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Maternal child health nursing

Chapters 2 & 3

Gail Notes

Family- two or more people living together in the same household that share an emotional bond and perform certain interrelated social tasks.

Family of orientation - the family one is born into

Family of procreation - a family one establishes

Each family has three components:

  1. Structure- membership or composition
  2. Function
  3. Role

Structure:

  1. Nuclear family- mom, dad, kids
  2. Extended family- multigenerational family (grandma, niece, aunt, etc and members of the nuclear family live under one roof)
  3. Single parent families are on the rise in the U.S
    1. Divorce
    2. Separation
    3. Desertion
    4. Choice
  4. Blended families- a divorced or widowed person with children marries someone who has children
  5. Communal families- a group of people who have chosen to live together as an extended family group. Characterized by a common ownership of goods
  6. Cohabitation- living together without being married
  7. Gay/lesbian family
  8. Foster family or adoptive family- in a foster family it is important to find out who has the legal responsibility to sign for health care of the child the foster parent may or may not have this right. As the children get older, they may want to find out whom their biological parents are.
  9. Interracial/interfaith relationships

Functions of the family

  1. #1 is basic needs- food, shelter, clothes, safety
  2. Economic function and distribution of resources
  3. Education- acquisition of knowledge and skills
  4. Socialization- language, religion, values, sexuality
  5. Communication-
  6. Division of labor- who does what
  7. Discipline or order- punishment and reward
  8. Reproduction, recruitment and release of members
  9. Maintenance of motivation or morale- sense of pride in the family serves as support during crisis
  10. Placement of members into larger society
  11. Psychological function- support network, learn coping skills

Changing patterns of family life

  1. Mobility
  2. Poverty
  3. Increase in homeless families
  4. Increase in divorce
  5. Increase in abuse
  6. Increase in health care monitoring
  7. Decrease in family size
  8. Increase in dual employment
  9. Increase in single parent family

Family life cycles

Stage 1- couples form cohabitation; they work to achieve three tasks

    1. Establish a mutually satisfying relationship
    2. Learn to relate to families of orientation
    3. Engage in reproductive life planning if applicable

Stage 2 - early childbearing family

Nurses assess the parents’ ability to care for the child both in times of good health and illness. Perfect time for client teaching. Ask what they do if the child is ill. If the answer is not the best solution to the problem or therapeutic as long as it is sensible it probably means that the parents have mastered this stage.

Stage 3 - the parents with preschool children

Accidents become a major health concern

Stage 4 - the family with school aged children

Nursing concerns are immunizations, safety related to electric or auto accidents, and encourage a meaningful school experience

Stage 5 - the family with adolescent children

The family must loosen family ties to allow the child freedom and prepare them for life on their own. A nurse is neutral person who can assist when talking about sex, firearms, drugs, alcohol, etc

Stage 6 - the launching center family

Children leave the home and begin life on their own. Parents may have a decrease in self-esteem and less able to cope.

Stage 7 - The family of middle years

Return to two - partner nuclear unit - freedom to travel, have hobbies, spend time with their partner or they may experience the empty nest syndrome- some may have another child at this point

Stage 8- Family in retirement or older age

The couple offers a great deal of support to young families and often baby-sit grandchildren

Nursing implications:

  1. What is the developmental stage of the family?
    1. Is this the first baby?
    2. Is there a teenager in the family?
    3. Who assumes what roles in the family?
  2. What is the communication pathway?
  3. MCH nursing recognizes that the structure and composition of the family determines the support, relationships, and interactions within the family
  4. What is the cultural background of the family? Culture embodies values, beliefs, traditions, and that can influence people’s response to crisis, illness, and childbearing.
  5. Nurses must be culturally competent and sensitive.
    1. Culturally competent- to have the capacity to work effectively with people integrating elements of their culture.
    2. To become competent you have to assess the following
        1. Language of the client- effective communication is the key in a therapeutic relationship
        2. Space and time orientation
        3. Work orientation
        4. Family structure and role orientation
        5. Religion
        6. Health beliefs
        7. Reaction to pain
        8. Nutrition
        9. Male/female roles

    1. Culturally sensitive- understanding and accepting different cultural values, attitudes and behaviors.
    2. How can nurses be more culturally competent? Have a self-awareness of your own biases and prejudice. If you so not this can lead to misinterpretation and misunderstandings. Also increase your knowledge of other cultures through reading, documentaries, or the internet

Respect the values and customs of other individuals. Strive to adapt to changes in cultural diversity

Most of the information here was taken from Maternal and Child health nursing by Pillitteri.

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