INDIVIDUAL, FAMILY, & COMMUNITY
HEALTH
HEALING GROUP
‫الفكره التي تحيا على نبض ق لوبكم‬
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) (9th 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
 The family
 The 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 ‫ مفهوم‬of individuality

Concept of Holism ‫الشمولية‬

Concept of Homeostasis ‫التوازن‬
Individual Health
Dimensions ‫ أبعاد‬of Individuality
Person’s total
character:
behaviors, attitudes,
emotional state,
abilities, appearance
Perceptions
(‫)اإلدراك‬: 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 ‫ ال نظير له‬being (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 ‫االنسجام‬
Holism

Example:

When providing family-centered nursing care for a
mother who has a child with Thalassemia ‫الثالسيميا‬, 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 ‫ تسعى‬to
maintain physiological equilibrium or balance
through adaptation ‫ تكيف‬to 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 ‫ أمن‬and self-esteem must be met
to maintain psychological homeostasis
When one of the psychological needs is threaten ‫ تهدد‬or 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
them the values and customs of the society
 A life experience; satisfying experience to counterbalance
the frustrating ‫ محبط‬ones

Assessing the Health of Individuals






Health history & Physical examination
Physical fitness assessment
Lifestyle
Health risk appraisal ‫تقييم‬
Health beliefs system
Life-stress ‫ توتر‬review
Theoretical Framework: health
promotion of individual and families

The two major theoretical frameworks are:
 Needs
theories
 Rank ‫ مرتبة‬human 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

Maslow’s Hierarchy of Needs

Human needs are ranked on an ascending ‫تصاعدي‬
scale according to essentiality ‫ اإلستخدامات األساسية‬of 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

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 ‫ تحفز‬needs which
comes between the physiologic and safety needs.

Stimulation needs include activity, exploration ‫استكشاف‬,
manipulation ‫ معالجة‬and novelty ‫ حداثة‬to 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

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 ‫( مؤجلة‬e.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 معقولة‬child car is a great
stress to the family
Family Health: Types of Families

Single-parent family


Adolescent family



Stresses of a single-parent family are financial concerns,
work overload ‫ العمل الزائد‬and fatigue ‫ تعب‬and social
isolation
These parents are emotionally, physically and financially
are ill prepared to take the responsibilities of parenthood
Foster family: legally ‫من الناحية القانونية‬separate 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 ‫ الحدود‬of 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: StructuralFunctional Theory

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: StructuralFunctional 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 ‫ تفاعل‬formally 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

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