Family Roles, Structures and

Functions
Defining the Concept of Family

 A family is defined by the U.S. Census Bureau (2009) as “a group of

people related by blood, marriage, or adoption living together.”
 Allender and Spradley (2008) define the family in a much broader context
as “two or more people who live in the same household (usually), share a
common emotional bond, and perform certain interrelated social tasks.
Family Types

 Many types or structures of families exist, and family structures change over
time as they are affected by birth, work, death, divorce, and the growth of
family members. For the purposes of assessing families in maternal and
child health nursing, two basic family types can be described:
 • Family of orientation (the family one is born into; or oneself, mother,
father, and siblings, if any)
 • Family of procreation (a family one establishes; or oneself, spouse or
significant other, and children)
 Dyad Family
 consists of two people living together, usually a woman and a man,
without children
 Cohabitation Family
 composed of heterosexual couples, and perhaps children, who live
together but remain unmarried
 Nuclear Family
 composed of a husband, wife, and children
 Polygamous Family
 A family composed of multiple wives
 Extended (Multigenerational) Family
 includes not only the nuclear family but also other family members such as grandmothers,
grandfathers, aunts, uncles, cousins, and grandchildren
 Single-Parent Family
 Composed of only one head of the family
 Blended Family
 a remarriage or reconstituted family, a divorced or widowed person with children marries
someone who also has children
 Communal Family
 formed by groups of people who choose to live together as an extended family. Their
relationship to each other is motivated by social or religious values rather than kinship
(Cherlin, 2008).
 Gay or Lesbian Family
 individuals of the same sex live together as partners for companionship, financial security, and
sexual fulfillment
 Foster Family
 Substitute home for children who doesn't have someone to care for them. Foster parents may
or may not have children of their own. They receive remuneration for their care of the foster
child. May be temporary or permanent.
 Adoptive Family
 types of families (nuclear, extended, cohabitation, single-parent, gay and lesbian) adopt
children to be part of their family.
Family Tasks

 Duvall and Miller (1990) identified eight tasks that are essential for a family to perform to
survive as a healthy unit. These tasks differ in degree from family to family and depend
on the growth stage of the family, but they are usually present to some extent in all
families.
Physical maintenance:
 A healthy family provides food, shelter, clothing, and health care for its members.

Socialization of family members:

 This task involves preparing children to live in the community and to interact with people
outside the family. It means the family has an open communication system among family
members and outward to the community
Allocation of resources:
 Determining which family needs will be met and their order of priority is allocation of
resources. In healthy families, there is justification, consistency, and fairness in the
distribution. Resources include not only material goods but also affection and space
Maintenance of order:
 This task includes establishing family values, establishing rules about expected family
responsibilities and roles, and enforcing common regulations for family members such as
using “time out” for toddlers. In healthy families, members know the family rules and respect
and follow them.
Division of labor:
 Healthy families evenly divide the work load among members and are flexible enough that
they can change work loads as needed
Reproduction, recruitment, and release of family members:
 Often not a great deal of thought is given to this task; who lives in a family often happens
more by changing circumstances than by true choice.
Placement of members into the larger society:
 Healthy families realize that they do not have to operate alone but can reach out to other
families or their community for help when needed. Selecting a birth setting, a special
school setting, or choosing a hospital or hospice setting is part of this task .
 Maintenance of motivation and morale:
Healthy families are able to maintain a sense of unity and pride in the family.
When this is created, a sense of pride helps members defend the family against
threats as well as serve as support people for each other during crises.
Family Developmental Stages

 Families, like individuals, pass through predictable developmental stages (Duvall & Miller, 1990). To assess
whether a family is using stage-appropriate health promotion activities, it is helpful to first determine a
family’s developmental stage. The age of the oldest child marks the stage.
Stage 1: Marriage
 what occurs during it is also applicable to couples forming cohabitation, lesbian/gay, or single alliances.
During this first stage of family development, members work to:
 • Establish a mutually satisfying relationship
 • Learn to relate well to their families of orientation
 • If applicable, engage in reproductive life planning
Stage 2: The Early Childbearing Family
 The birth or adoption of a first baby is usually both an exciting and a stressful event because it
requires both economic and social role changes. An important nursing role during this period is
health education about well-child care and how to integrate a new member into a family. It is a
further developmental step for a family to change from being able to care for a well baby to being
able to care for an ill one.
Stage 3: The Family With a Preschool Child
 A family with preschool children is a busy family because children at this age demand a great deal of
time. Their imagination is at such a peak that safety considerations such as avoiding unintentional
injuries (accidents) become a major health concern.
Stage 4: The Family With a School-Age Child
 Parents of school-age children have the important responsibility of preparing their children to function in
a complex world while at the same time maintaining their own satisfying marriage relationship.
 Important nursing concerns during this family stage are monitoring children’s health in terms of
immunization, dental care, and health care assessments; monitoring child safety related to home or
automobile accidents; and encouraging a meaningful school experience that will make learning a lifetime
concern, not one of merely 12 years.
Stage 5: The Family With an Adolescent
 The primary goal for a family with a teenager differs considerably from the goal of the family in
previous stages, which was to strengthen family ties and maintain family unity.
 Violence—accidents, homicide, and suicide—is the major cause of death in adolescents (NCHS,
2009).
 A nurse working with families at this stage needs to spend time counseling members on safety
(driving defensively and not under the influence of alcohol; safer sex practices; proper care and
respect for firearms) and the dangers of chemical abuse.
 A nurse can be a neutral person to assist families at this stage when communication can be difficult
while maintaining confidentiality between the family members.
Stage 6: The Launching Stage Family: The Family With a Young Adult
 the stage at which children leave to establish their own households is the most difficult stage because it
appears to represent the breaking up of the family
 The stage may represent a loss of self-esteem for parents, who feel themselves being replaced by other
people in their children’s lives.
 Illness imposed on a family at this stage can be detrimental to the family structure, breaking up an
already disorganized and noncohesive group
 A nurse can serve as an important counselor to such a family. He or she can help the parents see that
what their children are doing is what they have spent a long time preparing them to do, or that leaving
home is a positive, not a negative, step in family growth.
Stage 7: The Family of Middle Years
 When a family returns to a two-partner unit, as it was before childbearing, the partners may view this
stage either as the prime time of their lives (an opportunity to travel, economic independence, and
time to spend on hobbies) or as a period of gradual decline (lacking the constant activity and
stimulation of children in the home, finding life boring without them, or experiencing an “empty nest”
syndrome).
Stage 8: The Family in Retirement or Older Age
 families at this stage are not having children, they remain important in maternal and child health
because they can offer a great deal of support and advice to young adults who are just beginning their
families.
Assessment of Family Structure and Function

 Genogram
a diagram that details family
structure, provides information about
the family’s history and the roles of
various family members over time,
usually through several generations. It
can provide a basis for discussion and
analysis of family interaction.
 Ecomap
a diagram of family and community
relationships which documents if the
family “fits” in their community
Constructing such a map helps you
assess the emotional support available
to a family from the community.
Thank you….