Chapter 3.

Childbearing and
Childrearing Family in
Community
IDENTIFY HEALTHY PEOPLE GOALS 2030
Goals for a nurses: Healthy People 2030
1. Increase the rate of adult smokers to stop smoking
2. Increase the proportion of young children who are screened for an ASD and other
developmental delay by 35 months of age
3. Increase the proportion of children with special care needs who have a system of
care from a present level
4. Increase the rate of infants who are exclusively breastfed until 6 months
5. Reduce physical violence by intimate partners

DESCRIVE WHAT CONSTITUTES A HEALTHY COMMUNITY

Maternal - Child Nursing Care and the Community

Nursing in a community aims to make the community feel safer, strengthening them
in the process.

Nursing issues related to the community are the following:

families feela unsafe in walking to the streets at night with broken streetlights

multiple vehicle accidents due to a malfunctioning traffic light

need to let people know that a duck pond is over 3 ft deep

Any problem in the community is a huge impact for nursing care, whether big or
small.
Examples of nursing activities are.

participating in a fundraising charity events such as a walkathron

Chapter 3. Childbearing and Childrearing Family in Community 1

 encouraging a block of homeowners to form a block parent association to
ensure safe passsage for students to and from the school or activities

Organizing adolescents from a local high school to begin a reading program at

a grade school to increase interest in reading and improve the literacy rate of
students

Know the individuals aspects of the community, so u can be aware om why people
got ill before they seek healthcare.
Family as part of a Community

Community

Defined as a group of people individuals interacting with one another within

a limited geographical area.

ASSESSING A COMMUNITY
Age span

Is the community a young, settled in, or retired one? Is the family within the
usual age span of residents in the community and thereby assured of
support people?

Education

If the family has school aged children, are thete schools nearby? Is there a
public library for self education, is there easy access to such places if the
person becomes physically challeged? If a special progran such a diet and
counseling is needed, does it exist?

Environment

Are the environment risk present, such as air pollution? Busy highways?
Train yards? Pools of water where drowning could occur? Could
hypothermia be a problem?

Financial status

is there a high rste of unemployment in the community? What is the

average income level? Will the family have adequate finances to manage
comfortably in this neighborhood? Are supplemental aid programs
available?

Chapter 3. Childbearing and Childrearing Family in Community 2

 HealthCare

Is there a healthcare agency the family can use for comprehensive care? Is
it convenient in terms of finances, time, an transpo? Is it accessible for
people with disabilities

Housing

Are houses mainly privately owned or apartments rented, are homes close
enough together to afford east contact? Are they in good repair? Will new
construction or deteriorated building housing be a safety problem

Politics

is teh community active politically? Can adultd reach a local polling place to
vote, or do they know how to apply for absentee ballots?

Recreation

are recreational activities of interest available? Are they economically

feasible? Are there some sites that are apt to create health problems such
as ski resorts (broken bones), a lake (drowning), or a horse racing track
(smoke filled air)

Spirituality

Is there a facility where the family can worship who they can choose? Is there a
mixture of worship centers to show the community accepts cultural diversity?

Safety

what is the crime rate? Is there adequate amount of protection so family

memebrs can feel safe to hike or jog? Do they feel safe to remain home
alone? Do they know about the available hotlines and local police and fire
department numbers? Do houses have smoke and carbon monoxide
alarms in the bed room and near the kitchen?

Culture

what is the dominant culture in the community? Does the family fit into this
environment? are foods that are culturally significant available?

Transportation

Chapter 3. Childbearing and Childrearing Family in Community 3

 is there public transportation? Will family memebrs have access to it if they
become physically challenged?

Draw a ecomap of a family relationship to its community to identify if they fit.

TIPS TO IMPROVE FAMILY COMMUNICATION

Q: My family doesn't communicate well, how can I improve this?

A: Have an sit down together meals and discuss issues: if thats not possible..

Plan a time daily to let the family touch base (can be 15 mins)

Have all members have check in daily emails or text message

Set up a bulletin on who is the one to check on

Plan a wake up time so that everyone can have breakfast together

Reserve one night as "family night" where the entire family bonds together.

Have rules in family nights: no phones, television, computers, tablets

Encourage children to interact with each other, limit them in living a

sedementary lifestyle or isolation

Plan special activities for holiday or weekends that involves the whole family;
hiking, picnic, visiting a museum, or park

Participate in each other's activities: one one member is playing a ball game,
everyone must attend to support that person

IDENTIFY COMMON FAMILY STRUCTURES AND FUNCTIONS AND THE ROLES

WITHIN FAMILIES

Family

Definition by the US Census Bureau (2015) "as a householder and one or

more other people living in the same household who are related by birth,
marriage, or adoption

Family Types
This plays a view of perspective

Family of Orientation - Family one is born into; one self, parents, and siblings, if
any

Chapter 3. Childbearing and Childrearing Family in Community 4

 Family of procreation - A family one establishes; one self, spouse or significant
other, and children, if any.

Child-Free and Childless family

Family or couple who lives together without having kids

either by choice or suffering from infertility

positive aspects: companionship, shared resources

negative aspects: feeling of guilt when couple delays having kids, only
to suffer infertility issues in the future.

Cohabitation Family

Couples who lived other, with or without children, but not married

Older people age 50, are entering into a cohabitation family status

it has the same benefits as being legally married, like companionship

and financial security

drawbacks; no long term benefits, or legal benefits when separated,

and kids (custudy) or money issues involved is a challenge.

Nuclear Family

traditional family includes two parents and a child

An important nursing responsibility is to help nuclear families to reach

out support people towards their community or extended family.

positive aspect: support for family members; sense of security

negative aspects; may lack support people in a crisis situation

Binuclear family

a family created by divorce, where child is raised by two families

Extended family

or multigenerational family, includes members such as grandparents,

uncles and aunts, cousins and grandchildren

Older members usually acts as role models

Chapter 3. Childbearing and Childrearing Family in Community 5

 There's usually one member who is a breadwinner (main income
provider) which could lead to straining the family resources

Therefore, the nurse must help all members of the family to

communicate with one another.

Positive aspects; many people for childcare and member support

Negative aspects: resources may be stretched thin because of few

wage earners.

Single - Parent Family

Plays a large role in childbearing

Most of these types of family have low income

Not to mention that it's time consuming, and physically and mentally
exhausting.

Parents usually experience low self esteem went something went

wrong, hence its important identify it as it will hamper proper decision
making skills.

The special strength however, is that a child-one parent only

relationship (if they have a good relationship with each other) are more
tighter, have a super strong bond, and are self reliant and
interdependent

If a divorce happens, children must have a guidance, and the mother

and father must work together, and dependent on who has custody, is
liable for consent form of care that needs to be signed.

Blended family

(remarried)

a divorce or windowed person remarried another person with children,

and this is a child concerns because of the fear of ruining a relationship
of the biological parents, with their stepparents

Usually financial difficulties are uncommon, there's a huge financial

limitation because of paying child support, all while using the finances
to maintain a current marriage.

Chapter 3. Childbearing and Childrearing Family in Community 6

 Nurses responsibilities is to offer emotional support to blended family
members until adjustment of mutual living has been resolved.

positive: increased security and resources: exposure to different

customs or cultirr may help children become more adaptable to new
situation

negative: rivalry or competition among children, adjusting to a

stepparent.

The LGBTQ+ Family

They function as a nuclear family, only difference is their gender identity

and sexual orientation

Their children may come from a previous heterosexual marriage, or a

form of alternativr birth.

LGBT suffer greater healthcare disparities than cisgender -

heterosexual counterparts

Foster Family

children who are place in a foster home, or substitute home by home

protection at the age of 17, because their original families couldn't take
care of them.

They have a hard time adjusting from their original home to a foster one

A nurse must know who has legal responsibility to sign for healthcare
for the child

positive aspects: prevents children from being raised in a large insecure

setting

negative aspects; emotional difficulty, and difficulty to establish

meaningful relationship as they are always moving.

Adoptive family

New parents who adopt kids should take them to a healthcare facility so
that the child's baseline of health information can be made, potential
problems discussed, solutions explored. Because possibly they may
lack routine immunization or have delayed motor development.

Chapter 3. Childbearing and Childrearing Family in Community 7

 Preparation for parenthood is way different for familes, a convention
family may prepare for 9 months, while an adoptive family can only
prepare in the time span of 24 hours.

Take note on how the conventian children reacts to an adoptive child,

as if not resolved, can lead to conflict.

Kids must know that they are adopted, they may act in a "homeymoon
behavior" or act in fear of giving them away.

Counseling is continues journey, make sure that before you end a

nurse-client(child) relationship, introduce them to a new healthcare
provider, rather than leaving them on the spot, so that they wont feel
abandoned. Adoptive children usually fears abandonedship

When adoptive children grew up, they feel worry because they might
end up like their parents. Hencd children who seeks their biological
father is not for the sake that their adoptive parents are close with them,
but its because they want to know their identity.

Positive: children grow up well cared for and has a sense of love, while
original parents feel relieve that their children will go to a better place

Negative: child view themselves as the root cause of the problem if the
original parents has been divorced.

Family Functions & Roles

Each family functions as a unit, and functions way more effectively if they
delegate task to one another. Family is also run on generations, passing
tradition and culture to the next generation.

Roles of a family member can be flexible, most are wage earners, others
are financial manager, problem solver, decision maker, nurturer, health
manager, the environmentalist, culture bearer, and gatekeeper.

Roles of family and their assessment can be referred to your textbooks

Family Task

Family has 8 tasks to function as a unit. Assessing these

characterisitics will help reduce stress load and allow the family to move
in a healthy direction.

Chapter 3. Childbearing and Childrearing Family in Community 8

 Physical maintenance

Healthy family who has everything: food, water, shelter, clothing

and healthcare

Socialization of Family Members

The family has an open source of communication towards family

and the community

Each members feels accepted, and know how to interact with other
people, such as nurses, or police officers.

Allocation of Resources

Family decides who gets priority. Ranging from material to

emotional needs.

Maintenance of Order

Each family member has functions, roles, rules, values, and

responsibilites

Time out is a rule for toddlers

A healthy family follow rules and values, a dysfunctioning family

doesn’t

Division of Labor

Delegating or distributing task to members, and must be

interchangable and flexible for all.

Reproduction, recruitment, and release of family members

Membership changes through circumstances than a choice.

A new born in an already crowded family doenst feels exciting, and

late teenager who went to dorm in college feels abandoned

Placement of members into a larger society

A healthy family doesnt live alone.

They can get community resources such as school, place to

worship, healthcare, etc.

Chapter 3. Childbearing and Childrearing Family in Community 9

 Maintenance of motivation and morale
A healthy family have a sense of pride and unity. When something went
wrong, they can defend and look out for each other

A nurse must assess if each members fo the family feels loyal to

the family, just so you can have an idea of the family situation.

Look at book for Nursing Care Planning Tips For Effective Communication

ASSESS A FAMILY STRUCTURE

Look at the book for developmental stage

Genogram

A diagram that represents the family structure and its health history.

Make an example

CHANGING PATTERNS OF FAMILY LIFE

Divorce rates

It sucks, its comparable to a death of a love one

It has three seperate phases

Antagonistic stage

Parents fighting, feels that they no longer feel compatible for each
other

Children feels bad because they thought that the fighting came
from them.

Seperation Stage

Lives changes for both sides.

Children feels relieved that there’s no more tension or infighting, but

now are grieving for the lack of a father/mother figure.

Reshape stage

Depends on the family status, the child have to move on.

Chapter 3. Childbearing and Childrearing Family in Community 10

 Parents should avoid playing the victim, the injured party, or portraying that
the former spouse was evil.

A child must know why the divorce happens, and reassuring them at its not
their fault.

Decrease family size

Birth declined since the 1990.

Nurse should counsel the child on how to manage stress, cope with failure,
deal with team sports loss, as they dont have siblings as rolemodels

Dual Parent employment

Mothers are now a part of the labor force. Which means, less time for child care

Instruction on how to take and give medicine for parents and children must
be accounted for.

Make a plan for parents on when to take medication, all at the same time,
the parents must supervise them. Traditional time schedule is not
recommended (before breakfast, after school childcare, and bedtime)

Teach kids to be fast learners, and let them understand life tragedies by
news happens over time.

To avoid exposure to violence on TV; limit tv time for 18 months old

children. For school age: its best to limit or avoid tv, so that they can bond
with friends, and make time for workouts, and studies

MAKE SURE TO MONITOR THE TIME SPENT IN THE INTERNET:

MISINFORMATION AND PREDATORS EXIST.

A nurse is responsible for a family to set up an effective day care center

agaisnt infections, or an after school program.

TEST YOURSELF

Employ feynmenn technique

Do practice test

Make a diagram

Make a NCP

Chapter 3. Childbearing and Childrearing Family in Community 11

Chapter 3. Childbearing and Childrearing Family in Community 12