1. FAMILY SOCIAL SCIENCE THEORIESFAMILY SOCIAL SCIENCE THEORIES
USED IN FAMILY HEALTH CAREUSED IN FAMILY HEALTH CARE
BYBY
ARUN.MARUN.M

2. FAMILY SOCIAL SCIENCEFAMILY SOCIAL SCIENCE
THEORIESTHEORIES
Duvall’s family developmental theoryDuvall’s family developmental theory
Von Bertalanffy’s systems theory .Von Bertalanffy’s systems theory .
Friedman’s structural – functionalFriedman’s structural – functional
theory.theory.
Aguilera & Messick’s CrisisAguilera & Messick’s Crisis
intervention theory.intervention theory.

3. 1. DUVALL’S FAMILY DEVELOPMENTAL1. DUVALL’S FAMILY DEVELOPMENTAL
THEORYTHEORY
Major conceptsMajor concepts
VIII stages of family life cycleVIII stages of family life cycle ::
Beginning families (married couple withoutBeginning families (married couple without
children).children).
Early child bearing (oldest child is 30 months ofEarly child bearing (oldest child is 30 months of
age).age).
Families with preschoolers (oldest 2.5 – 6 yearsFamilies with preschoolers (oldest 2.5 – 6 years
of age).of age).
Families with School children (oldest of 6-13Families with School children (oldest of 6-13
year of age).year of age).

4. Families with teenagers (oldest 13 yearsFamilies with teenagers (oldest 13 years
– 20 years).– 20 years).
Launching centre families (young adult–Launching centre families (young adult–
time from first & last child leavingtime from first & last child leaving
home).home).
Middle aged families (Residing along toMiddle aged families (Residing along to
retirement).retirement).
Aging families (Retirement to death ofAging families (Retirement to death of
both spouses)both spouses)

5. VIII Basic TasksVIII Basic Tasks
1.Physical maintenance1.Physical maintenance

ClothingClothing

Sufficient nourishing foodSufficient nourishing food

Health careHealth care
2.Allocation of resources2.Allocation of resources

FinancesFinances

ShelterShelter

Personal timePersonal time

EnergyEnergy

RelationshipsRelationships

6. 3.Division of labour3.Division of labour
IncomeIncome
Managing household tasksManaging household tasks
Maintaining homeMaintaining home
Care for youngCare for young
Care for oldCare for old
4.Socialization of family members4.Socialization of family members
The family assumes responsibility for guidingThe family assumes responsibility for guiding
development of nature and acceptable patterns ofdevelopment of nature and acceptable patterns of
socially acceptable behaviour in eating, elimination,socially acceptable behaviour in eating, elimination,
sleeping, sexuality, aggression and intervention withsleeping, sexuality, aggression and intervention with
others.others.

7. 5.5. Reproduction, recruitment and release ofReproduction, recruitment and release of
family membersfamily members
Child bearing, adoption and rearing childrenChild bearing, adoption and rearing children
6.Maintenance of order6.Maintenance of order
Order is maintained by the communication ofOrder is maintained by the communication of
acceptable behaviour.acceptable behaviour.
Types of intensity of interaction, patterns ofTypes of intensity of interaction, patterns of
affection and sexual expression are sanctioned byaffection and sexual expression are sanctioned by
parental behaviour to ensure acceptance in society.parental behaviour to ensure acceptance in society.

8. 7.Placement of members in the larger7.Placement of members in the larger
societysociety

Family members establish roots in societyFamily members establish roots in society
through relationships in church, school,through relationships in church, school,
political and other organization.political and other organization.

This will protect the family members fromThis will protect the family members from
undesirable outside influences.undesirable outside influences.

May prohibit membership in objectionableMay prohibit membership in objectionable
groups.groups.

9. 8.Maintenance of motivation and morale8.Maintenance of motivation and morale::

Family members reward each other for theirFamily members reward each other for their
achievements and provide for an individualsachievements and provide for an individuals
needs of acceptance, encouragements andneeds of acceptance, encouragements and
affection.affection.

The family develops a philosophy of life andThe family develops a philosophy of life and
sense of family unity and loyalty, thereby enablingsense of family unity and loyalty, thereby enabling
members to adopt to both personal and familymembers to adopt to both personal and family
crisescrises..

11. UsesUses
1.1. Can be used an excellent guide for assessing,Can be used an excellent guide for assessing,
analyzing and planning around basic familyanalyzing and planning around basic family
tasks at a specific developmental stage.tasks at a specific developmental stage.
2. Applicable for nuclear families with growing2. Applicable for nuclear families with growing
children and families who are experiencingchildren and families who are experiencing
health related problems.health related problems.
3. The nurse must first determine the family’s3. The nurse must first determine the family’s
stage of development then examine the tasksstage of development then examine the tasks
that are appropriate for respective stage.that are appropriate for respective stage.

12. 2 . STRUCTURAL- FUNCTIONAL2 . STRUCTURAL- FUNCTIONAL
THEORY BY FRIEDMANTHEORY BY FRIEDMAN ..
Major conceptsMajor concepts
A. Structural componentsA. Structural components::
It examines the family composition,It examines the family composition,
how it is organized and how members relate tohow it is organized and how members relate to
one another in terms of their values,one another in terms of their values,
communication, network, role system andcommunication, network, role system and
power.power.

13. Value systemsValue systems::
 Developed by exposure to and experience withDeveloped by exposure to and experience with
influential groups and individuals such as parents,influential groups and individuals such as parents,
culture, religion and ethnic groups.culture, religion and ethnic groups.
Values leads to chosen behaviours, which areValues leads to chosen behaviours, which are
reinforced by others and expressed by familyreinforced by others and expressed by family
members behaviours, how they allocate resourcesmembers behaviours, how they allocate resources
and where time and energy are invested.and where time and energy are invested.
These values are related to health care, education,These values are related to health care, education,
independence, productivity and cleanlinessindependence, productivity and cleanliness..

14. Communication patterns:Communication patterns:
As family evolve the develop communicationAs family evolve the develop communication
patterns, ways of relating to each other.patterns, ways of relating to each other.
It may be functional or dysfunctionalIt may be functional or dysfunctional
It involves verbal and nonverbal behavioursIt involves verbal and nonverbal behaviours
including tone, intent and message.including tone, intent and message.

15. Role structureRole structure::
In a family, members adopt varying roles thatIn a family, members adopt varying roles that
may change over time.may change over time.
Role can be formal (or) informal and adopted orRole can be formal (or) informal and adopted or
assignedassigned
Are there conflicts which between roleAre there conflicts which between role
expectations of others & roles adopted byexpectations of others & roles adopted by
members.members.
Flexibility of family members in changing rolesFlexibility of family members in changing roles
as neededas needed

16. Power structure;Power structure;
It is determined by various influencing factors –It is determined by various influencing factors –
social, ethic class, family, communicationsocial, ethic class, family, communication
pattern, interpersonal and financial resources,pattern, interpersonal and financial resources,
family coalitions, and implementation tofamily coalitions, and implementation to
decision.decision.
To identity the family power structure considerTo identity the family power structure consider
who is really incharge of the family & why.who is really incharge of the family & why.
Who makes the major decision & rules?Who makes the major decision & rules?

17. Who is consulted about family plans /Who is consulted about family plans /
changes.changes.
The family power structure may beThe family power structure may be
AuthoritarianAuthoritarian
DemocraticDemocratic
PaternalisticPaternalistic
MaternalisticMaternalistic
It may very with the issue of handIt may very with the issue of hand..

18. ..B. Functional componentsB. Functional components::
Interactional outcomes resulting from the familyInteractional outcomes resulting from the family
organizational structure it includesorganizational structure it includes
Affective:Affective:
The social and emotional development needs ofThe social and emotional development needs of
family members must be recognized and met by familyfamily members must be recognized and met by family
members.members.
Reduce tensionReduce tension
Maintaining moraleMaintaining morale
Conveying esteemConveying esteem
Love for family membersLove for family members

19. Physical necessities and care:Physical necessities and care:
Adult family members Responsible forAdult family members Responsible for
providingproviding
FoodFood
ClothingClothing
ShelterShelter
Health careHealth care
Protection from dangerProtection from danger

20. EconomicEconomic
FinancialFinancial
SpaceSpace
Material goodsMaterial goods
Allocating resources to family membersAllocating resources to family members
Reproduction:Reproduction:
The adult family members assumeThe adult family members assume
responsibility for conception andresponsibility for conception and
contraceptioncontraception

21. Socialization and social placementSocialization and social placement
 The adult family members determine social rolesThe adult family members determine social roles
for children.for children.
 Instill family values and expectations.Instill family values and expectations.
 These things are accomplished by providing andThese things are accomplished by providing and
sharing experiences with others in the family,sharing experiences with others in the family,
schools, community organizations and religiousschools, community organizations and religious
groupgroup

22. Family copingFamily coping::
For family stability and growth, the membersFor family stability and growth, the members
need adaptive patterns and problem solvingneed adaptive patterns and problem solving
abilities to respond to demands andabilities to respond to demands and
expectations outside the family that createexpectations outside the family that create
changes within the familychanges within the family
The structural functional components andThe structural functional components and
parts all intimately interrelate and interactparts all intimately interrelate and interact
each component and part is affected by theeach component and part is affected by the
others.others.

23. Conceptual Frame work based on

24. UsesUses
This theory is used to assess forThis theory is used to assess for
modification of structure or function of themodification of structure or function of the
family.family.
It is used to assess the normal and healthIt is used to assess the normal and health
problems of family memberproblems of family member
For E.g.:For E.g.:
Head of the family met an accident.Head of the family met an accident.
Family with handicapped children.Family with handicapped children.
Head of the family suffering with paralysisHead of the family suffering with paralysis

25. Situational or Maturational EventsSituational or Maturational Events
Balancing factorsBalancing factors
RealisticRealistic ←← Perception of eventsPerception of events →→UnrealisticUnrealistic
AdequateAdequate ←← Situational supportsSituational supports →→ InadequateInadequate
EffectiveEffective ←← Coping mechanismCoping mechanism →→ IneffectiveIneffective
↓ ↓↓ ↓
Equilibrium DisequilibriumEquilibrium Disequilibrium
3. AGUILERA AND MESSICK’S3. AGUILERA AND MESSICK’S
CRISIS INTERVENTION MODELCRISIS INTERVENTION MODEL

26. Major conceptsMajor concepts::
Aguilera and Messick’s consider a stressfulAguilera and Messick’s consider a stressful
event or change in the individual’s life involving loss orevent or change in the individual’s life involving loss or
threat of loss, which disturbs the individual’sthreat of loss, which disturbs the individual’s
equilibrium.equilibrium.
Crises are categorized as maturational or situational.Crises are categorized as maturational or situational.
Maturational crisesMaturational crises – Are those events that occurs– Are those events that occurs
routinely, It include marriage, pregnancy, going awayroutinely, It include marriage, pregnancy, going away
to school and the death of a friend or spouse.to school and the death of a friend or spouse.
Situational crisesSituational crises – Are unexpected event such as failing– Are unexpected event such as failing
an examination. Losing a job, receiving a promotionan examination. Losing a job, receiving a promotion
and sustaining an injury.and sustaining an injury.

27. Aguilera and messick’s also identified threeAguilera and messick’s also identified three
balancing factors and these factors reducebalancing factors and these factors reduce
the risk of crises and help the individual tothe risk of crises and help the individual to
maintain equilibrium.maintain equilibrium.
The factors are as follows:The factors are as follows:
1.Realistic perception of the event1.Realistic perception of the event
2.Adequate situational support2.Adequate situational support
3.Adequate coping mechanism3.Adequate coping mechanism

28. 1. Realistic perception of the event1. Realistic perception of the event
The meaning of an individual attaches to an eventThe meaning of an individual attaches to an event
influences the perception.influences the perception.
Sometimes past experiences evoke feelingsSometimes past experiences evoke feelings
unrelated to the event.unrelated to the event.
These feelings may disort the individualsThese feelings may disort the individuals
perception and magnify the consequences of theperception and magnify the consequences of the
event.event.
When an individual attaches great significance toWhen an individual attaches great significance to
an event, a disorted perception is likely to occur.an event, a disorted perception is likely to occur.

29. The individual’s feelings and emotions may create anThe individual’s feelings and emotions may create an
unrealistic picture of the present and future, whichunrealistic picture of the present and future, which
hinders effective decision making and may lead tohinders effective decision making and may lead to
crisis.crisis.
Those with a realistic perception of the event are ableThose with a realistic perception of the event are able
to view the situation in perspective, which reducesto view the situation in perspective, which reduces
the chance that their emotions will could decisionthe chance that their emotions will could decision
making.making.
A realistic perception of the event may avert a crisis.A realistic perception of the event may avert a crisis.

30. The individual’s feelings and emotions mayThe individual’s feelings and emotions may
create unrealistic picture of the present andcreate unrealistic picture of the present and
future, which hinders effective decision makingfuture, which hinders effective decision making
and may lead to crisis.and may lead to crisis.
Those with a realistic perception of the eventThose with a realistic perception of the event
are able to view the situation in perspective,are able to view the situation in perspective,
which reduces the chance that their emotionswhich reduces the chance that their emotions
will could decision making.will could decision making.
A realistic perception of the event may avert aA realistic perception of the event may avert a
crisis.crisis.

31. 2. Adequate situational supports2. Adequate situational supports::
When faced with a loss or threat of loss,When faced with a loss or threat of loss,
individuals share the meaning of the eventindividuals share the meaning of the event
with significant others.with significant others.
Individuals rely an others to assist them inIndividuals rely an others to assist them in
times of need.times of need.
This sharing helps the individuals place theThis sharing helps the individuals place the
event in perspective.event in perspective.

32. Situational supports are considered adequateSituational supports are considered adequate
when individuals feel they can share thewhen individuals feel they can share the
concern with and receive support fromconcern with and receive support from
significant others.significant others.
Sometimes an individual cannot share theSometimes an individual cannot share the
concern with others for fear of losing respectconcern with others for fear of losing respect
or esteem.or esteem.
When individuals lack others with whom toWhen individuals lack others with whom to
share the events or concerns, their situationalshare the events or concerns, their situational
supports are inadequate. This may causesupports are inadequate. This may cause
disequilibrium and lead to crisis.disequilibrium and lead to crisis.

33. 3. Adequate coping mechanisms:3. Adequate coping mechanisms:
From life experiences, individuals learn a repertoireFrom life experiences, individuals learn a repertoire
of coping responses or pattern.of coping responses or pattern.
These patterns assist individuals in reduce tension,These patterns assist individuals in reduce tension,
adapting to daily stressful events and maintainingadapting to daily stressful events and maintaining
equilibrium.equilibrium.
Occasionally a stressful event occurs thatOccasionally a stressful event occurs that
overwhelms the individual.overwhelms the individual.
There may be a unfamiliar situation.There may be a unfamiliar situation.
When usual coping responses are ineffective,When usual coping responses are ineffective,
disequilibrium and crisis may occur.disequilibrium and crisis may occur.
Aguilera and messick’s crisis intervention modelAguilera and messick’s crisis intervention model
describer, three balancing factors. Each factor mustdescriber, three balancing factors. Each factor must
be adequately present to maintain equilibrium andbe adequately present to maintain equilibrium and
avoid crisis.avoid crisis.

34. UsesUses
This model is used for individuals or familiesThis model is used for individuals or families
experiencing situational or maturational crisesexperiencing situational or maturational crises
1. Pregnancy & child bearing strains1. Pregnancy & child bearing strains
2. Illness and Family ‘Care’ strains2. Illness and Family ‘Care’ strains
3. Marital strains3. Marital strains
4. Family legal violations4. Family legal violations
5. Intra family strains5. Intra family strains
6.Work family transitions and strains6.Work family transitions and strains
7. Transitions ‘in’ & ‘out’7. Transitions ‘in’ & ‘out’
8. Losses8. Losses

35. 4. VON BERTALANFFY SYSTEM THEORY4. VON BERTALANFFY SYSTEM THEORY
Major conceptsMajor concepts
System:System:
It consists of a set of interacting components within aIt consists of a set of interacting components within a
boundary that filters the type and rate of exchange withboundary that filters the type and rate of exchange with
the environment. It composed of both structural andthe environment. It composed of both structural and
functional componentsfunctional components..
Structural componentStructural component –– refers to the arrangements of therefers to the arrangements of the
parts at a given time.parts at a given time.
Functional componentFunctional component –– is the process of continuousis the process of continuous
change in the system as matter, energy and informationchange in the system as matter, energy and information
are exchange with the environmentare exchange with the environment..

36. Family systems are greater than differentFamily systems are greater than different
from the sum of their parts.from the sum of their parts.
There are hierarchies within family systemThere are hierarchies within family system
and between subsystemsand between subsystems
(i.e Mother and Child) and the family and(i.e Mother and Child) and the family and
community.community.
There are boundaries in the family systemThere are boundaries in the family system
and they can be open, closed, or random.and they can be open, closed, or random.
Family systems increase in complexity overFamily systems increase in complexity over
time, to allow greater adaptability, tolerancetime, to allow greater adaptability, tolerance
to change, and growth by differentiation.to change, and growth by differentiation.

37. Family systems change constantly in responseFamily systems change constantly in response
to stresses and strains from within as well asto stresses and strains from within as well as
from outside environments.from outside environments.
Change in one part of family systems affects theChange in one part of family systems affects the
total system.total system.
Causality is modified by feedback. Therefore,Causality is modified by feedback. Therefore,
causality never exists in the real worldcausality never exists in the real world..

38. Family systems are an organized whole, withFamily systems are an organized whole, with
individuals in the family being interdependentindividuals in the family being interdependent
and interactive.and interactive.
Family systems patters are circular rather thanFamily systems patters are circular rather than
liner, therefore change must be directedliner, therefore change must be directed
toward the cycle.toward the cycle.
Family systems have homeostasis features toFamily systems have homeostasis features to
maintain stable patterns, which can bemaintain stable patterns, which can be
adaptive or maladaptiveadaptive or maladaptive..

39. Input Thruput
process
Output
Feedback
Suprasystem
CONCEPTUAL FRAMEWORK BASED ON VON
BERTALANFFY SYSTEM THEORY

40. UsesUses
This theory is used to educate the familiesThis theory is used to educate the families
relates to health problemsrelates to health problems
For example:For example:
Prevention of diarrhoeal diseases amongPrevention of diarrhoeal diseases among
children.children.
Prevention of sexually transmitted diseases.Prevention of sexually transmitted diseases.
Prevention of nutritional anaemia, diabetesPrevention of nutritional anaemia, diabetes
and hypertension.and hypertension.
It also used to educate the community peopleIt also used to educate the community people
regarding nutrition, personal hygiene andregarding nutrition, personal hygiene and
immunizationimmunization..

41. This theory encourages nurses to see clientsThis theory encourages nurses to see clients
as participating members of the family.as participating members of the family.
Community health nurse use this theory toCommunity health nurse use this theory to
assess the effects of illness.assess the effects of illness.
It emphasis on the whole rather than onIt emphasis on the whole rather than on
individuals.individuals.