Key Historical Developments

Abstract

This paper will show the changes in the family dynamics and role of the health care provider in taking care of the patient and including the family in the patients care. The load that is placed on the ever changing family is increasing more than at any other time in the history of our country. However, the importance of including the family in the patients care cannot be underestimated.

Family Health Nursing

The traditional American family has been a mother and a father with siblings in the same household. Today, the changes in the family have evolved into more complex families, with different cultures, races and needs. Different politicians' have defined families and their importance, according to their political careers and have made agenda changes that they feel address some of the problems with the family. For instance, President Clinton's emphasis was on responsible parenting for non-resident parents, where as President Bush has chosen to pursue the definition of marriage as a definition for families. A good definition of family retrieved from www.stats.indiana.edu/web/definitions/data_definitions.htm

"A family consists of a householder and one or more other persons living in the same household who are related to the householder by birth, marriage, or adoption. All persons in a household who are related to the householder are regarded as members of his or her family. Families are classified by type as either a "married-couple family" or "other family" according to the sex of the householder and the presence of relatives."

America has moved away from the traditional families partly because of the increase of geographic and economic mobility, thus leaving the traditional family fragmented. Information, that has been normally been taught in the home, is now being taught in schools, from peer groups, and the mass media. This phenomenon has given way to conflicting information, placing information from the parent against other factors.

Today, the definition of family is very wide and complex and ever changing in America. There are homosexual partners raising children. There are blended families, where two single parents with children merge into one family. There are many multigenerational families, where the grand parents of one of the parents and their children are living together. Also, included in all of the families are the multicultural variations that may exist. Included in the strange family dynamic is the "street families", this is a phenomena is attributed to runaway street children. Street families are made up of "friends" with like circumstances, living together and using each other for support, these people usually don't have an address. Lastly the most common growing group is the single parent family, with one parent raising one or more children. According to Peters (2004), "the dramatic increase over the last three decades in the number of children living in single parent households (or not living with both biological parents) has caused concern among researchers and policy makers alike."

It is important for nurses to understand the dynamics of the family that they are giving care to. Some of the most important areas of nursing where the dynamics of the family comes into play are in the area of hospice and home health, also children with disabilities and the mentally challenged. One of the main goals in these areas of nursing practice is to include the family in the plan of care of the patient. Furthermore, the family is one with the patient in these instances.

When caring for patients, one must consider the fact of the underlying culture and language. According to Whaley and Wong (1989), "Nurses continually encounter beliefs and practices that may facilitate or impede nursing interventions, including attitudes toward family planning, food habits, and folkways that are firmly entrenched in the culture." Religious beliefs also may play a role in the family which may alter care. One example of considering religion in