Week 11 Flashcards

1
Q

What is a family sociological definition

A

Giddens A 2006: a group of individuals related to one another by blood ties, marriage or adoption, who form an economic unit, the adult members of which are responsible for the upbringing of children
Sharma R: people related by marriage, birth or adoption who share a common kitchen and financial resources on a Regular basis
A Maupin 2017: increasingly complex (step families, blended/patchwork families, same sex parents); biological family vs ‘logical family’

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2
Q

Family definition. Office for national statistics

A

“A family is a married, civil partnered or cohabiting couple with or without children, or a lone parent with at least one child, who lives at the same address; children may be dependent or non-dependent”

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3
Q

What is a family

A

Often an emphasis on structure/social function
A ‘basic unit’ in society and health/medical care?
Common ground between definitions:
-at least 2 people (married/cohabiting adults or a single adult with or without (unmarried)children
-related both biologically and non biologically
-relationships imply a level of care and responsibility for each other especially children
Assumption children leave and have children of their own

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4
Q

Family types

A

Lone parent: single parent and child
Nuclear traditional: mother/father and biological children
Nuclear adopted: mother/father and adopted children
Nuclear same sex: mother/mother or father/father and children (own or adopted)
Extended: parents, children, grandparents, brothers and sisters, aunts and uncles
Reconstituted/blended/patchwork family: at least 1 adult has children from previous relationship
Postmodern family? Sex/gender fluidity increasingly recognised

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5
Q

Different aspects seen as important

A

‘Bringing up children’ what about non dependent children, Caring for elders
‘Engine of socialisation’: teaching norms and rules of behaviour explicitly or implicitly (eg gender)
Relationship between family members (biological-marriage/sexual/care) assumption that biology is strongest potentials conflict and harm
Family as “microcosm” with clearly defined social roles breadwinner, homemaker etc
Family as economical unit (bringing in and sharing resources; paid and unpaid labour)

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6
Q

Moral panics around family

A

Welfare of the whole society seen at risk when family roles/structures change
Especially related to motherhood- women blamed for working when they have children but also selfish when they dont
Section 28 1988-2003 banned “the teaching of the acceptability of homosexuality as a pretended family relationship”

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7
Q

Worrying about late motherhood

A

Defying nature and risking heartbreak? Bewley and Davies 2005 article over risk of deferring pregnancy past 35
Babies in your 30s? Don’t worry, your great grandma did it too J healey: social and economic structures post 2nd world war led to early parenthood and baby boom

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8
Q

Changing families

A

Mothers have children later (compared to 50s and 60s)
Divorce rate is slightly down from peak in 1990s but still many blended families
Increases in lone parent families
Increase in cohabiting families with children
More people living alone (esp when older)
Increase visibility same sex families. Civil partnership 2004, same sex marriage 2014
Many young families with migrant background (grandparent and support systems back home)

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9
Q

What is a household

A

A group of people who share living space
Householders will often relax together, eat together and share household chores
ONS: people in household share cooking facilities and living/dining area
Housing law 1961/2006 different: a household is either a single person or one family, houses in multiple occupation HMO contain several households sharing amenities. Stricter set of rules apply to landlords

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10
Q

HMOs and health Barratt 2017

A

Range of experience- sharing with friends vs thrown together with strangers
People living in HMOs are often vulnerable- ex prisoners, care leavers, insufficient benefits
-often badly maintained (gas/electric/mold); converted B&Bs especially problematic
-impact other tenants esp where crowded (eg TB, multi resistant bacteria, Covid, 2nd hand smoke)
-impact mental health (reduced to one room, privacy, noise, drugs, alcohol)

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11
Q

Families, household, health

A

Wide range of relationships eg strangers, friends, sharing by choice or necessity
Responsibilities when one member household is ill
During pandemic: restrictions on interaction outside household (sharing facilities such as kitchen/bathroom)
Assumptions about people as “monogamous, coupled and living with their partner or nuclear family” pienaar 2021

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12
Q

Families and determinants of health

A

Genetic transmission or risks/diseases: sickle cell, Huntington’s, obesity. No one’s fault, responsibility to inform
Healthy/unhealthy lifestyle: exercise, diet, smoking, alcohol,
Attitudes to health and illness, healthcare seeking behaviour: experiences others illness; seeking family members advice
Body image: dieting mothers as female role models; sport and masculinity
Wider structural factors

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13
Q

When a family member is ill

A

At onset of illness: diagnosis of symptoms; taking children to doctor, urging others to seek healthcare, calling for help in crisis
Managing illness: alleviating symptoms; care and comfort (esp for children)
When illness becomes chronic: provision of support in the longer term/ being the carer
Interacting with health services: advocating, interpreting, being involved in care decisions
Effect of illness on family vice versa

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14
Q

Family lifecycle McGoldrick and Carter 1982 adapted by Tansella 1995

A

Developmental task DT. Life cycle stage :LC
1971
18+: parent/offspring separation DT. Unattached adult between families LC
25m/23f: commitment to new family system DT. The newly married couple joining families LC
26m/24f: accepting a new generation DT. The family with young children LC
41m/39f: increasing flexibility of family boundaries to accommodate developing children’s independence DT. The family with adolescents
46m/44f: accepting the exiting family members DT. Launching children and moving on LC
51m/49f: accepting shifting generational roles DT. The fmaily later life

In 2005/6
18+
32m/29f
33m/30f
48m/43f
53m/50f
58m/55f

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15
Q

Health issues at different stages

A

Caring for children (doctor visits, vaccines)
Physical and mental health needs adolescents
Health risks of becoming independent
Talking about health within the family;sharing experiences of illness
Supporting older family members ( and accepting support eg looking after children)
Transitions can be risky

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16
Q

Implications of changes for health

A

Later childbirth
Ageing population
More people living along or far from family
Vulnerable people with no support outside NHS/social care services
Where do responsibilities of family end and those of the state begin
Should this be organised differently

17
Q

Family as a ‘problem’

A

Tansella identifies 3 ways in which the family normally comes to GPs attention as a problem:
-family fails in its expected patient care function
-another family member has a physical or psychological breakdown
-there’s non compliance and friction between patient, family and doctor that interfere with case management
These indicate the family is unable to cope with the patients illness and may need psychological intervention

18
Q

Centripetal vs centrifugal family

A

Relationship style varies between families
Mainly centripetal (close knit) type:
-seeking gratification mainly within family
-importance harmony minimising conflict
-discouraging movements towards more autonomy
Mainly centrifugal (pulling apart) type:
-seeking gratification mainly outside family
-less communication comfortable with conflict
-discouraging dependency

19
Q

Illness in the family can reinforce existing interaction patterns

A

Illness tends to encourage closeness
Centripetal family (becoming too close): external world perceived threat, problems or hostile feelings denied or hidden
Centrifugal family:(moving apart): illness increases distance between family members, fleeing (perceived) responsibility
Families usually move between centripetal/centrifugal type as needed
Some families unable to shift style as needed eg by allowing young adult to move back in

20
Q

Healthcare implications of problematic interaction patterns

A

Centripetal (inward looking families):
-existing centripetal focus may be amplified by illness
-may distrust medical advice
-patient autonomy at risk
-organising around illness; permanent crisis mode
-cutting ties to external world (stigmatised illness)
Centrifugal (outward looking families):
-may not offer patient the support they need,
-lack of understanding/communication between family members,
-strain/resentment towards the ill family member, -conflict eg siblings feeling neglected

21
Q

Implications for primary care

A

It’s important to understand family dynamics
Involve family members in discussions where possible/appropriate
Be aware of potential crisis points
Work with family strengths
Challenge dysfunctional patterns carefully

22
Q

Potential impact of long term caring

A

No access to social care support, respite breaks or counselling 64%
Negative impact on working life 59%
Negative impact mental health 58%
Negative effects on both physical and mental health 27%
Over 1.3 million people provide over 50 hours of care per week
Carers providing high levels of care were twice as likely to be permanently sick or disabled