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Chapter 5

Family Health Nursing Care

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INTRODUCTION

  • Family health care services are an important part of services provided to community.
  • Family is the central point of social structure and considered as main unit of society and nation.
  • To enhance, the wellbeing of community or nation, it is important to improve health status of the family.

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CONCEPT OF FAMILY HEALTH NURSING CARE

  • The family is the basic unit of any health system. Without family care services, the goal of health services cannot be achieved.
  • Family health services act as a problem-solving process in which the family health nurse provides services regardless of the families' socioeconomic status.
  • Comprehensive health care.

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Definitions

Family

The basic unit in society traditionally consisting of two parents rearing their children.

Family is a group of two or more persons related by birth, marriage adoption and residing together in a household.

—US Bureau

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Family Health

It is defined as possession of the ability to continue fulfilling the family needs and achieve the family developmental tasks in interaction with social, economic, political and health system.

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Family Health Care

It is defined as the continuing, comprehensive care provided to the family and to all the members of the family.

Family Health Nursing

It is a nursing aspect of organized family health care services which are directed or focused on family as the unit care with health as the goal.

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GOALS OF FAMILY HEALTH CARE

  • To reduce maternal, infant and childhood mortality and morbidity rate.
  • To encourage for family planning to space out children and ensure planned parenthood.
  • To improve nutritional status of all members of family.

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OBJECTIVES OF FAMILY HEALTH CARE

  • To assess health needs and problems of family members.
  • To ensure family’s understanding and acceptance toward health problems of the family.
  • To identify various factors (social, cultural, economic, lifestyle) that affect health of family.
  • To provide need-based comprehensive care to the family.

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PRINCIPLES OF FAMILY HEALTH CARE

  • Establish good professional relationship with the family members.
  • Proper health education and guidance should be provided to the family.
  • Collect information about family norms such as customs and religion.
  • Health services should be provided without any discrimination of gender, age, religion, income, etc.

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FAMILY AS A UNIT OF HEALTH CARE SERVICES

  • Family is considered as basic unit of health care services on the basis of the following points:
  • Family is a vital social, biological and cultural unit.
  • Family is the fundamental unit of any nation.
  • Illness of any one family member affects the other family members health as all the family members united by the ties of marriage, blood, adoption.
  • Social, cultural health beliefs majorly impact the health status of family members.

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FAMILY HEALTH CARE SERVICES

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Birth control methods

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PRINCIPLES OF FAMILY HEALTH CARE SERVICES

  • Community health nurse should follow these principles while implementing care to a family:
  • Before implementing family health services, obtain information regarding the families residing in area.
  • Provide health services which are need based only.
  • These services should have a clearly defined goal.
  • Involve all the members of the family in the planning and implementation of services.
  • Services should be equally distributed, although priority should be given to high risk.

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FAMILY HEALTH CARE PLAN/NURSING PROCESS

It refers to the series of steps directed toward meeting the health needs and solving problems of the family members. It requires continuous, systematic, need-based care to achieve desired goal.

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Aim

To provide systematic methodology for nursing practice in the family.

Characteristics of Family Health Nursing Process

  • Family centered care and goal directed.
  • Systematic and organized family health care approach.
  • Interpersonal and based on nurse–client and family member relationship.
  • Ongoing and dynamic process.
  • Applicable to all individual, family and community.

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Family health nursing care plan

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Phases of family health nursing process

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MATERNAL AND CHILD HEALTH SERVICES

Maternal and child health refers to the promotive, preventive, curative and rehabilitative health care for mother and children. It includes maternal health, child health, family planning, school health, adolescents and health aspects of children.

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Aims

  • Reduction in maternal and infant mortality rate.
  • Promotion of reproductive health.
  • Promotion of child and adolescent development (physical and psychological) in the family.

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Indicators of Maternal and Child Health

Maternal and child health can be measured by the following indicators:

  • Maternal mortality rate
  • Infant mortality rate
  • Neonatal mortality rate
  • Perinatal mortality rate
  • Under-five mortality rate
  • Child survival rate

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Organizational Activities of Maternal Child Health Services

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Facilitating Complete Checkup of Child and Mother

Components are as follow:

  • Antenatal care
  • Intranatal care
  • Postnatal care
  • Neonatal care

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Dealing with the Health Problems of Mothers and Children

The health problems of mother and children should be tackle on time to prevent the complications.

The problems may include malnutrition, infertility, and the consequences of unregulated fertility.

  • Causes of infertility can be:
    • Psychological problems
    • Malnutrition
    • Excessive use of alcohol
    • Hormonal imbalance

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Management

  • Identify the cause
  • Investigation of the cause
  • Provide psychological support
  • Proper treatment and referral if needed.

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Integrated Management of Neonatal and Childhood Illness (IMNCI)

Its aims to prevent and manage five major childhood diseases i.e., ARI, diaarhea, measles, malaria and malnutrition. The main focus is on preventive, promotive and curative aspects.

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Objectives

  • To reduce the number of illness
  • To improve the growth and development of children.
  • To reduce the mortality rate in the children.

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Components

  • To enhance the skill of health care workers.
  • To enhance the health care infrastructure.
  • Involve the community.

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Principles

  • All the sick young infants upto 2 months of age must be assessed for possible bacterial infection.
  • All the sick children from the age of 2 months upto 5 years must be examined for dangerous signs which indicates immediate admission to hospital.
  • All the sick children from the age of 2 months upto 5 years must be routinely assessed for nutritional and immunization status, feeding and other problems.

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Health Education to Parents on Child Care

  • Education of parents should start immediately after the conception. Psychological support should be given to the couple.
  • After the delivery education should be given to the mother regarding the breast feeding.
  • Education can be given to the parents regarding Kangaroo Mother Care (KMC).
  • Parents should be educated regarding the importance of immunization of the child on the proper time.

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FAMILY WELFARE SERVICES

Family Welfare Program is implemented by the Center and State Government and they provide services according to rural and urban area setup.

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Family Welfare Services in Rural Areas

  • Strengthening of physical facilities and manpower.
  • Provision of essential equipment and drugs as per the standards in rural setup.
  • Modification and conversion of subcenters into Primary Health Centers (PHCs).
  • Training of health workers.
  • Strengthening of immunization program.

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Family Welfare Services in Urban Areas

  • The postpartum programs
  • Pap smear test facility program
  • Sterilization bed scheme
  • Urban revamping scheme
  • Urban family welfare centers

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ROLES OF COMMUNITY HEALTH NURSE IN FAMILY HEALTH SERVICE

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FUNCTIONS OF COMMUNITY HEALTH NURSE IN COMMUNITY HEALTH SERVICES

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QUALITIES OF FAMILY HEALTH NURSE

  • Family-centred approach
  • Holistic approach (wellness)
  • Do not judge during the approach
  • Self-awareness
  • Accept different values and beliefs
  • Able to work in adverse conditions

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FAMILY HEALTH RECORDS

It refers to the forms on which information about an individual or family is recorded. These are the records of diseases and health conditions of family or community.

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Advantages

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Principles of Records

  • Records should be accurate and factual.
  • It should be written clearly and legibly in such a manner that the text cannot be erased.
  • Clear identity of the patient should be mentioned in the records.
  • Each side of the page should be numbered.
  • Be signed along with each entry.
  • Records should all the include subjective information

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Common Records Maintained in Health Centers

  • Family folder
  • Mother care register
  • Child care register
  • Vital events records
  • Minor ailments treatment register
  • Referral register
  • MCH card
  • Antenatal/Postnatal records
  • Infant record
  • Preschool child record
  • Consumable stock register
  • Family records
  • Individual health records

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