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Showing posts with label preventive medicine. Show all posts
Showing posts with label preventive medicine. Show all posts

Wednesday, November 11, 2009

Family Life Cycle - Preventive Medicine

Topic Overview

What is a family life cycle?

The emotional and intellectual stages you pass through from childhood to your retirement years as a member of a family are called the family life cycle. In each stage, you face challenges in your family life that cause you to develop or gain new skills. Developing these skills helps you work through the changes that nearly every family (traditional or nontraditional) goes through.
Not everyone passes through these stages smoothly. Situations such as severe illness, financial problems, or the death of a loved one can have an effect on how well you pass through the stages. Fortunately, if you miss skills in one stage, you can learn them in later stages.
The stages of the family life cycle are:
·                     Independence.
·                     Coupling or marriage.
·                     Parenting: Babies through adolescents.
·                     Launching adult children.
·                     Retirement or senior years.

Why is it important to understand the family life cycle?

Mastering the skills and milestones of each stage allows you to successfully move from one stage of development to the next. If you don't master the skills, you may still move on to the next phase of the cycle, but you are more likely to have difficulty with relationships and future transitions. Family life cycle theory suggests that successful transitioning may also help to prevent disease and emotional or stress-related disorders.
Whether you are a parent or child, brother or sister, bonded by blood or love, your experiences through the family life cycle will affect who you are and who you become. The more you understand about the challenges of each stage of the cycle, the more likely you are to successfully move on.

What can disrupt the normal cycle?

The stress of daily living or coping with a chronic medical condition or other crisis disrupts the normal family cycle. A crisis or ongoing stress can delay the transition to the next phase of life, or you may move on but without the necessary skills to succeed.

How can I improve my family life cycle?

Be assured, you can learn missed skills and improve your and your family's quality of life at any stage. Self-examination, education, and perhaps counseling are ways to improve yourself and your family life. These are also actions that can help you manage other issues such as going through a divorce or being a part of a nontraditional family structure.
Independence Stage
Independence is the most critical stage of the family life cycle. As you enter young adulthood, you begin to separate emotionally from your family. During this stage, you strive to become fully able to support yourself emotionally, physically, socially, and financially. You begin to develop unique qualities and characteristics that define your individual identity.
Intimacy is a vital skill to develop during your independent, young adult years. Intimacy is the ability to develop and maintain close relationships that can endure hard times and other challenges. In an intimate relationship, you learn about:
·                     Commitment.
·                     Commonality or similarity.
·                     Compatibility.
·                     Attachment.
·                     Dependence on another person who is not in your family.
·                     Shared emotion in a relationship.
You also learn who you are outside of your identity within your family. Your ability to develop an intimate relationship depends on how successful you were at developing your individual identity earlier in life.
Exploring interests and career goals is part of developing independence. To live successfully away from your family, you must develop financial and emotional independence.
You also begin to be responsible for your own health in this stage, becoming responsible for your nutritional, physical, and medical needs. Developing healthy habits at this time—such as good nutrition, regular exercise, and safe sex practices—is important for lifelong good health and happiness.
You learn new aspects of independence throughout your lifetime. Even when you have moved on to another stage of life, such as coupling, you continue to learn independence within the context of that stage.
During the independence stage, you hope to:
·                     Learn to see yourself as a separate person in relation to your original family—parents, siblings, and extended family members.
·                     Develop intimate peer relationships outside the family.
·                     Establish yourself in your work or career.
Other important qualities you develop during this phase include:
·                     Trust.
·                     Morals.
·                     Initiative.
·                     Guilt.
·                     Work ethic.
·                     Identity, or who you are in the world.
Coupling Stage
After you achieve independence, the next stage in the family life cycle is coupling. You explore your ability to commit to a new family and a new way of life. While being in a committed relationship with someone without the act of marriage does involve a process of adaptation and relationship building, marriage often requires unique skills.
When you join families through marriage, you form a new family system. Your family blueprint—your personal ideas, expectations, and values, shaped by the relationships and experiences with your original family—combines with your spouse's to form a new family blueprint. This requires reshaping your and your spouse's goals. In the most functional marriages, partners combine their beliefs and behaviors in a synergistic way. Synergy in the family life cycle is the ability to take two different points of view and create an option that neither person had considered. It differs from a compromise in that it is not giving up something; rather, it is using the energy from the two people to create a third, better option.
You may find that some of the ideas or expectations that you held in the past are not realistic at this stage. Some common areas of adjustment include:
·                     Finances.
·                     Lifestyle.
·                     Recreational activities or hobbies.
·                     Relationships with in-laws.
·                     Sexuality or sexual compatibility.
·                     Friendships.
·                     Putting another person's needs before your own.
The ultimate goal at this stage is to achieve interdependence, which occurs when you are able to fully enter into a relationship with another person. Interdependence also requires that you share goals and that you are able to occasionally place the needs of another above your own. However, before you can achieve interdependence, you must have first acquired a high degree of independence.
The relationship skills you learn in coupling serve as a foundation for other relationships, such as parent-child, teacher-student, or physician-patient.
Within a couple, you learn:
·                     Advanced interpersonal communication.
·                     Problem-solving skills.
·                     Common spiritual and emotional development goals.
·                     How to form boundaries in relationships.
·                     When to place the needs or importance of the other person above your own.
Most research indicates that early on, a happy marriage is full of passion and sexual intimacy, which can become less important in later successful marriage. A satisfying marriage at this stage includes a high amount of considerate or kind acts (such as doing something nice for the other person without being asked) and praise.
The life skills you learn in this stage are important in developing true interdependence and the ability to have a cooperative and healthy relationship. Some of the challenges of this stage include:
·                     Transitioning into the new family system.
·                     Including your spouse in your relationships with friends and family members.
·                     Being committed to making your marriage work.
·                     Putting the needs of another ahead of your own.
You and your spouse will have less stress if the transition into a new family system is smooth, and less stress often means better health.
Your specific goals for this stage of the family life cycle are:
·                     Forming a new family with your spouse.
·                     Realigning your relationships with your family of origin and your friends to now include your spouse.
Parenting: Babies Through Adolescents

Making the decision to have a baby

At some point in your marriage, you and your spouse will face the "baby decision," although some couples know going into a marriage that they do not want children. Parenting is one of the most challenging phases of the family life cycle.
The decision to have children is one that affects your individual development, the identity of your family, and your marital relationship. Children are so time-consuming that skills not learned in previous stages will be difficult to pick up at this stage. Your ability to communicate well, maintain your relationships, and solve problems are often tested during this stage.
Introducing a child into your family results in a major change in roles for you and your spouse. Each parent has three distinct and demanding roles: as an individual, a spouse, and a parent. As new parents, your individual identities shift along with how you relate to each other and to others. If you have not learned compromise and commitment in the previous stage, you may not possess the skills you need to transition well into this stage.
Along with the joy that comes from having a child, you may feel a great deal of stress and fear about these changes. A woman might have concerns about being pregnant and going through childbirth. Fathers tend to keep their fears and stress to themselves, which can cause health problems.
Discussing your emotional or physical concerns with your family physician, obstetrician, or counselor can help you deal with these and future challenges.

Parenting young children

Adapting children into other relationships, including your marriage, is a key emotional process of this stage. You will take on the parenting role and transition from being a member of a couple to being a parent. While you are still evolving as individuals, you and your spouse are also becoming decision makers for your family. Continuing to express your individuality while working well together as a couple results in a strong marriage.
Your child's healthy development depends on your ability to provide a safe, loving, and organized environment. Children benefit when their parents have a strong marriage.
Caring for young children cuts into the amount of time you might otherwise spend alone or with your spouse. If there were skills you didn't learn in previous phases, such as compromise for the good of the family, your marriage may suffer. Divorce and extramarital affairs often occur during the raising of small children when the parents have not learned proper life skills.
However, for those who have the proper tools, this can be a very rewarding, happy time, even with all of its challenges. Optimally, you develop as an individual and as a member of a couple and a family.
Specific goals when young children join your family are:
·                     Adjusting your marital system to make space for children.
·                     Taking on parenting roles.
·                     Realigning your relationships with your extended family to include parenting and grandparenting roles.

Parenting adolescents

Parenting teenagers can be a rough time for your family and can test your relationship skills. It's also a time for positive growth and creative exploration for your entire family. Families that function best during this period have strong, flexible marriages developed through good communication, problem solving, mutual caring, support, and trust.
Most teens experiment with different thoughts, beliefs, and styles, which can cause family conflict. Your strengths as an individual and as part of a couple are critical as you deal with the increasing challenges of rearing a teenager. Strive for a balanced atmosphere in which your teenager has a sense of support and emotional safety as well as opportunities to try new behaviors. An important skill at this stage is flexibility as you encourage your child to become independent and creative. Establish boundaries for your teenager while at the same time encouraging exploration.
If you properly developed your individual identity in earlier stages of your life, you will be much more secure about the changes your child is going through. However, if you did not fully develop the needed skills at earlier stages of life, you may feel very threatened by your child's new developments.
Flexibility in the roles each person plays in the family system is a valuable skill to develop at this stage. Responsibilities such as the demands of a job or caring for someone who is ill may require each person in the family to take on various, and sometimes changing, roles.
This is a time when one or more family members may feel some level of depression or other distress. It may also lead to physical complaints that have no physical cause (somatization disorders such as stomach upsets and some headaches) along with other stress-related disorders.
Nurturing your marriage and your individual growth can sometimes be ignored at this stage. Toward the end of this phase, a parent's focus shifts from the maturing teen to career and marriage. Neglecting your personal development and your marriage can make this shift difficult.
You also may begin thinking about your role in caring for aging parents. Making your own health a priority in this phase is helpful as you enter the next stage of the family life cycle.
Specific goals during the stage of parenting adolescents include:
·                     Shifting parent-child relationships to allow the child to move in and out of the family system.
·                     Shifting focus back to your midlife marital and career issues.
·                     Beginning a shift toward concern for older generations in your extended family.
Empty Nest: Launching Adult Children
The stage of launching adult children begins when your first child leaves home and ends with the "empty nest." When older children leave home, there are both positive and negative consequences. If your family has developed significant skills through the family life cycle, your children will be ready to leave home, ready to handle life's challenges. Free from the everyday demands of parenting, you may choose to rekindle your own marriage and possibly your career goals.
Developing adult relationships with your children is a key skill in this stage. You may be challenged to accept new members into your family through your children's marriages or relationships. You may focus on reprioritizing your life, forgiving those who have wronged you (maybe long ago), and assessing your beliefs about life.
If you have not moved through the phases with the appropriate tools and attitudes, you may not have taught your children needed skills to live well on their own. If you and your spouse have not transitioned together, you may no longer feel compatible with each other. Remember, however, that you can still obtain missed skills. Self-examination, education, and counseling can enhance your life and help ensure a healthy transition to the next phase.
This is a time when your health and energy levels may decline. Some people are diagnosed with chronic illnesses. Symptoms of these diseases can limit normal activities and even long-enjoyed pastimes. Health issues related to midlife may begin to occur and can include:
·                     High blood pressure (hypertension).
·                     Weight problems.
·                     Arthritis.
·                     Menopause.
·                     Osteoporosis.
·                     Heart disease (coronary artery disease).
·                     Depression.
·                     Stress-related illnesses.
You may also be caring for aging parents in this phase, which can be stressful and affect your own health.
Specific goals to attain at this stage include:
·                     Refocusing on your marriage without children.
·                     Developing adult relationships with your grown children.
·                     Realigning relationships to include in-laws and grandchildren when your children have begun their own families.
Retirement or Senior Stage of Life
During the retirement phase of the family life cycle, many changes occur in your life. Welcoming new family members or seeing others leave your family is often a large part of this stage as your children marry or divorce or you become a grandparent.
This stage can be a great adventure where you are free from the responsibilities of raising your children and can simply enjoy the fruits of your life's work. Challenges you may face include being a support to other family members, even as you are still exploring your own interests and activities or focusing on maintaining your marriage. Many people are caring for elderly parents at this time. You may feel challenged by their emotional, financial, and physical needs while trying to help them retain their independence.
You may experience declining physical and mental abilities or changes in your financial or social status. Sometimes, you must deal with the death of other family members, including your spouse. The quality of your life at this stage depends on how well you adjusted to the changes in earlier stages. It often also depends on how well you have cared for your own health up to this point. Normal aging will affect your body, resulting in loss of bone density, wrinkles, aches, and pains. The chances of having a mental or chronic physical illness does increase with age; however, aging does not mean you will automatically experience poor health.
Retirement can be a fulfilling and happy time. Becoming a grandparent can bring you great joy without the responsibility of raising a child. Those who are without adequate support systems or not well off financially, however, may have a more difficult time in this phase of life.
Specific goals to attain at this final stage of your family life cycle include:
·                     Maintaining your own interests and physical functioning, along with those of your spouse, as your body ages.
·                     Exploring new family and social roles.
·                     Providing emotional support for your adult children and extended family members.
·                     Making room in the family system for the wisdom and experience of older adults.
·                     Providing support for the older generation without overfunctioning for them.
·                     Dealing with the loss of a spouse, siblings, and other peers, and preparing for your own death.
·                     Reviewing your life and reflecting on all you have learned and experienced during your life cycle.

Concept of Family - Preventive Medicine




The Concept of Family
Definition of Family
•          The concept of family or the role of the family remains to be defined by universal agreement.
•          Various disciplines have developed their own definition of family. Each is based on that field.
•          Sociological viewpoint – enduring social form in which a person is incorporated
•          Biologic viewpoint – genetic transmission unit
•          Psychologic viewpoint – matrix of personality development and the most intimate emotional unit of society
A few examples of the differing definitions of family illustrate the many perspective form which people view the family.
United Nations:
•          A group of people related by blood, marriages or adoption, which live together in one household.
Parsons and Bales:
•          That social unity whose primary tasks are socialization of children and the stabilization of adult personalities
Ramsey and Lewis:
•                          A small social system made up of individuals related to each other, biologically or by reason of strong affections and loyalty, that comprises a permanent household (or cluster of households) and persists over decades. Members enter through birth, marriage or adoption and leave by death; roles of members change over time and through the history of the group.
•                          Common to all definitions of family are that families comprise more than one person, with at least one adult, and that these persons are related to one another by blood or social contract.
Characteristics of Family
•          The family is a basic unit found in some form in all societies. It is special kind of small group which has unique characteristics different from other social system.
•          The family has inherent strength because of inherited and developmental commonalities, affectional ties, and social expectations that it should operate in certain ways.
•          1. Family membership implies a lifelong involvement.
•          Membership in the family unit is virtually permanent. Members are not expelled because of decrease ability to function or because of change in priorities of the family as an organization. One can never totally deny one’s parent, siblings or children.
•          2. Family relationships are primarily affectional in   nature.
•          Families place a higher value on caring, loving and affection than other social groups. The emotional structure of the family tends to be very strong, and family membership constitutes a fundamental part of each individual’s identity.
•          3. Family endures through time.
•          Families are primary groups which endure over relatively long period of time. It is each member’s shared identification of himself as part of a family which binds that unit together rather than any specific tie such as blood, marriage or residence.  
•          Despite built in problems and conflicts in the family, there are bonds of affection, a sense of responsibility, and sense of belonging that continuously draw the family together.
•          4. Family members have shared attributes
•          Some physical and psychological attributes are genetically influenced, so family members often have similar attributes. Living in the same home, sharing social activities, having similar schooling, and experiencing the same successes and failures give family members a common background in which they can comfortably develop.
Basic Areas of Family Function
1.       Biologic
a.       Child rearing/caring
b.      Nutrition
c.       Health maintenance
d.      Recreation
e.      Reproduction
  1. Economic
    1. Provision of adequate financial resources
    2. Resource allocation
    3. Ensure financial security of members
  2. Educational
    1. Teach, skills, attitudes relating to other function
4.       Psychologic/Affection
a.       Promote the natural development of personalities
b.      Offer optimum psychological protection
c.       Promotes ability to form relationship with people in the family circle
5.       Socio-cultural
a.       Socialization of children promotion of status and legitimacy
Types of Families
1.       Nuclear Family
Persons and Bales, 1955:
•          The members of the nuclear family, consisting of parents and their still dependent children, ordinarily occupying a separate dwelling not shared with members of the family of origin/orientation of their spouse.
•          The household is in the typical case economically independent, subsiding in the first instance from the occupational earnings of the husband/father.
2.       Nuclear Family Dyad
Childless husband and wife or to “empty nesters” whose children have grown and left home.
3.       Extended Family
Three generations or more living in a household either unilaterally or bilaterally extended.
4.       Kin Network Family
Nuclear households or unmarried members living in close geographical proximity and operating within a reciprocal system of exchange of goods and services.
5.       Single Parent Family
This is consist of only one parent with one or more children, an arrangement resulting from divorce, separation, abandonment, death, adoption, never-married parent, or one parent is working away from the family (OFW’s)
6.       Blended Family
Remarried men and women, living in common household with children from previous marriages. The new family also may produce offspring of its own. The media commonly refers to this form of family as “yours, mine, and ours”
7.       Communal/Corporate Family
Groupings of individuals which are formed for specific ideological societal purposes. Considered as an alternative lifestyle for people who feel alienated from the predominantly economically oriented society.
Types of Communal Family:
a. Monogamous – household of more than one monogamous couple with children, sharing common facilities, resources, and appliances; socialization of the child is a group activity
b. Group marriage – household of adults and offspring known as one family, where all individuals are married to each other and all are parents to the children; usually develops a status system with leaders believed to have charisma
c. Highly formalized structures
                Ex: Amish Community in Lancaster County Pennsylvania
d. Loosely knit groups
                Ex: Sta. Cruz mountains near Boulder Creek in California
8.       Institutional Family
Children in orphanages, residential schools, or correctional institutions
Family Social Class Patterns
Upper Class
•          much more closely knit, greater concern for maintaining family name and prestige
Middle Class
•          believes in hard work, initiative, independence, responsibility economic security and self-improvement through education
Lower Class
•          sees life as a continuous struggle for survival, resigned to a life of frustration and defect
Characteristics of Filipino Family
1.       closely knit
2.       bilaterally extended
3.       strong family orientation
4.       authority is based on seniority/age
5.       externally patriarchal, internally matriarchal
6.       high value on education of children
7.       predominantly Catholic (80% of population)
8.       child-centered
9.       average number is 5 (NEDA statistics)
10.   environmental stresses: economic, political industrialization/urbanization, health problems