KONSEP KELUARGA

ASTUTI YUNI NURSASI, SKp., MNBAGIAN JIKOM FIK-UI

INTRODUCTION TO THE FAMILY• THE FAMILY - ALONG WITH THE INDIVIDUAL, GROUP AND

COMMUNITY - IS NURSING’S CLIENT OR RECIPIENT OF CARE.• TWO BASIC PURPOSES OF THE FAMILY ARE TO MEET THE

NEEDS OF THE SOCIETY OF WHICH IT IS A PART AND TO MEET THE NEEDS OF THE INDIVIDUALS IN IT.

• WHY WORK WITH THE FAMILY? 1. THE FAMILY IS A CRITICAL RESOURCE FOR DELIVERING HEALTH CARE

2. IN A FAMILY UNIT, ANY DISFUNCTION THAT AFFECT ONE OR MORE FAMILY MEMBER WILL AFFECT, IN SOME WAY AFFECT OTHER MEMBER AS WELL AS THE UNIT AS A WHOLE 3. THERE IS A STRONG INTERRELATIONSHIP BETWEEN FAMILY AND HEALTH STATUS OF ITS MEMBERS 4. CASE FINDING 5. ACHIEVE A CLEARER UNDERSTANDING OF THE INDIVIDUALS AND THEIR FUNCTIONING 6. THE FAMILY IS A VITAL SUPPORT SYSTEM FOR INDIVIDUALS

FAMILY DEFINITIONS• DEFINITION OF FAMILY VARY BY DISCIPLINE, THE

PROFESSIONAL AND DISTINCT GROUPS OF FAMILY.• FAMILY IS AN AGGREGATE MADE UP OF A BODY OF

UNITS, THE INDIVIDUALS THAT REPRESENT THE WHOLE OR THE FAMILY.

• THE CONCEPT OF FAMILY HAS 5 CRITICAL ATTRIBUTES (STUART, 1991):1. THE FAMILY IS A SYSTEM OR UNIT.2. FAMILY MEMBERS MAY OR MAY NOT BE RELATED AND MAY

OR MAY NOT LIVE TOGETHER.3. THE UNIT MAY OR MAY NOT CONTAIN CHILDREN.4. COMMITMENT AND ATTACHMENT EXIST AMONG UNIT

MEMBERS AND INCLUDE FUTURE OBLIGATION.5. THE UNIT CARE GIVING FUNCTIONS CONSIST OF

PROTECTION, NOURISHMENT, AND SOCIALIZATION OF UNIT MEMBERS.

VARIED FAMILY FORMS

• TRADITIONAL1. NUCLEAR FAMILY (1

PARENT WORKING)2. NUCLEAR FAMILY (DUAL-

EARNER)3. NUCLEAR DYAD4. SINGLE-PARENT FAMILY5. SINGLE ADULT LIVING

ALONE.6. THREE GENERATION

EXTENDED FAMILY.7. MIDDLE-AGED OR

ELDERLY COUPLE.8. EXTENDED KIN

NETWORK.

• NONTRADITIONAL1. UNMARRIED PARENT AND

CHILD FAMILY.2. UNMARRIED COUPLE AND

CHILD FAMILY.3. COHABITING COUPLE.4. GAY/LESBIAN FAMILY.5. AUGMENTED FAMILY.6. COMMUNE FAMILY.

FAMILY LIFE CYCLE (DUVALL, 1985)

1. BEGINNING FAMILY (MARRIAGE).2. EARLY CHILDBEARING FAMILY (ELDEST CHILD IS IN

INFANCY THROUGH 30 MONTHS OF AGES)3. PRESCHOOL CHILDREN (ELDEST CHILD IS 2.5 TO 5

YEARS OF AGE)4. SCHOOL-AGE CHILDREN (ELDEST CHILD IS 6 TO 12

YEARS OF AGE)5. TEENAGE CHILDREN (ELDEST CHILD IS 13 TO 20 YEARS

OF AGE)6. LAUNCHING FAMILY (OLDEST TO YOUNGEST CHILD

LEAVES HOME)7. MIDDLE-AGE FAMILY (REMAINING MARITAL DYAD TO

RETIREMENT)8. AGING FAMILY (RETIREMENT TO DEATH OF BOTH

SPOUSES)

THE STRUCTURAL DIMENSIONS OF THE FAMILY

• FAMILY COMMUNICATION PATTERNS/ PROCESS

• FAMILY POWER• FAMILY ROLE• FAMILY NORMS

AND VALUES

FAMILY COMMUNICATION PATTERNS AND PROCESSES

ELEMENTS OF COMMUNI-CATION• A SENDER OF A MESSAGES• A FORM/ CHANNEL OF THE

MESSAGE• A RECEIVER• SOME INTERACTION

BETWEEN THE SENDER AND THE RECEIVER

DEFINING COMMUNICATIONCOMMUNICATION IS THE PROCESS OF EXCHANGING FEELINGS, DESIRES, NEEDS, INFORMATION AND OPINIONS (McCUBBIN & DAHL, 1985)

FAMILY COMMUNICATIONA SYMBOLIC, TRANSACTIONAL PROCESS OF CREATING ANDSHARING MEANINGS IN THE FAMILY.

FAMILY COMMUNICATION PATTERNS AND PROCESSES

COMMUNICATION PRINCIPLES• ALL BEHAVIORS IS COMMUNICATION SO IT IS IMPOSSIBLE

NOT TO COMMUNICATE.• COMMUNICATION NOT ONLY CONVEYS INFORMATION OR

CONTENT, BUT IS COUPLED WITH A COMMAND (INSTRUCTION) ----> THEREFORE MESSAGES CONTAIN 2 LEVELS OF COMMUNICATION: CONTENT AND INSTRUCTIONS.

• COMMUNICATIONS INVOLVE A TRANSACTIONAL PROCESS AND IN THE INTERCHANGE EACH RESPONSE CONTAINS THE PRECEDING COMMUNICATION.

• TWO TYPES OF COMMUNICATION: DIGITAL AND ANALOGIC.

• DIGITAL: VERBAL COMMUNICATION; ANALOGIC: BODY LANGUAGE

• THE REDUNDANCY PRINCIPLE.• ALL COMMUNIATIONAL INTERACTIONS ARE EITHER

SYMMETRICAL OR COMPLIMENTARY.

SPECIFIC FUNCTIONAL AND DYSFUNCTIONAL COMMUNICATION PROCESS

DYSFUNCTIONAL COMMUNI-

CATION PROCESSSENDER• MAKING ASSUMPTIONS.• EXPRESSES FEELINGS UNCLEARLY.• MAKES JUDGMENTAL RESPONSES.• IS UNABLE TO DEFINE OWN NEEDS.• EXHIBITS INCONGRUENT

COMMUNICATION.

RECEIVER• FAILS TO LISTEN.• USES DISQUALIFICATION.• RESPONDS OFFENSIVELY AND

NEGATIVELY.• FAILS TO EXPLORE SENDER’S

MESSAGE.• FAILS TO VALIDATE MESSAGES.

BOTH SENDER AND RECEIVER• COMMUNICATE IN DIFFERENT

WAFELENGTHS (PARALEL TALK)• ARE UNABLE TO FOCUS ON ONE

ISSUE.

FUNCTIONAL COMMUNI-CATION PROCESS SENDER• FIRMLY AND CLEARLY STATES

CASE.• CLARIFIES AND QUALIFIES

MESSAGES.• INVITES FEEDBACK.• IS RECEPTIVE TO FEEDBACK

RECEIVER• ACTIVELY AND EFFECTIVELY

LISTENS.• GIVES FEEDBACK.• VALIDATES THE MERIT OR

WORTH OF THE MESSAGE

FAMILY COMMUNICATION PATTERNS AND PROCESSES

FUNCTIONAL COMMU-NICATION PATTERNS IN THE FAMILY• COMMUNICATING CLEARLY

AND CONGRUENTLY• EMOTIONAL COMMUNICATION• OPEN AREAS OF COMMUNICA-

TION AND SELF-DISCLOSURE• POWER HIERARCHY AND

FAMILY RULES• FAMILY CONFLICT AND FAMILY

CONFLICT RESOLUTION

DYSFUNCTIONALCOMMUNICATION PATTERNS IN THE FAMILY• SELF-

CENTEREDNESS• NEED FOR TOTAL

AGREEMENT• LACK OF

EMPATHY• CLOSED AREAS

OF COMMUNICATION

FACTORS INFLUENCING FAMILY COMMUNICATION PATTERNS

• THE CONTEXT/ SITUATION• THE FAMILY’S ETHNIC

BACKGROUND• THE FAMILY LIFE CYCLE• GENDER DIFFERENCES• FAMILY FORM• THE FAMILY’S SOCIO-

ECONOMIC STATUS• IDIOSYNCRATIC FACTORS:

THE FAMILY MINI-CULTURE

THE FAMILY POWER STRUCTURE

FAMILY POWER BASES• LEGITIMATE POWER/

AUTHORITY• HELPLESS OR

POWERLESS POWER• REFERENT POWER• RESOURCE POWER• EXPERT POWER• REWARD POWER• COERCIVE POWER• INFORMATIONAL POWER• AFFECTIVE POWER• TENSION MANAGEMENT

POWER

DEFINITIONS OF FAMILY POWER:A CHARACTERISTIC OF THE FAMILY SYSTEM ------> IS THEABILITY - POTENTIAL OR

ACTUAL- OF INDIVIDUAL MEMBER TO CHANGE THE BEHAVIOR OF OTHER FAMILY MEMBERS.MAJOR COMPONENTS OF

FAMILY POWER: INFLUENCE/DOMINANCE

AND DECISION MAKING.

VARIABLES AFFECTING FAMILY POWER STRUCTURE

1. FAMILY POWER HIERARCHY 2. TYPE OF FAMILY FORM 3. FORMATION OF COALITION 4. FAMILY COMMUNICATION NETWORK 5. SOCIAL CLASS 6. FAMILY DEVELOPMENTAL STAGE 7. SITUATIONAL CONTIGENCIES 8. ETHNIC AND RELIGIOUS INFLUENCES 9. PERSON VARIABLES10. SPOUSES’ EMOTIONAL INTERDEPENDENCY AND COMMITMENT TO MARRIAGE

THE FAMILY POWER STRUCTURE

POWER OUTCOMES• POWER OR

DECISION-MAKING PROCESSES

• DECISION MAKING BY CONSENSUS

• DECISION MAKING BY ACCOMMODATION

• DE-FACTO DECISION MAKING

THE FAMILY POWER STRUCTUREFAMILY VIOLENCE: POWER CHARACTERISTICSTHEORIES OF FAMILY VIOLENCE• THE INTRAINDIVIDUAL PERSPECTIVE:

THIS PERSPECTIVE FOCUSES ON THE PERSONALITY CHARACTERISTICS OF THE PERPERATOR AND VICTIM AS “CAUSING” FAMILY VIOLENCE.

• THE SOCIOCULTURAL PERSPECTIVE:SOCIOCULTURAL FACTORS, RELATED TO SOCIETAL OR CULTURAL DIFFERENCES IN VIEWING VIOLENCE AS A WAY TO RESOLVE FAMILY PROBLEMS

• THE SOCIAL-PSYCHOLOGICAL PERSPECTIVE:THIS PERSPECTIVE EXPLAINS FAMILY VIOLENCE AS A FUNCTION OF THE INTERFACE BETWEEN THE INDIVIDUAL AND SOCIETY WITH RESPECT TO ISSUES OF POWER, CONTROL, SOCIAL CLASS (POVERTY), EMPLOYMENT OPPORTUNITIES AND TRANSFER OF PROPERTY.

FAMILY ROLE STRUCTURE

ROLE THEORY AND DEFINITIONROLE: THE

HOMOGENEOUS SETS OF BEHAVIORS

THAT ARE NORMATIVELY DEFINED AND EXPECTED OF AN OCCUPANT OF A GIVEN SOCIAL POSITION.

POSITION/STATUS: A PERSON’S LOCATION IN A SOCIAL SYSTEM

ROLE BEHAVIOR, ROLE PER-FORMANCE, ROLE ENACTMENT: WHAT IS A PERSON ACTUALLY DOES WITHIN A POSITION IN RESPONSE TO ROLE EXPECTATION.

ROLE SHARING: PARTICIPATION OF 2 OR MORE PEOPLE IN THE SAME ROLES EVEN THOUGH THEY HOLD DIFFERENT POSITION.

ROLE TAKING: ABLE TO ASSIGN A ROLE TO THE OTHER AND ALSO BETTER UNDERSTAND HOW THEY SHOUD BEHAVE IN THEIR OWN

ROLES

FAMILY ROLE STRUCTURE

ROLE THEORY AND DEFINITIONRECIPROCAL OR COMPLEMENTARYROLES: A ROLE IS INTERDEPENDENTWITH AND PATTERNED TO MESH WITH THAT OF A ROLE PARTNER.

ROLE STRESS/STRAIN: IT OCCURS WHEN A SOCIAL STRUCTURE CREATES VERY DIFFICULT, CONFLICTING ORIMPOSSIBLE DEMANDS FOR OCCUPANTS OF POSITION WITHIN THAT SOCIAL STRUCTURE.

ROLE STRAIN:SUBJECTIVE FEELINGS

OF FRUSTRATION AND TENSION.

ROLE CONFLICT: OCCURS WHEN THE OCCUPANT OF A POSITION PERCEIVES THAT HE OR SHE IS CONFRONTED WITH INCOMPATIBLE EXPECTATION.

FAMILY ROLE STRUCTURE

FORMAL FAMILY ROLES• PROVIDER ROLE• HOUSEKEEPER ROLE• CHILD-CARE ROLE• CHILD-SOCIALIZATION CARE• RECREATIONAL ROLE• KINSHIP ROLE• THERAPEUTIC ROLE• SEXUAL ROLE

INFORMAL FAMILY ROLES• ENCOURAGER• HARMONIZER• INITIATOR-CONTRIBUTOR• COMPROMISER• BLOCKER• DOMINATOR• THE BLAMER• FOLLOWER• RECOGNITION SEEKER• MARTYR• THE GREAT STONE FACE• PAL• THE FAMILY SCAPEGOAT• THE PLACATOR• THE FAMILY CARETAKER• THE FAMILY PIONEER

FAMILY ROLE STRUCTURE

VARIABLES AFFECTING ROLE STRUCTURE• SOCIAL CLASS• FAMILY FORMS• ETHNIC BACKGROUND• FAMILY

DEVELOPMENTAL STAGE

• ROLE MODELS• SITUATIONAL EVENTS

FAMILY ROLES DURING HEALTHAND ILLNESS– ROLE OF MOTHER IN

HEALTH AND ILLNESS

– THE FAMILY CARE-GIVER ROLE

– ROLE CHANGES DURING ILLNESS AND HOSPITALIZATION

FAMILY VALUESAMERICA’S CORE VALUE• PRODUCTIVITY/INDIVIDUAL

ACHIEVEMENT• INDIVIDUALISM• MATERIALISM/THE CONSUMPTION

ETHIC• THE WORK ETHIC• EDUCATION• EQUALITY• PROGRESS AND MASTERY OVER THE

ENVIRONMENT• FUTURE TIME ORIENTATION• EFFICIENCY, ORDERLINESS, AND

PRACTICALITY• RATIONALITY• QUALITY OF LIFE AND MAINTAINING

HEALTH• THE ‘DOING’ ORIENTATION• TOLERANCE OF DIVERSITY

FAMILY VALUES:A SYSTEM OF IDEAS, ATITUDES, AND BELIEFSABOUT THE WORTH OF

AN ENTITY OR CONCEPT

THAT CONSCIOUSLY AND UNCONSCIOUSLY BIND TOGETHER THE

MEMBER OF A FAMILY IN A COMMON CULTURE.

FAMILY VALUES

MAJOR VARIABLES AFFECTING FAMILY VALUES• FAMILY’S

SOCIOECONOMIC STATUS

• FAMILY’S ETHNICITY AND ACCULTURATION

• GEOGRAPHICAL LOCATION (URBAN, SUBURBAN, OR RURAL)

• GENERATIONAL DIFFERENCES

VALUE CONFLICTS• DIVERSE SOCIAL VALUES• CLASH OF VALUES

BETWEEN DOMINANT CULTURE AND SUBCULTURE

• CLASH OF VALUES BETWEEN GENERATIONS

FAMILY FUNCTIONS

5 FAMILY FUNCTIONS:• REPRODUCTIVE

FUNCTION• ECONOMIC

FUNCTION• AFFECTIVE

FUNCTION• SOCIALIZATION

FUNCTION• HEALTH CARE

FUNCTION

THE FAMILY AFFECTIVE FUNCTION• MAINTAINING MUTUAL

NURTURANCE• DEVELOPMENT OF CLOSE

RELATIONSHIP• MUTUAL RESPECT

BALANCE• BONDING AND

IDENTIFICATION• SEPARATENESS AND

CONNECTEDNESS• NEED-RESPONSE

PATTERNS• THE THERAPEUTIC ROLE

THE FAMILY HEALTH CARE FUNCTION

FAMILIES’ HEALTH PRACTICES:• LIFESTYLE PRACTICES• FAMILY DIETARY PRACTICES• FAMILY SLEEP AND REST

PRACTICES• FAMILY EXERCISE AND

RECREATION• FAMILY DRUG HABITS• FAMILY SELF-CARE PRACTICES• ENVIRONMENTAL AND HYGIENE

PRACTICES• MEDICALLY BASED PREVENTIVE

PRACTICES• DENTAL HEALTH CARE

PRACTICES

5 TUGAS KESEHATAN

KELUARGA:1. MENGENAL MASALAH2. MENGAMBIL

KEPUTUSAN3. MELAKUKAN

PERAWATAN DI RUMAH

4. MEMODIFIKASI LINGKUNGAN

5. MENGGUNAKAN FASILITAS PELAYANAN KESEHATAN

THANK YOU

HAPPY LEARNING AND

GOOD LUCK