INDIVIDUAL FAMILY COMMUNITY HEALTH HEALING GROUP Individual Family

INDIVIDUAL, FAMILY, & COMMUNITY HEALTH HEALING GROUP ﺍﻟﻔﻜﺮﻩ ﺍﻟﺘﻲ ﺗﺤﻴﺎ ﻋﻠﻰ ﻧﺒﺾ ﻗﻠﻮﺑﻜﻢ

Individual, Family & Community Health Objectives Describe the roles and functions of the family within the Jordanian context. Explain the importance of familism in the context of Jordanian culture as opposed to the western concept of individualism. Explain the meaning of holism to nursing practice within the context of Jordan. Understanding the meaning of homeostasis concept Explain human needs

Individual, Family & Community Health Required Readings Kozier & Erb's Fundamentals of Nursing: Concepts, Process and Practice(2012) (9 th ed. ) Chapter Number 7; Community Nursing & Care Continuity (pages 119 -123) Chapter Number 16; Health Promotion (pages 276 -297) Chapter Number 24; Promoting Family Health(pages 435445)

Individual, Family & Community Health Nurses assess and plan health care for three types of clients: The individual family community The individual’s beliefs and values influence health practices, and the support that usually comes from the family and reinforced by the community also affect the individual’s health practices

Individual Health Concept ﻣﻔﻬﻮﻡ of individuality Concept of Holism ﺍﻟﺸﻤﻮﻟﻴﺔ Concept of Homeostasis ﺍﻟﺘﻮﺍﺯﻥ

Individual Health Dimensions ﺃﺒﻌﺎﺩ of Individuality Person’s total character: behaviors, attitudes, emotional state, abilities, appearance Perceptions ( )ﺍﻹﺩﺭﺍﻙ : ways the person interprets the environment/a situation which affects how he feels and acts to the situation Self-identity ; ﺍﻟﻬﻮﻳﺔ ﺍﻟﺬﺍﺗﻴﺔ perception of self as a separate & distinct entity alone and in interactions with others

Concept of Individuality Each individual is a unique ﻻ ﻧﻈﻴﺮ ﻟﻪ being (genetics, experience and environmental interactions). Nurses should focus on total and individualized care when providing nursing care to any client: Total care involves the general principles that apply to a client in term of age and medical condition. Individualized care involves applying the general principles taking into consideration information particular for a client as an individual

Concept of Individuality An example explains total and individual care: Example: school-age child with epilepsy ﺩﺍﺀ ﺍﻟﺼﺮﻉ who wants to engage in the school swimming team; participating in physical activities is a developmental stage that all school-age children would like to experience however, because the child has epilepsy swimming would not be appropriate for him because of the risk for accidents and injury other physical activity may be better such as soccer team

Holism An individual is NOT assembly of parts and processes Holism views a person as a whole/complete with all areas relate to each others Holism considers the relationship between the individual and external environment and others Nursing care is directed toward restoring ﺍﺳﺘﻌﺎﺩﺓ overall harmony ﺍﻻﻧﺴﺠﺎﻡ

Holism Example: When providing family-centered nursing care for a mother who has a child with Thalassemia ﺍﻟﺜﻼﺳﻴﻤﻴﺎ , a nurse should consider how the illness affects the family relationships, mother’s energy level, rest & sleep, usual activities, mood sense of well-being and financial status ﺍﻟﻮﺿﻊ ﺍﻟﻤﺎﻟﻲ

Homeostasis Homeostasis: balance: equilibrium ﺗﻮﺍﺯﻥ Homeostasis does not apply immobility of the system Human being , as separate from the external environment, is constantly endeavoring ﺗﺴﻌﻰ to maintain physiological equilibrium or balance through adaptation ﺗﻜﻴﻒ to the environment (Cannon, 1939) Types of homeostasis: physiological and psychological

Homeostasis: system A System is composed of Matter (body) Energy (chemical or thermal) Communication (nervous system) Types of systems are: Closed system: does not exchange energy, matter or information with its environment, receives no inputs from outside and gives no output to the environment Open system: matter, energy and information move into and out of the system

Homeostasis: Open system

Homeostasis: system Open system: All living systems are open such as human beings Input consists of matter, energy or information enters the system Throughput processing/absorbing the input Output consists of energy, matter or information is given out by the system Feedback some of the output is returned to the system as input. Feedback enables the system to regulate itself

Homeostasis: system Open system:

Physiological Homeostasis Refers to a relative stability of the body’s internal environment Homeostasis mechanisms are: Self-regulating: automatic response to changing in a healthy person Compensatory (counterbalancing ) ﻣﻮﺍﺯﻧﺔ : the body’s response to abnormal situation such as cold to maintain normal body temperature despite the exposure to cold Negative feedback systems : most biologic systems are controlled by negative feedback ( example: parathyroid hormone (PH) and blood Calcium level (Ca). When Ca drops PH increases and when PH increases the Ca increases, high Ca level inhibits PH production Several feedback mechanisms

Psychological Homeostasis Refers to emotional balance or mental well-being Needs such as love, security ﺃﻤﻦ and self-esteem must be met to maintain psychological homeostasis When one of the psychological needs is threaten ﺗﻬﺪﺩ or not met a certain coping mechanism is activated to provide homeostasis Coping mechanism is acquired through experience of living and interacting with others

Psychological Homeostasis In order for a person to maintain psychological homeostasis or stability a person should have: Stable physical environment (basic needs must be met, feed, feels safe & secure) Stable psychological environment ( feelings of love and trust) Healthy role models (adults) so children can learn from the values and customs of the society A life experience; satisfying experience to counterbalance the frustrating ﻣﺤﺒﻂ ones

Assessing the Health of Individuals Health history & Physical examination Physical fitness assessment Lifestyle Health risk appraisal ﺗﻘﻴﻴﻢ Health beliefs system Life-stress ﺗﻮﺗﺮ review

Theoretical Framework: health promotion of individual and families The two major theoretical frameworks are: Needs theories Rank ﻣﺮﺗﺒﺔ human needs according to its importance for a person’s survival Developmental Categorize stage theories a person’s behaviors or tasks into age ranges groups describe characteristics associated with the majority of individuals at a certain developmental stage (e. g. infancy period)

Theoretical Framework: Needs theories Maslow’s Hierarchy of Needs Kalish’s Hierarchy of Needs Characteristics of Basic Needs

Theoretical Framework: Maslow’s Hierarchy of Needs Human needs are ranked on an ascending ﺗﺼﺎﻋﺪﻱ scale according to essentiality ﺍﻹﺳﺘﺨﺪﺍﻣﺎﺕ ﺍﻷﺴﺎﺳﻴﺔ of the needs for survival ﺑﻘﺎﺀ There are five levels of human needs

Theoretical Framework: Maslow’s Hierarchy of Needs

Theoretical Framework: Maslow’s Hierarchy of Needs Self-esteem needs : feelings of independence, competence, self-respect, recognition ﺗﻘﺪﻳﺮ , respect, appreciation). Self-actualization ﺗﺤﻘﻴﻖ ﺍﻟﺬﺍﺕ Sees life clearly and realistically & Accepts the world for what it is Open to new ideas Has superior perception Understand art, music, politics and philosophy Highly creative, flexible and courageous Dedicated to some work Self-confident and self respected Highly independent Friendly and loving

Theoretical Framework: Kalish’s Hierarchy of Needs: Adapted Maslow’s hierarchy of needs and added another level Kalish’s hierarchy consists of six levels of needs The sixth level refers to stimulation ﺗﺤﻔﺰ needs which comes between the physiologic and safety needs. Stimulation needs include activity, exploration ﺍﺳﺘﻜﺸﺎﻑ , manipulation ﻣﻌﺎﻟﺠﺔ and novelty ﺣﺪﺍﺛﺔ to achieve optimal growth and development (for children)

Theoretical Framework: Kalish’s Hierarchy of Needs Selfactualization Self-Esteem Love & Belonging Safety & Security Stimulation: sex, activity, exploration, manipulation, novelty Physiologic

Theoretical Framework: Characteristics of Basic Needs all people have the same basic needs Meeting those needs is influenced by a person own culture (e. g. privacy is important in some cultures others is unimportant) People meet their needs relative to their own priorities ﺃﻮﻟﻮﻳﺎﺕ in some condition basic needs can be deferred ( ﻣﺆﺠﻠﺔ e. g. need of independence) Failure to meet needs leads to illness

Family Health Family is the basic unit of the society Family consists of a group of people who are considered to be significant to each other Family consists of persons (structure) and their responsibilities within the family (roles) Family-centered nursing refers to; The interest in the health of the family as a unit Considered the impact of the family on the health , values and productivity of individual family members

Family Health: Functions of the Family Providing adequate nutrition and health care services for physical growth and health Creating an atmosphere that influences cognitive and psychosocial growth of its members Family’s unique values and beliefs affect family members health care practices

Family Health: Types of Families Traditional family nuclear family: parents and their offspring. The mother assumes nurturing role and the father provides the money Extended family: relatives of nuclear family aunts, grandparents, uncles Two-career family Both parents work outside to provide money Finding an affordable ﺑﺄﺴﻌﺎﺭ ﻣﻌﻘﻮﻟﺔ child car is a great stress to the family

Family Health: Types of Single-parent family Stresses of a single-parent family are financial concerns, work overload ﺍﻟﻌﻤﻞ ﺍﻟﺰﺍﺋﺪ and fatigue ﺗﻌﺐ and social isolation Adolescent family Families These parents are emotionally, physically and financially are ill prepared to take the responsibilities of parenthood Foster family: legally ﻣﻦ ﺍﻟﻨﺎﺣﻴﺔ ﺍﻟﻘﺎﻧﻮﻧﻴﺔ separate children from their birth parents and place them with a family Blended/step family: family units who join together

Family Health: Types of Families Intra-generational family: similar to extended family Cohabiting family : unrelated individuals or families who live under one roof Single adults living alone: adults who live alone

Theoretical Framework: Assess Family Health Theoretical frameworks provide a context or structure to view health and health promotion for families There are two theory: Systems theory Structural-functional theory

Theoretical Framework: System theory Family system members are interdependent , working toward specific purpose and goals A family is an open system Family is continually interacting with and influenced by other systems in the community Boundaries ﺍﻟﺤﺪﻭﺩ of the family regulate input from other systems and output from the family system to the community or society

Theoretical Framework: System theory Example of using systems theory for health promotion of a family with child who is injured from home accident More attention to injured child may make other feel left out A parent feels guilt of not preventing the accident Asking a family member for financial support

Theoretical Framework: Structural. Functional Theory focuses on: Structure of the family including the membership of the family and the relationships among family members Mother-daughter Brother-sister Spouse-partner Functional aspect of the family by examining the effects of family members (intra-family) relationships on the family and other systems. Family members function in harmony, working toward shared goals, such as provided care and services to members

Theoretical Framework: Structural. Functional Theory Example : injured child in the family Nurse considered the structure of the family: parents, another child in the family and extended family Understanding Who family functions is the decision maker Do family members communicate Family functions: Economic and emotional stability of the family members

Family Assessment It gives an overview of the family process and helps the nurse identify strengths and resources, weaknesses of the family Describes health status of the family and its individual members Assessment begins with a complete health history. This provides information about existing or potential health problems Genogram enables a nurse to visualize how family members are genetically related and assess pattern of chronic diseases Ecomap for each family member or a family as a unit provides information about the family/individual interactions with external community environment such as school, work. Interactions such as health beliefs and lifestyle behaviors

Family Assessment: Genogram

Family Assessment: Ecomap

Family Assessment: Ecomap

Family Assessment Health beliefs Family communication patterns Family coping mechanisms Family violence Risk for health problems Hereditary or genetic factors Sex Ethnicity Sociologic factors Lifestyle practices

Roles & Functions of the family in Jordan

Community Health A community is a collection of people who share some attribute of their lives and interact with each other in some way Also a community can also be defined as a social system in which the members interact ﺗﻔﺎﻋﻞ formally or informally and form networks that operate for the benefit of all people in the community Community health nursing focuses on promoting and preserving the health of population groups

Functions of a Community Production, distribution and consumption of goods & services Socialization ; transmitting values, knowledge, culture and skills to others Social control: way order is maintained in a community Social inter-participation: social activities to meet people’s need of companionship Mutual support: ability to provide resource at a time of illness and disaster

Aspects of a Community Subsystem Assessment Physical environment Education Safety and transportation Politics & government Health & social services Communication Economics Recreation ﺍﺳﺘﺠﻤﺎﻡ