JONATHAN C.

PACUNAYEN, RMT, MD
Department of Family and Community Medicine

IMPACT OF ILLNESS b. Have healthy communication

lines
Illness: encompasses the person’s perceptions, c. Provide good emotional
emotions, and experiences of the disease, as support
well as the suffering and changes the patient B. Barriers:
and the family have to undergo in the presence a. Dysfunctional families with
of that disease. poor lines of communication
b. Poor emotional connectivity
Factors influencing How Families Cope with
Illness: Typology of Illness:
A. Intrafamilial factors: A. Enablers:
a. Family resources a. Acute
b. Family life cycle stages b. Self-limiting
c. Degree of family functionality c. Non-fatal disease with no
B. External factors: incapacitation
a. Typology of illness B. Barriers:
b. Stigma associated with the a. Acute and life-threatening
disease b. Chronic and debilitating
c. Rapidly progressive and
Family Resources: terminal illness
A. Enablers:
a. Adequate financial resources Stigma associated with the Disease:
b. Good social support system A. Enablers:
c. Strong spirituality a. Diseases that do not carry social
d. Ability to tap community stigma
resources B. Barriers:
B. Barriers a. Highly communicable diseases
a. Limited financial resources that carry with it a social stigma
b. Lack of a social support group isolating patients and families
c. Lack of access to community
resources Family Illness Trajectory:
A. Onset of symptoms/illness
Family Life Cycle Stage: a. This stage covers the period
A. Enablers: from the time the patient
a. Stages wherein family members demonstrates physical
are concentrating within the symptoms or feels that there is
family something wrong to the period
B. Barriers: consultation is sought
a. Stages that are supposed to b. Health beliefs and previous
launch members outside the experiences help shape what
system patients and their families do at
this stage and how soon they
Degree of family functionality seek consult
A. Enablers: B. Impact phase – reaction to diagnosis
a. Functional families that are a. This is where the initial contact
flexible in adapting to changing with the physician is usually
roles established

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JONATHAN C. PACUNAYEN, RMT, MD
Department of Family and Community Medicine

b. Important for the physician to

explore first what the patient A complete genogram should include:
his/her family already know and A. The names and ages of all family
ask what they still want to know members
C. Major therapeutic efforts B. The exact dates of birth, marriage,
a. The period of great mobilization separation, divorce, death (including
when the family pursues cause), and other significant life events
avenues for treatment or C. Information covering three or more
palliation generations
b. Physician’s task is to offer the D. Illnesses (including hereditary and
family’s options that are significant problems or illnesses)
effective at a cost they can E. The firstborn of each family to the left
afford and are acceptable to the with other siblings sequentially to the
patient and the family belief’s right
system F. Indication of which members live
D. Recovery phase – adjustment to together in the same household
outcome G. The names of two families with the
a. Usually marked by the address of the index family
disappearance of symptoms for H. The informant/s
acute, self-limiting illness or I. The date the genogram was generated
returning to the home
environment and some degree Family Map:
of functionality for chronic A. Tool designed to reflect family
illness relationships and interaction patterns
b. Depends on the factors B. Very important for the physician in
previously stated, as well as on obtaining a therapeutic ally for the
the anticipated outcomes of the delivery of care in the family
disease process C. Provides a schematic description on
whom to ask for assistance in making
***In what stage of the illness trajectory does decisions for the patient
previous knowledge, prior experiences, and D. Possible source of a somatic complaint
own medical beliefs play a great role? may also be identified based on the
A. Onset of illness to Diagnosis mapping of family relationships
B. Impact/Reaction phase
C. Major Therapeutic Efforts
D. Early Adjustment to Outcome
E. Adjustment to permanency of outcome

Family Genogram:
A. can be used to gather data about an
individual, couple, or family, especially
on inheritance patterns, family illnesses,
family members, family structures, and
emotional processes over time
B. A useful strategy in encouraging family
members who may have been reluctant
to get involved in discussions on family Family APGAR:
matters to participate.

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JONATHAN C. PACUNAYEN, RMT, MD
Department of Family and Community Medicine

A. Tool that qualitatively measures family dependent on his wife and children for all his
functioning activities of daily living. The commitment of
B. Elicits the patient’s perception and level Rodrigo’s family members to devote time to
of satisfaction on the current state of support each other’s physical and emotional
her family members’ relationships growth in this period of medical crisis
represents which aspect of the family APGAR?
Adaptation: It is the family’s utilization of the A. Adaptation
resources available within and outside of the B. Partnership
family system when significant life events pose C. Growth
a crisis D. Affection
E. Resolve
Partnership: It is the sharing of the family
members in decision-making and During one family meeting, Inday mentioned
responsibilities that she wanted to go abroad to work there,
establish a career, and probably start her own
Growth: It is the physical and emotional growth family. However, her father vehemently
attained by each family member from the disapproves of her decision and is ordering her
family’s ability to support and guide to stay and run the family business instead. This
has been a stressor and a cause of depression
Affection: It is the loving and caring relationship for Inday. In which part of the Family APGAR do
of the family you think she will score the lowest?
A. Adaptation
Resolve: it is the commitment of family B. Partnership
members to devote time to support each C. Growth
other’s physical and emotional growth. It also D. Affection
pertains to the sharing of wealth and space E. Resolve

According to related literatures, Family APGAR

is valuable in the following
conditions/situations:
A. Symptoms that manifest themselves as
psychosomatic disorder, such as
frequent headaches, anxiety,
depression, insomnia, fatigue, and
increased pediatric complaints
B. Difficult patients
C. Marital or sexual difficulties
D. Multiple presentations by multiple
family members
E. Drug or alcohol abuse
F. Evidence of sexual and physical abuse
on the wife or child
G. Multiple presentations of a family
member – “the thick file syndrome”

***Rodrigo is a 53-year old known

hypertensive, who recently suffered a major
cerebrovascular accident, making him

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