Print Aug 10 Fam. as a Unit-1
-
Upload
alexiz-gubatan -
Category
Documents
-
view
221 -
download
0
Transcript of Print Aug 10 Fam. as a Unit-1
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
1/107
Cynthia Lazaro-Hipol, MD,MPH,FPAFP
Introduction: Family Medicine
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
2/107
Family Medicine
y medical specialty
y continuing and comprehensive health
care for the individual and family.y integrates the biological, clinical, and
behavioral sciences.
y
encompasses all ages, both sexes,each organ system, and every disease
entity.
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
3/107
Family medicine is a three-
dimensional specialty
(1) knowledge,
(2) skill and(3) Process
patient-physician relationship with
the patient viewed in the context ofthe family
relationship is valued, developed,
nurtured and maintained
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
4/107
Basic Principles of Patient Care in
Family Practice
yPatient - Centered
yComprehensive CareyContinuity of care
yContext of CareyCoordination of care
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
5/107
Biopsychosocial Model (Patient-
Centered)
y approach patients with sensitivity and
responsiveness to culture, age, gender,
and disabilities
y develops their ability to collect and
incorporate appropriate psychosocial,
cultural, and family data into patient-centered management plans
(Annals of Family Medicine Supplement, March 2004).
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
6/107
Comprehensive Care (Whole Person
Care)
y emphasizes the importance of caring for
the whole person by providing
opportunities for students to participatey in longitudinal, integrated, preventive
services and treatment of common
acute and chronic medical problemsfor patients and families in all phases
of the life cycle.
(Annals of Family Medicine Supplement,
March 2004).
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
7/107
Continuity ofCare (Continuous Healing
Relationships)
y values and promotes continuous healing
relationships by
y providing a personal medical home for
patients and their families
y maintaining ongoing responsibility for
the health care of patients and families
y facilitating transitions between theprimary care provider, referral agencies,
and consultants.
(Annals of Family Medicine Supplement, March 2004).
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
8/107
Context ofCare (Evidence-Based)
y emphasizes the development of patient-
and family-centered treatment plans
yevidence-based, safe, and designed to
produce high-quality outcomes that
enhance functional outcome and
quality of life in a culturally responsivemanner
(Annals of Family Medicine Supplement,
March 2004).
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
9/107
Coordination / Complexity ofCare
(Integration)
y functions as the integrator of
complex care and collaborates as ahealth care team member in
disease management, health
promotion, and patient education.
(Annals of Family Medicine
Supplement, March 2004).
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
10/107
Attribute Description
A deepunderstanding ofthe dynamics ofthe whole
person
consider all the influenceson a persons health.integrate rather than
fragment care, involvingpeople in the prevention ofillness and the care of
their problems, diseases,and injuries
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
11/107
Attribute Description
A generativeimpact on
patients
lives
participate in the birth, growth,
and death of their patients and
want to make a difference intheir lives.
family physicians foster personal
growth in individuals and help
with behavior change that may
lead to better health and a
greater sense of well-being
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
12/107
Attribute DescriptionA talent for
humanizing
the health
care
experience
intimate relationships over time
enable family physicians to connect
with people.
explain complex medical issues in
ways that their patients can
understand.
take into account the culture and
values of their patients, while
helping them get the best care
possible
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
13/107
Attribute Description
A natural
command of
complexity
comfortable with
uncertainty and
complexity.
trained to be inclusive, to
consider all the factors
that lead to health and
well-beingnot just pills
and procedures
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
14/107
A commitment to
multidimensional
accessibility
not only physically accessible to
patients and their families andfriends,
able to maintain open, honest
and sharing communicationswith all who are involved in the
care process
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
15/107
Roles of a Family Physician??
yEducator/ Health Advocate
yResearcher
yManager
yCommunity Organizer
yCare-giver
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
16/107
cancer patients should expect to
receive
y competent general medical care, advice
regardingy treatment, care coordination, pain
management, and
y end-of-life care and emotional supportfrom their primary care physicians.
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
17/107
Characteristics of the New Model of
Family Medicine
Patient-centered careyPatients are active participants in their
health and health care.
yThe practice has a patient-centered,
relationship-oriented culture that
emphasizes the importance of meetingpatients needs, reaffirming that the
fundamental basis for health care is
"people taking care of people"65
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
18/107
Characteristics of the New Model of
Family Medicine
Personal medical home
y
The practice serves as apersonal medical home for
each patient, ensuring
access to comprehensive,integrated care through an
ongoing relationship
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
19/107
Characteristics of the New Model
of Family Medicine
Team approachy
health care is not delivered by anindividual, but rather by a
ymultidisciplinary team approach for
delivering and continually improving
care for an identified population41,67
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
20/107
Characteristics of the New Model of
Family Medicine
Elimination of barriers to
accessythrough implementation of open
scheduling, expanded office hours,
and additional, convenient optionsfor communication between
patients and practice staff
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
21/107
Characteristics of the New Model of
Family MedicineAdvanced information systems
y use an information system to deliver and
improve care, to provide effective practice
administration, to communicate with patients, tonetwork with other practices, and to monitor the
health of the community.68
yA standardized electronic health record (EHR),
adapted to the specific needs of family
physicians, constitutes the central nervous
system of the practice
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
22/107
Characteristics of the New Model of
Family Medicine
Redesigned officesy
Offices should be redesigned tomeet changing patient needs and
expectations, to accommodate
innovative work processes, and to
ensure convenience, comfort, and
efficiency for patients and clinicians
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
23/107
Characteristics of the New Model of
Family Medicine
Whole-person orientationy integrated, whole-person care
y developing cooperative alliances with services
or organizations that extend beyond thepractice setting, but which are essential for
meeting the complete range of needs for a
given patient population.38
y The practice has the ability to help guide a
patient through the health care system by
integrating carenot simply coordinating it
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
24/107
Characteristics of the New Model of
Family Medicine
Care provided within a
community contextyA culturally sensitive, community-
oriented, population-perspective
focus
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
25/107
Characteristics of the New Model of
Family Medicine
Emphasis on quality and safety
ySystems are in place for the
ongoing assessment of
performance and outcomes and for
implementation of appropriatechanges to enhance quality and
safety
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
26/107
Characteristics of the New Model of
Family Medicine
Commitment to provide family
medicines basket of services
yA commitment to provide patients with
family medicines full basket of
serviceseither directly or indirectly
through established relationships withother clinicians
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
27/107
Basket of Services in the New Model of
Family Medicine
yHealth care provided to children
and adults
y Integration of personal health care
(coordinate and facilitate care)
y
Health assessment (evaluate healthand risk status)
y Disease prevention (early detection
of asymptomatic disease)
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
28/107
Basket of Services in the New Model of
Family Medicine
yHealth promotion (primary
prevention and health
behavior/lifestyle modification)yPatient education and support for
self-care
y Diagnosis and management ofacute injuries and illnesses
yDiagnosis and management of
chronic diseases
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
29/107
Basket of Services in the New Model of
Family Medicine
ySupportive care, including end-of-life care
y Maternity care; hospital care
y Primary mental health carey Consultation and referral services as
necessary
y
Advocacy for the patient within the healthcare system
y Quality improvement and practice-based
research
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
30/107
Traditional Model New Model of Practice
Systems often disrupt the
patient-physician relationship
Systems support continuous
healing relationshipsCare is provided to both sexes
and all ages; includes all
stages of the individual and
family life cycles in continuous,healing relationships
Care is provided to both sexes
and all ages; includes all
stages of the individual and
family life cycles in continuous,healing relationships
Physician is center stage Patient is center stage
Unnecessary barriers to
access by patients
Open access by patients
Care is mostly reactive Care is both responsive andprospective
Care is often fragmented Care is integrated
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
31/107
Traditional Model New Model of Practice
Paper medical record Electronic health record
Unpredictable package ofservices is offered Commitment to providingdirectly and/or coordinating a
defined basket of services
Individual patient oriented Individual and community
oriented
Communication with practice issynchronous (in person or by
telephone)
Communication with thepractice is both synchronous
and asynchronous (e-mail,
Web portal, voice mail)
Quality and safety of care are
assumed
Processes are in place for
ongoing measurement and
improvement of quality and
safety
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
32/107
Traditional Model New Model of Practice
Physician is the main
source of care
Multidisciplinary team
is the source of care
Individual physician-
patient visits
Individual and group
visits involving severalpatients and members
of the health care team
Consumes knowledge Generates newknowledge through
practice-based research
Experience based Evidence based
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
33/107
A family Physician
MD
Residency Training CME
Diplomate Examination
Felow
Certified Family Physician
2000
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
34/107
Afamily physician is
yA doctor who graduated in the
1960s; went back to his
hometown; see patients of all ages
and with varied diseases??????
Jose dela Cruz, MD
Physician- Surgeon
False
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
35/107
yA doctor who graduated
three years ago ; passed theboard; went back to his
hometown and is presentlytreating patients of all
ages????????????
A family physician is
False
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
36/107
yA doctor who graduated 10
years ago; Completed aresidency training in Pediatrics;
Passed the Diplomate Board;
Sees patients of all ages andwith varied diseases?????????
A family physician is
False
True
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
37/107
Afamily physician isyA doctor who graduated in the 1970s,
went back to his hometown and
practice. Attended CME activities of the
Philippine Academy of Family Physicianin the 1980 s. Got a certificate as a
Certified Family Physician.
Jose dela Cruz, MDPhysician- Surgeon
?????????????True
False
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
38/107
Afamily physician is
yA doctor who graduated in 1975; earned
a Masters degree in Public Health;wentback to his hometown and practice; see
patients of all ages and varied
diseases?
False
False
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
39/107
Afamily physician is
yA doctor who graduated in 1985;
Underwent three years training inFamily Medicine; did not take any
diplomate exam; went back to his
hometown and practice.? TrueFalse
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
40/107
Afamily physician is
yA doctor who graduated in 1085;
Finished a residency training in
Family Medicine; Passed thediplomate exam; earned a Masters
degree in Public Health.went back
to his hometown and practice.? TrueTrue
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
41/107
Afamily physician is
yA doctor who graduated in the
1970s, went back to his hometown
and practice. Attended CME
activities of the Philippine Academy
of Family Physician in the 1980 s.
Got a certificate as a Certified
Family Physician.Passed the
diplomate exam. See patients of all
ages and with different complaints.True
True
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
42/107
y For nos 6 and 9, refer to the case below:
y Dr. Gloria Grajera is a 60 year old private practitioner. She
had her residency training in Family Medicine.S
he has nowa MD, FPAFP after her name. She admitted a patientsuffering from uncomplicated Myocardial Infarction 2 daysago. She referred the patient to her friend, an internistyesterday for she noted some irregularities in her pulse. Dr.Grajera ordered the dietician to give her patient soft diet forthe next three to five days. Likewise she advised the patientnot to mobilize or move around because it would causemore harm to the patients heart.
y Dr. Grajera is a:
y Internist
y Family Physician
y Specialist
y B and C
y A,B,C
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
43/107
y For nos 6 and 9, refer to the case below:
y Dr. Gloria Grajera is a 60 year old private practitioner. She
had her residency training in Family Medicine.S
he has nowa MD, FPAFP after her name. She admitted a patientsuffering from uncomplicated Myocardial Infarction 2 daysago. She referred the patient to her friend, an internistyesterday for she noted some irregularities in her pulse. Dr.Grajera ordered the dietician to give her patient soft diet forthe next three to five days. Likewise she advised the patientnot to mobilize or move around because it would causemore harm to the patients heart.
y The role/s performed by the above physician:
y Caregiver
y Researcher
y Manager
y Educator
y Combination of the above
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
44/107
y Dr. Gloria Grajera is a 60 year old privatepractitioner. She had her residency training inFamily Medicine. She has now a MD, FPAFP afterher name. She admitted a patient suffering fromuncomplicated Myocardial Infarction 2 days ago.She referred the patient to her friend, an internistyesterday for she noted some irregularities in herpulse. Dr. Grajera ordered the dietician to give her
patient soft diet for the next three to five days.Likewise she advised the patient not to mobilize ormove around because it would cause more harm tothe patients heart.
y Most likely, Dr. Grajera is practicing in ay Primary Care hospitaly Secondary Care Hospital
y Tertiary Care Hospital
y Only B or C
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
45/107
y Dr. Gloria Grajera is a 60 year old privatepractitioner. She had her residency training inFamily Medicine. She has now a MD, FPAFP afterher name. She admitted a patient suffering fromuncomplicated Myocardial Infarction 2 days ago.She referred the patient to her friend, an internistyesterday for she noted some irregularities in herpulse. Dr. Grajera ordered the dietician to give her
patient soft diet for the next three to five days.Likewise she advised the patient not to mobilize ormove around because it would cause more harm tothe patients heart.
y The kind of care given by the above physician:y Comprehensivey Continuousy Coordination of carey A and By A and C
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
46/107
familyas a unit ofcare
prepared by:
cynthia l. hipol, md, mph, fpafp
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
47/107
family,definitions
in terms of affinity- group of people related by blood,
marriage or adoption, who live
together in one household*
*UNITED NATIONS
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
48/107
family,definitions
Household: a group of personsliving under one roof and
sharing the same kitchen and
housekeeping arrangements
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
49/107
family, definitions, cont.
involve delineation of family
structure, functions,composition, and
affectionalities
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
50/107
familystrengths,cont.
1. ability to provide for the
familys physical, emotional ,spiritual,and cultural needs
- spiritual : sharing of basic beliefs- cultural : sharing of cultural values
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
51/107
familystrengths,cont.
2. child - rearingpractices and discipline
1. respect each others views anddecisions on child rearing
practices
2. if a single parent, the capacity of a
single parent to be consistent and
effective in raising the children
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
52/107
familystrengths,cont.
3. communication
- the ability to communicateand express a wide range of
emotions and feelings both
verbally and non verbally
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
53/107
familystrengths,cont.
4. support, security, and
encouragement4.1 provide each members with
feelings of security and
encouragement4.2 balance in the pattern of
family activities
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
54/107
familystrengths, cont.
5. growth :producing
relationships;- the familys ability to maintain
and build friendships and relationships in
the neighborhood
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
55/107
familystrengths, cont.
6. responsible community- relationships: the capacity of
the family members to assumeresponsibility through participations in
social, cultural or community activities
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
56/107
familystrengths, cont.
7. self - help and accepting help
- ability to seek and accept help
when they think they need it8. flexibility of family functions
- and roles: family members ability
to fill in for one another duringtimes of illness or when needed
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
57/107
familystrengths, cont.
9. crisis as a means of
growth-ability to unite and become supportive during
a crisis or traumatic experience
10. family unity, loyalty and
intra- familycooperation
- ability to recognize and use family
traditions and rituals that promote unity and
pride
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
58/107
familyas a special unit
1. family membership is a lifelong
involvement
2. shared attributes3. sense of belonging
4. social expectations
5. built-in problems6. family endures despite conflicts
and built -in problems
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
59/107
whyfamilyas a unit ofcare
1. family is the social context for
health care
2. patients problem is the familys
problem
3. family is the greatest ally in
treatment
4. patients family is present in patient
interview
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
60/107
what is familycare ?
1. taking care of all individuals in the
family one by one2. dealing with family as object of
management
3. influencing family members to
change factors affecting an
individuals health
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
61/107
what familyphysicians need to
know
aboutfamilies
1. understanding family structure
and function
2. awareness of how familiescommunicate
3. skills in observing how families
operate4. ability to relate family / individual
5. reinforce central function of
family
Family in Stressful2
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
62/107
Cycle ofFamily Function
y
Functional
Equilibrium
1 life event 2
Family indisequilibrium3
Resources
adequate4
Adaptation
(coping)5
Resources
Inadequate6
Crisis)7
Extrafamilial
resources
8
Maladaptation
(coping)9
Pathological
equilibrium10
Stressful
life event11
Terminal
disequilibrium12
Smilktein
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
63/107
The Filipino Family
yReliance on the family for love,
support, and refuge has historicallybeen as much an economicnecessity as it is a cultural tradition.
y the relationship to family is not just apractical trade off of autonomy forsocial security.
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
64/107
The Filipino Family
y transcends socioeconomic, educational,and regional differences and is part of acollectivistic cultural orientation or way ofperceiving the place of the individual in thesocial context (Gochenour, 1990; Santos,1983).
y is the source of one's personal identity and ofemotional and material support; it also is thefocus of one's primary duty and commitment.Dependence on, loyalty to, and solidarity withthe family and kin group are of the highestpriority (Okamura & Agbayani, 1991).
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
65/107
classification offamilies
according to structure
nuclear family extended family
polygamous family
single - parent family
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
66/107
families according to structure
1. nuclearfamily
married man and woman with their
offspring (biological/adopted) occupy a separate dwelling not
shared with members of the
family of orientation of either
spouse economically independent
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
67/107
families according to structure,cont.
2. extended family
includes three generations
shared responsibilities
maintenance of expressive and
emotional relations beyond the
nuclear family
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
68/107
There are three basic family systems
extended family
y
Unmarried adult daughters and sonstypically remain in their parents' homeand contribute to family support.
yAdditional extended family memberssuch as grandparents, aunts, uncles,or cousins also may live in the samehouse and assume vital roles (Almirol,1982; PAFEF, 1982; Santos, 1983).
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
69/107
families according to structure,cont.
3. single - parent family
may result from:
-
the loss of the spouse from death, divorce,
separation or desertion
from the out of wedlock birth of a child
from the adoption of a child
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
70/107
families according to structure,cont.
4. blended family
includes step parents, andstepchildren
may be caused by separation,
divorce, remarriage
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
71/107
basic family systems
y nuclear family which consists of ahusband, wife and children
y extended family which brings togetherseveral generations in direct line andkinship ties built by marriage.
y polygamous family which consists of ahusband or wife and several spousesand their children;
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
72/107
yIn Christian Filipinas, the family
is monogamous, one wife and
one husband at a given timewhilepolygamous or multiple
wives in Muslim Filipino families
is allowed. Nowadays, Muslimsgenerally practice monogamy
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
73/107
y
Filipino
Family(Mag-anak)
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
74/107
y
Type of relationshipemphasized
yConjugal : marital bondy
Consanguinal: blood tiesyPersonal virtuesyChoice of marital partner,
friends, godparentsyWeakness/immorality/defects
Muslim Rural Filipino Urban Filipino Western
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
75/107
Muslim Rural Filipino Urban Filipino Western
Paternal dominance Paternal dominancewith maternaldecision makingsome areas
Paternal dominancewith maternaldecision makingsome areas
Trend towardcomplete equalitybetween husband& wife
Family is theproperty holderand source oflabor
Family is the propertyholder and sourceof labor
Important in property;less effective islabor unit
Economic role minorexcept as unit ofconsumption
Strong discipline of
children
Moderate strong
discipline ofchildren
Combination of
discipline andindulgence oftreatment ofchildren
Trend toward the
equality inparent-childrelationship
Family choice ofmate
Romantic love exaltedsubordinate toparental approval
Individual maritalchoice withparental approval
Romantic love allimportant withparental approval
playing minorrole
No free associationwith oppositesex except forcollege educated
Chaperonage or groupdating
Chaperonage givingway of dating
Little and nochaperonage andno taboos
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
76/107
Muslim Rural Filipino Urban Filipino Western
Double standard of
morality
Double standard of
morality
Double standard
with queridasbeing challengeby wives
Tendency to a
single standardfor both sexesfor fewertaboos for both.Prostitutionavailable,mistresses rare
Divorce simple forhusband;available for
cause forwife
No divorce; legalseparation withright ofremarriageConsensualmarriage notuncommon
Prostitutionavailable;No divorce. Legalseparationwithout rightof remarriage
Divorce obtainableon manygrounds, butsubject to legalrestrictions andfinancialburdensome
Extended familyoften livetogetherHigh birth rate;high infantmorality rate
Extended family tiesstrong butusually separatedwellings. Highbirth rate; lowinfant mortalityrate
Extended familyweaker than inrural areas. Birthbetween that ofMuslim andWestern infantmortality low
Small familyincludes only 2generations andnot collateralrelatives. Lowbirth rate andlow infantmortality
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
77/107
familyset - up
1. democraticset upparents respect their childs decisions
and ideas, tolerance, understanding and
permisiveness prevail
2. authoritarian set up
conformity to parental guidance,more punishments than praises
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
78/107
y
Naming:patronymic vs matronymicy Authority
yPatriarchal
yMatriarchal
yEqualitarian
Rules of ResidenceyNeolocalyMatrilocalyPatrilocal
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
79/107
y
"Traditional families and other socialsystems are highly authoritarian.Age, power, prestige, and wealthare the chief sources of authority"
(S
antos, 1983, p. 140).
y Within the family, age determines ahierarchical system of authority that
flows downward from oldest toyoungest.
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
80/107
y
Outside the family, otherfactors such as social class,professional status or official
government affiliation, andecclesiastical positions maysupersede age as
determining factors in thelocus of authority.
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
81/107
yEgalitarian roles and relationshipsbetween men and women arefurther reflected in family decision
making processes.
yFamily authority is based on respect
for age, regardless of sex.
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
82/107
yFamily decisions are made only
after a consensus has beenreached to ensure that the ultimatedecision will be representative of
and acted on by all family members.
yFamily disagreements are avoided,
if possible; when disagreements dooccur, they are kept strictly withinthe family (PAPEP, 1982).
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
83/107
yAlthough the father may be ostensibly
perceived as the main authority figurein the nuclear family, the mother hasconsiderable authority and influence.
yShe generally controls the finances,may work full time (even with manychildren at home), and earns as much
as or more than half the familyincome.
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
84/107
yWomen enjoy high status in the family
and in the society at large. Bilaterallineage attests to this higher status ofFilipinas compared with women inmore patriarchal Asian countries.
yThe long accepted phenomenon ofthe "working mother" in the
Philippines thus does not pose adrastic role change as it does forother recent Asian immigrant familiesin the United States (PAPEP, 1982).
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
85/107
basic areas offamily
function
1. biologic 2. economic
3. educational
4. psychologic
5. socio - cultural or socialization
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
86/107
familyrelationship
and interaction
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
87/107
y Children are the center of the parent'sconcerns. They are viewed as an extension
of the family and recipients of the family'sgood fortune.
y Parents are expected topersuade a child toaccept their point of view, rather thanimpose their authority on the child withoutconsideration for the child's preferences orwishes.
y
The child, in turn, is expected to showproper respect and obedience, tocompromise, and to maintain goodrelationships with all other family members(PAPEP, 1982).
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
88/107
y In the Pilipino culture, the birth ofchildren is an expected and desiredoutcome of marriage. Most couplesprefer to have children of bothsexes, and there is typically no
special preference for males overfemales.
yChildren are considered a special
"gift from God," and a large family isproof of God's favor and blessing(Guthrie & Jacobs, 1966).
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
89/107
I. ordinal position
1. first born - persevering, serious,more responsive to adults, achievement-
oriented
2. middle child - optimistic ,sociable, aggressive and competitive
. 3.youngestchild- demanding,outgoing, narcissistic, though by natureaffectionate
II parent child interaction /
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
90/107
II. parent child interaction /
familyrelationship
1. rejecting parent
has an insecure, aggressive, sadistic, nervous,stabborn and uncooperative child
2. submissive parentbears an aggressive, careless, disobedient and
uncooperative child
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
91/107
II. parent - child interactions/familyrelationships,cont.
3. dominating parent gives out an uncooperative, tense, quarrelsome
and disinterested child
4. absent father or mother
home
- child is aggressive, neurotic, jealous,uncooperative, delinquent and less confident in
the future and less able to trust adults
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
92/107
III. social class pattern of behavior
1.upper
class familyclosely- knit greater concern for
maintaining the family name and prestige
2. middle class family
believes in hard work, self reliance,initiative, independence, responsibility,economic security and self improvementthrough education
3. lowerclass family
largely unemployed, sees life is acontinuous process for survival and givesthe impression of being to a life of frustrationand defeat
Filipinos view education as
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
93/107
Filipinos view education asy a "passport to good jobs, economic security,
social acceptance, and as a way out of a
cycle of poverty and lower class status, notonly for their children, but for the whole family"(Santos, 1983, p. 146).
y
family concern
y an economic investment toward which familymembers must contribute significant effort andoften personal sacrifice.
y the individual is expected to assume theresponsibility of helping his or her parentsfinance the education of the next child.
major strengths of the Pilipino
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
94/107
j g p
character:
ypakikipagkapwa-tao (having a regard for thedignity and being of others),( PhilippineSenate commissioned task force in 1988)
y family orientation, joy and humor, flexibility,adaptability and creativity, hard work andindustry, faith and religiosity, and ability tosurvive
(Licuanan, 1988). Each of these characteristics was summarized by Okamura andAgbayani (1991) and has been consistently identified by Church (1986) in areview of other studies on Pilipino personality values or ideals.
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
95/107
y
Pakikipagkapwa-tao is manifestedamong Filipinos in their basicsense of justice and fairness andconcern for other's well being.
Filipinos recognize the essentialhumanity of all people and regardothers with respect and empathy.
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
96/107
yPakikisama represents both avalue and a goal that consists ofmaintaining good feelings in allpersonal interactions and gettingalong with others at all costs.
To avoid open displays of conflict and
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
97/107
To avoid open displays of conflict andstressful confrontations, Filipinos may
yield to
y group opinion (even if it contradicts their owndesires),
y lavish extravagant praise on one another,y use metaphorical language rather than frank
termsy hide negative feelings or depressed spirits
beneath a pleasant demeanor,y
smile when things go wrong, avoid saying"no," and refrain from expressing anger orlosing their temper (Guthrie, 1968; Harper &Fullerton, 1994).
Hi
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
98/107
Hiyay
commonly translated as "shame,"y a feeling of"inferiority,
embarrassment, shyness, andalienation which is experienced as
acutely distressing" (Guthrie, 1968,p. 62).
y integrally related to the concept of"face" and a preoccupation withhow one appears in the eyes ofothers.
Hi
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
99/107
Hiya
y inculcated as a necessary part of achild's development and used as ameans to shape approved or
desired behaviors.
y Thus, an individual's capacity forappropriate behavior with authority
figures is a reflection of one's familyand upbringing and the fear of"losing face" (PAPEP, 1982).
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
100/107
utangna looby also is an integral aspect ofmaintaining group harmony andrelationships that require thebalancing of obligations anddebts
V. filipino values,cultural ideals,cont.
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
101/107
1.paggalang- respect for the individual
2. pagbabahala- concern for work and other people
3. pananagutan
- accountability for action taken
4. pagbabalikatan
- sharing the burden with others
5.pagbabayanihan -- cooperation with teamwork
6.pagmamalasakit
- solicituous concern for all
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
102/107
yNice to Know
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
103/107
THE FILIPINO FAMILY IN MODERN SOCIETY
y
The process of modernization is catching up with theFilipino familyy Change must occur if the family is to survive in a
changing world
The Size of the Familyy In spite offamily planning programs and education efforts
promotedy In spite of the economic difficulties of bringing up children,
y their birth is welcomed;o "Gifts from Godo sent to help their parents obtain a better life through filial love,
participation in income generating activities, insurance for their
parents old age, and sources of strengthening family bonds.y typical family : five children, although three to four (urban) and
four to five (rural) are considered by many parents as the idealfamily size
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
104/107
y Economic Pressures on the Family
y Effects ofPoverty on the Family
y The kinship system:
y The extended kinship Group:
Changing pattern:compadrazgo.yChanging roles of men and woman
y Double standard of morality
y Filipino Families must prepare
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
105/107
y Filipino Families must preparethemselves for:y
a serious reexamination of values andpractices.
y they will have to break with the past andadjust to the future. There is enough
evidence of the viability of the Filipino familyto make this adjustment and to ensure itssurvival.
yThe function of the family is being moreand more absorbed by other socialinstitutions such as the church and theschool, but the family will remain as a greatsource of emotional and psychologicalsatisfaction.
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
106/107
Filipino Family Values
People get strength and stability from their family. Assuch, many children have several godparents, the morethe better.
Concern for the extended family is seen in the
patronage provided to family members when they seekemployment.
It is common for members of the same family to workfor the same company, more likely than not. Jobs arehard to get and you can trust you relatives almost
always.
In fact, many collective bargaining agreements statethat preferential hiring will be given to family members.
-
8/4/2019 Print Aug 10 Fam. as a Unit-1
107/107