncooperative and quarrelsome child.
4. Absent Father or Mother at Home
52
Fear- for life and children
Most common reason) reason why victims are hesitant to leave relationships
53
in same-sex relationship: Fear for exposure and hate
| crimes.)
(2nd most common) in same-sex relationship: Fear for exposure and hate
54
whats the majority age of abused
20-24
55
● Majority were physical or sexual violence, followed by
| physical violence
highest form of abuse for girls is sexual
56
NDHS 2017, 1 in 4
ever-married women aged 15-49 has ever experienced
physical violence, sexual or emotional violence from
husband or partner
Women who are separated, divorced or widowed are more
| likely to experience ALL forms of
57
RA 9262 AND PHYSICAL INJURY
or Anti-Violence Against Women Act of
2004 which penalizes abusive husbands and live-in
partners.
58
what is family violence
violence is abuse of power within relationships of
family, trust or dependency. It can include many forms of
abusive behavior:
59
who are the primary victims of family violence
women
› children
› seniors
› people with disabilities
60
Risk factors for girls and women or who are targeted for abuse or trafficking
- Usually young
- From poor socio-economic background
- Who belongs to an ethnic/Cultural group
- Disability
61
Primary biologic and psycho-physiologic disorder
| › Physiological abnormalities taking place in a patient’s
Disease
62
Includes the sufferer’s perceptions, emotions, and
experiences of the disease and the broad range of
dislocations felt by both the sufferer and his family
Illness
63
Includes the sufferer’s perceptions, emotions, and
experiences of the disease and the broad range of
dislocations felt by both the sufferer and his family
Illness
64
types of onset
acute
| gradual
65
types of course
progressive
constant
relapsing
66
types of outcome
no effect on life span
progressive then fatal
unpredictable
67
STAGES IN FAMILY ILLNESS AND
TRAJECTORY
STAGE I: Onset of Illness to Diagnosis
STAGE II: Impact phase- Reaction to Diagnosis
STAGE III: Major Therapeutic Efforts
STAGE IV: Recovery Phase - Early Adjustment to
Outcome
STAGE V: Adjustment to the Permanency of the
Outcome
68
Stages of Family Reaction
```
1. Denial (few days to few weeks)
› if prolonged, it could lead to a premorbid pattern of
abnormal behavior.
2. Anger
3. Bargaining
4. Depression
5. Acceptance
```
69
Family assessment tools:
1. Family lifeline
2. Family genogram
3. Family map
4. Family APGAR
5. SCREEM
6. Draw-a-family-test (DRAFT)
7. Family circle
70
Summarizes the history of the family, particularly
chronologically significant experiences
- how the family has coped
Family lifeline
71
```
Used to gather data about an indivi
Very excellent tool to use in learning about the family
structure
› Components
- Family Tree
- Functional chart: genogram gives a more dynamic
image of the family
- Family illness/history
```
Family Genogram
72
is a tool designed to reflect family
relationships and interaction patterns
● It facilitates the communication of information about the
family system and its dynamics in order to address
psychosocial issues
Family map
73
qualitatively measures family functioning
● Rapid screening instrument for family dysfunction
● Elicit the patient’s perception and level of satisfaction on
the current state of her family member’s relationships.
```
Adaptation
Partnership
growth
affection
resolve
```
apgar
74
It is very important in the assessment of the family as to
its capacity to participate in provision of health care or
to cope with crisis
› Commonly used when the need for care is long or last a
lifetime
› It can also be used to assess the resources of the difficult
and non-compliant patients.
● It is an acronym that represents family resources
› Social, Cultural, Religious, Economic, Education, Medical
screem
75
Provides clues on the significant psychological issues
within the family system.
● Task: patient is asked to draw members of his/her family.
› Does not measure the person’s inherent ability to
draw but how he pictures his family members.
DRAW-A-FAMILY-TEST (DRAFT)`
76
brief, graphic method for disclosing, gathering, and
discussing family dynamics as discussed by one or more
family members
● Often used in individuals, but they can be applied to small
groups as well
● Through this tool one can assess openness, boundaries,
support, function, triangulation, and interdependence..draw variable sizes of circle
family circle
