Objectives for this Session Learn the effect of families and their

complex relationships to health Discuss the family life cycle and why we

need to study it Determine the two levels of orders of

magnitude of change Learn the stages of the family life cycle, the

key principles and conflicts in each stages

Research on Families and Health The family is the primary social context in

which health care issues are addressed Most health beliefs and behaviors are

developed and maintained within the family Family members provide most of the health

care for patients Family support affects the outcome of most

chronic medical illnesses

Ex. 3x mortality rate for MI patients with few or no family support

Emotional support is the most important and influential type of family support

3 types of family support: Instrumental, Informational and Emotional

1. Instrumental Support - actual provision of services or care giving by family members2. Informational Support - involves giving health related information and advice3. Emotional Support - provides empathy, love and care

Marriage is the most influential family relationship on health

Married> widowed> divorced/single Negative, critical or hostile family

relationships have a stronger influence on health than positive relationships

Family psychoeducation is an effective intervention for health problems

Family Influence Genetic Influence Family is crucial in child development Infectious disease spreads in the family Family factors affect morbidity and mortality

in adults Family support is important in recovery from

illness

FAMILY LIFE CYCLE Provides chronologically oriented sequence

of events in family life View of the stressful changes in the family Events in the FLC can be related to clinical

events and to health maintenance in the family

Provide view in terms of intergenerational connectedness in the family

Clinicians can view family problems and strengths

Views symptoms and dysfuntions in relation to normal functioning over time

The individual life cycle takes place within the family life cycle, which is the primary context of human development. As such, it is crucial in understanding the emotional problems that people develop as they move together through life

Family stress is greatest at transition points from one stage to another of the family developmental process

The Family is a System Moving Through Time Families incorporate new members only by

birth, adoption, or marriage, and members can leave only by death

Main value in families is in the relationship, which are irreplaceable

2 Levels of Orders of Magnitude ChangeFirst Order Change

o Involve adaptationo Do not involve change in the main

structure of the familyo Do not involve a change in an

individual’s identity and familyo a “NEED TO DO” something newo -Tasks that must be accomplished

by the family and its members working within a stage in the FLC

Second Order Changeo Involve transformation of an

individual’s status or meaningo a “NEED TO BE” something newo Change in the role and identity of

family members o Change in the very basic attributes

of the family systemo Occur between stages in the FLC

SAN BEDA COLLEGE OF MEDICINE Batch 2011Topic: Family’s Influence on Health

Family Life CycleFCM 1

Lecturer: Dr. Mek Solana Nov. 26, 2007

1

STAGES OF FAMILY LIFE CYCLE

Leaving Home: The Unattached Young Adult

“Between families” Start of the family life cycle Primary task : coming to terms with their

family of origin Issues on separation from parents/ family of

origin Formulation of personal goals Need for self-differentiation Alcoholism, smoking, STD’s, unwanted

pregnancies

Newly Married Couple The joining of families Key principle : Commitment to the new

subsystem Formation of the marital system Realignment of relationships with extended

families and friends to include the spouse Establishing home base Money matters Demands on new role Establishing a satisfying sexual relationship Interaction with friends and associates in

the community Facing the possibility of children and

planning for their coming

Family with Young Children Pregnancy for the first child to emergence of

adolescents Stage when child starts to go to school Becoming parents Key principle : Accepting marital system to

make space for children Taking on parenting role Key principle : Realignment of relationship

with extended family to include parenting & grand parenting roles

FLC phase that has the highest rate of divorce

Family with Adolescents Key principle : increasing flexibility of

boundaries to includ children independence Identity crisis Re-focus on midlife, marital and career

issues Beginning shift towards concern for the

older generation

Launching Family Begins when the first child leaves home Longest stage, most problematic of all

phases Key Principle : accepting a multitude of

entries and exits into the family system Adjustment to new family members Dealing with illness or death of

parents/grandparents Career stagnation vs financial liberation Extramarital affairs vs a restructured marital

relationship

The Family in Later Life Begins with departure of last child and

continues through retirement and death Old age and disease Financial/ retirement adjustments Death of spouse Empty nest syndrome Key process : accepting the shifting of

generational goals

SOLANA-VILLAFUERTE FAMILY

4 4 6

Nov. 25, 2007

I

Heart disease

Diabetes

Asthma

Victoria

Amy

Nene Julie

Junilyn 28

Lydia

Lester

Mien

Imelda Elizabeth

Grace

Graciano

Remedios

David 58

Tess 55

Justin 39

Mek 33

Thea2 mos

Nanay Puring 58

Michael

Reggie 31

Hearty 28

Chai 3

Jhay 22

Bhen20

George

HPN

Stroke

Mandy 28

2

The Changing Family Life Cycle Due to lower birth rate Longer life span/ expectancy Changing role of women Increasing divorce and remarriage rate

Role of Women in the FLC Central to the functioning of the family Identities determined primarily by their

function as wife and mother Life cycle phases linked almost exclusively

to child rearing activities A woman who choose a primary role as

mother and homemaker will have to face an “empty nest” phase later on in life

Women most prone to symptom development at life cycle transitions

The goals of career and family present severe dilemma

Likely to be depressed at childbirth Seek help during the child-rearing years Responsible for older relatives Bear emotional responsibility for all family

relationships

2 Types of Stressors1. Vertical Stressors – trans generational stressors transmitted down each generation, patterns of relating interactions, attributes, norms, taboos within family Issue: How each family deals with those

factors,taboos etc.

2. Horizontal Stressors – come with each cycle change

References: Isabelita Samanego, MD. Proceedings of

the Orientation Course in Family Medicine. PAFP, Inc.

Carter, B. and McGoldrick, M. The Changing Family Life Cycle, A Framework for Family Therapy, 2nd ed. 1989. p3-28.

Transcribers: Ryan S. Marcelo Yrenne James H. Teodosio, PTRP

SOLANA-VILLAFUERTE FAMILY

4 4 6

Nov. 25, 2007

I

II

III

Heart disease

Diabetes

Asthma

Manding

Victoria

Amy

Nene Julie

Junilyn 28

Lydia

Lester

Mien

Imelda Elizabeth

Grace

Graciano 82

Remedios 65

David 58

Tess 55

Justin 39

Mek 33

Thea2 mos

Michael

Reggie 31

Hearty 28

Chai 3

Jhay 22

Bhen20

George

HPN

Stroke

Mandy 28

Flow of Anxiety in a Family

Horizontal StressorsDEVELOPMENTAL- Life cycle transitionsUNPREDICTABLE- Untimely death, chronic illness, accident

Vertical StressorsFamily patterns, myths, legacies

SYSTEM LEVELS- Social, cultural, political, economic- Community, work, friends- Extended family- Nuclear family- Individual

3