Individual, Family, and Community Health

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Individual, Family, and Community Health

• By Jayson T. Valerio MSN, RN

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According to the ADN level of nursing education
and practice..

• Client is defined as
• plans and delivers nursing care to individuals
  and delivers nursing care to families or
  communities with an established plan of care.

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Individual Health

• Concept of
• Individuality
• human being
• is unique
• individualized
• care
• - total care

• Concept of
• Holism
• individual as a
• whole, complete
• or holistic
• relationship of
• individual to
• external
• environment
• and to others

• Concept of
• Homeostasis
• physiologic
• homeostasis
• psychologic
• homeostasis

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Homeostasis

• is a condition in which the body has to maintain
  a state of balance while continually changing.

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Physiologic Homeostasis

• means that the internal environment is relatively
  stable and constant

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4 Characteristics of Homeostasis

• Self-regulating
• Compensatory
• Regulated by negative feedback mechanism
• Require several feedback mechanisms to correct
  only one physiologic mechanism

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Psychologic Homeostasis

• refers to emotional balance or state of
  well-being

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Pre-requisites for a person to develop
psychologic homeostasis

• A stable physical environment in which the person
  feels safe and secure.
• A stable psychologic environment from infancy
  onward, so that feeling of trust and love
  develop.

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Pre-requisites for a person to develop
psychologic homeostasis

• A social environment that includes adults who are
  healthy role models.
• A life experience that provides satisfactions.

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Assessing the Health of Individuals
Health History
Physical Assessment
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Family Health

• Family is a basic unit of society.
• - simply as any group of people
  who live together.

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Functions of the Family

• Physical
• Economic
• Reproductive
• Affective and coping
• Socialization

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Why does the nurse need to be concerned about the
family?
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Impact of a Health Crisis on the Family

• Illness of one person affects the entire family
• Shifting roles and responsibilities
• Interrupted schedules
• Transportation issues
• Financial concerns
• Stressors on relationships

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What do American families look like today?

• Single Parents
• Single parents account for 27 percent of family
  households with children under 18.
• More than two million fathers are the primary
  caregivers of children under 18, a 62 percent
  increase since 1990.
• One in two children will live in a single-parent
  family at some point in childhood.
• One in three children is born to unmarried
  parents.

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What do American families look like today?

• Divorced Parents
• Nearly half of all marriages end in divorce.
• More than one million children have parents who
  separate or divorce each year.
• More than half of Americans today have been, are
  or will be in one or more stepfamily situations.
  

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What do American families look like today?

• Guardians/Foster Care
• One child out of 25 lives with neither parent.
• The 2000 US Census found that 2.4 million
  grandparents are the primary caregivers for the
  children in their families.

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What do American families look like today?

• Adoption
• According to national estimates, one million
  children in the United States live with adoptive
  parents, and from two percent to four percent of
  American families include an adopted child.
• More than 100,000 children are adopted each year.
  

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What do American families look like today?

• Gay-and Lesbian-Headed/Unmarried Partner
  Households
• Between six million and 10 million children of
  lesbian, gay and bisexual parents currently live
  in the United States.
• The number of unmarried partner households has
  increased by 72 percent in the last decade from
  three million in 1990 to more than five million
  in 2000. These figures include both same-sex and
  different-sex couples.

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What do American families look like today?

• Mixed-Race Families
• Interracial families are an ever-growing part of
  our national landscape. The 2000 Census showed
  that 2.8 million children under age 18 and nearly
  7 million Americans of all ages identify as more
  than one race.
• There are more than 4.5 million married and
  unmarried couples in the United States who are
  mixed racially or ethnically.

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Two Main Types of Family Structure

• Nuclear Family
• consists of parents and their offspring
• Extended Family
• - consists of nuclear family structure
  grandparents, aunts, uncles and live together

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Other Family Structures

• Traditional Family
• - parents reside in the home with their children,
  the mother assumes the nurturing role while the
  father assumes as the provider.
• Two-Career Family
• - both partners are working.

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Other Family Structures

• Single-Parent Family
• children live in a single-parent home
• Reasons adoption, divorce, separated, death of a
  spouse
• Stressors Child care, financial, role overload,
  fatigue

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Other Family Structures

• Adolescent Family
• infants are born to adolescent parents
• great risk for health and social problems

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Other Family Structures

• Foster Family
• - children who can no longer live with their
  biological parents may require placement with a
  family

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Other Family Structures

• Blended Family
• - is a traditional family, formed by when parents
  bring unrelated children from previous
  relationships together to form a new family

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Other Family Structures

• Intragenerational Family
• - children may continue to live together with
  their parents even after having their own children

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Other Family Structures

• Cohabiting Family
• consists of unrelated individuals or families who
  live under one roof
• Reasons a need for companionship, a desire to
  achieve a sense of family, testing a
  relationship, sharing expenses

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Other Family Structures

• Gay and Lesbian Family
• - homosexual adults may form families based on
  the same goals in heterosexual relationships

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Other Family Structures

• Single Adults Living Alone
• - individuals who live by themselves represent a
  significant portion of todays society

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Nursing Assessment of the Family

• Health Beliefs
• Family Communication Patterns
• Family Coping Mechanisms
• Risk for Health Problems
• Maturity Factors
• Hereditary Factors
• Sex or Race
• Sociologic Factors
• Lifestyle Factors

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Family Nursing Diagnoses

• Interrupted Family Processes
• Readiness for Enhanced Family Coping
• Disabled Family Coping
• Impaired Parenting
• Impaired Home Maintenance
• Caregiver Role Strain

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Nursing Interventions for Families in Crisis

• Help provide focus and set realistic goals.
• Give support and information.
• Assess familys readiness and ability to provide
  continued care at home. Identify and build on
  family strengths.
• Identify available resources for outside
  assistance when needed.
• Support restoration and reorganization of family
  functions. Help family to identify signs of
  progress.

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Know your local resource people facilities
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When a family member dies

• Individual loss
• Altered family structure
• Changes in roles
• Nurse may also feel the loss, re-experience a
  past loss, or contemplate future personal losses,
  may feel inadequate or powerless to help, may
  reassess personal values

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Grief Process
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Theoretical Framework Applications to the
Individual Family

• Needs Theories
• - Maslows
• Hierarchy of Needs

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Becoming Self-Actualized

• Realistic
• Correct judgment
• Perceptive-decisive
• Right wrong
• Good predictor
• Understands the arts, politics, and philosophy
• Dedicated to life work
• Creative, flexible, spontaneous, willing to take
  risks

• Self-confidence self-respect
• Little inner conflict
• Feels self-controlled, does not need fame
• High independence, desires privacy
• May appear remote or detached
• Friendly, loving, inner directed
• Can go against the flow
• Problem centered
• Accepts the world for what it is

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• Developmental Stage Theories-Typical behaviors
  within an age group

• Systems Theories-
• Structural-Functional Theory-

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Community Health

• Looking at the health of population groups
• Physical environment
• Education
• Safety and transportation
• Politics and Government
• Health and Social Services
• Communication
• Economics
• Recreation

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What Community Problems Impact the Health of its
Members?

• Overcrowding
• Bioterrorism
• Hazardous environments- Poisoning, pollution,
  water supply
• Crime
• Unemployment
• Recreational areas
• Educational Resources
• EMS, Healthcare Providers and Facilities

• Public Transportation
• Poor political representation
• Economics
• Child Care Facilities
• Waste treatment and disposal
• Traffic road safety
• Social Service
• Fire law enforcement personnel

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Hurricane Katrina
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LA Riots
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Twin Towers- September 11th
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Columbine High School
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Oklahoma City Bombings
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Virginia Tech Massacre
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Community Nursing Diagnoses

• Ineffective Community Coping
• Readiness for Enhanced Community Coping
• Ineffective Community Therapeutic Regimen
  Management

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Global Issues

• Poverty
• Pollution
• Maldistribution of
• resources

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Universal Happenings
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Nurses Need to View Health Problems from Multiple
Perspectives

• Individual
• Family
• Community
• Global
• Universal

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Get Involved And !

• YOU can make a difference for
• YOU - individual
• Your family
• Your community
• Your country and
• The whole world in general
• BUT you have to start from YOU!!!!!!!!!!
• HAVE A NICE TURKEY DAY TO ALL OF YOU!!!!!
• (dont eat too much)