Intro to fam med and FAMILY STRUCTURE AND FAMILY FUNCTION Flashcards
why study family and community mendicine
- shows that HC that emphasizes PHC has better outputs
- better health outcome
- less hospitilization
- increased patient satisfaction
- lower costs
Characteristics of Primary Health Care
› First contact accessibility
› Person-focused longitudinal care
› Comprehensiveness
› Coordination
as both an academic discipline and clinical
specialty
● Included in basic medical education
FAMILY MEDICINE
FAMILY MEDICINE
- ● 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
what is the basic social unit
family
COMMUNITY MEDICINE
- concerned for a population or a group of people
Community medicinde focuses on
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
similarities of Fam and com med
- both clinical and public
- RHU and OPD
- educate public on health education
- public health activities under the city health officer
is able to see patient in the context of
family, community, and society
› Family physician
addresses peoples issues and at
the same is able to see the situation in the context of the
family and individual
Community physician
PATHWAYS FOR SPECIALIZATION IN FAMILY
MEDICINE
- Traditional or Conventional Hospital-based Training- 3yrs
- Innovatice Practice based training- 4 -5yrs
All doctors are expected to be
Five- Star Physicians
distinct attitudes, skills, and knowledge
that qualify them to provide continuing and comprehensive
medical care, health maintenance, and preventive services
Five- Star Physicians
Five- Star Physicians are
- Educator
- Counselor
- Manager
- Social mobilizer
- Researcher
what is the scope of family medicine
scope of family medicine encompasses all ages, both
genders, each organ system, and every disease entity.
focus of family physician
● Individual (patient-centered)
● Family (family-focused)
● Community (community-oriented)
- 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
Counselor
- researcher, decision making is based on evidence
- appraise medical literature
- evidence based
Researcher
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
education
make links and conncections - first contact last out should be - provide care womb to tomb - Refer cases appropriately to coordinate
Manager
› Lead and actively participate in health policy-making
› Advocate patients’ rights and safety
› Mobilize communities towards worthy projects
Social mobilizer
what is soap
Subjective
Objective
Assesment
Plan
THE JOY OF FAMILY PRACTICE
- patients share there trust and
- provide better health care
the center of 5 star physician
Health care provider
types of family structure
- Nuclear family
- extended fam
- blended fam
- single parent
- communal fam
- basic unit of fam
- married fam with children
- married fam no children
- widow/divorced and with children
Nuclear Family
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
› 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
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
of individuals which re formed for specific
ideological or societal purposes
› May not be related
› Share common resources and living arrangements
Communal family
Basic areas of function of family
- biologic
- economic
- educational
- psychological
- socio cultural
responsible for reproduction and
child-rearing to become contributing members of the
family
biological
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
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
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
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
is defined on the basis of structure
family
group of people related by blood, marriages, or
adoption, which live together in one household.” - United
Nations
Family
group of persons living under one roof and
sharing the same kitchen and housekeeping arrangements.
household
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
as a basic autonomous social
institution
Family
what is the foundation of the nation
Filipino Family
BY DIFFERENT VIEWPOINTS of family
Sociological
biological
psychological
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
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
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
TYPES OF SET-UP
Democratic
Authoritarian
AUTHORITY PATTERNS
- Patriarchal
- matriarchal
- egalitarian
- within the family= age
authority outside the family
social class, professional status or official
government affiliation, and ecclesiastical positions
ORDINAL POSITION
first born
second born
youngest
PARENT-CHILD INTERACTION
- Rejecting Parent
- has an insecure, aggressive, nervous, and stubborn
child. - Submissive Parent
- has a careless and disobedient child. - Dominating Parent
- has an uncooperative and quarrelsome child. - Absent Father or Mother at Home
Fear- for life and children
Most common reason) reason why victims are hesitant to leave relationships
in same-sex relationship: Fear for exposure and hate
crimes.)
(2nd most common) in same-sex relationship: Fear for exposure and hate
whats the majority age of abused
20-24
● Majority were physical or sexual violence, followed by
physical violence
highest form of abuse for girls is sexual
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
RA 9262 AND PHYSICAL INJURY
or Anti-Violence Against Women Act of
2004 which penalizes abusive husbands and live-in
partners.
what is family violence
violence is abuse of power within relationships of
family, trust or dependency. It can include many forms of
abusive behavior:
who are the primary victims of family violence
women
› children
› seniors
› people with disabilities
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
Primary biologic and psycho-physiologic disorder
› Physiological abnormalities taking place in a patient’s
Disease
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
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
types of onset
acute
gradual
types of course
progressive
constant
relapsing
types of outcome
no effect on life span
progressive then fatal
unpredictable
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
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
Family assessment tools:
- Family lifeline
- Family genogram
- Family map
- Family APGAR
- SCREEM
- Draw-a-family-test (DRAFT)
- Family circle
Summarizes the history of the family, particularly
chronologically significant experiences
- how the family has coped
Family lifeline
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
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
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
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
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)`
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
