Topic: Family process

Subject: Community Health Nursing-II (For Diploma and B.Sc in Nursing)

Concept of family process 

Family process is a systematic approach to providing nursing care using assessment, diagnosis, outcome, identification, planning, implementation & evaluation. In order to provide effective nursing care through family process, community health nurses need to understand family’s roles, values, communication power & coping strategies.


  1. Inability of family system to meet needs of members carries out family functions or maintains communications for mutual growth & maturation. (Handbook of public & community health nursing practice p-358)
  2. Hanson describes family process as “the ongoing interaction between family members through which they accomplish their instrumental & expressive tasks.”

Defining characteristics:

  1. Inability of family members to each other for mutual growth & maturation.
  2. Failure to send & receive clear messages.
  3. Poorly communicated family rules, rituals, symbols, unexamined myths.
  4. Unhealthy family decision –making processes.
  5. Inability of family members to express & accept wide range of feelings.
  6. Inability to accept& receive help.
  7. Does not demonstrate respect for individuality & autonomy of members.
  8. Rigidity in functions &roles.
  9. Fails to accomplish current family developmental tasks.
  10. Inappropriate boundary maintenance.
  11. Inability to adapt to change.
  12. Inability to deal with traumatic or crisis experience constructively.
  13. Parents do not demonstrate respect for each other’s views on child- rearing practices.
  14. Inappropriate level & direction of energy.
  15. Inability to meet needs of members (Physical, security, emotional, spiritual).
  16. Family un-involved in community activities.(Hand book-358) .

Roles of family:

  1. Family members working outside the home, types of work & satisfaction with it.
  2. Household roles & responsibilities & how tasks are distributed.
  3. Ways child –rearing responsibilities are shared.
  4. Major decision maker & methods of decision making.
  5. Family member’s satisfaction with roles. The way tasks are divided & the way decisions are made.
  6. In the traditional nuclear family roles frequently are characterized as formal or informal.


Formal roles consists of a limited number of positions the family that are explicitly defined such as wife- mother, husband- father, son-brother & daughter –sister. There are certain role expectations with each of the formal .Such as wage earner, homemaker, financial manager, and cook& so on these roles are usually given to the person with the skills to carry them out. Formal role are explicit roles that each family role structure contains.


 Informal roles are often not as parent & usually meet the emotional needs of individuals or maintain the family’s equilibrium. Informal roles have different requirement that are less likely to be based age or sex & more likely to be based on the personality attributes of individual members.

Nursing roles for families:

It may be helpful in assisting families to more successfully through life stages, thereby reducing the risk for illness or crisis.

A. Couple:

  1. Counselor or sexual & role adjustment.
  2. Teacher & counselor in family planning.
  3. Teacher of parenting skills.
  4. Facilitator in interpersonal relationship.

B. Child bearing family:

  1. Monitor of personal care & referral for problems during pregnancy.
  2. Counselor on prenatal maternal habits.
  3. Counselor on prenatal nutrition.
  4. Counselor on breastfeeding.
  5. Co-coordinator with pediatric services.
  6. Supervisor of immunizations.

C. Family with pre-school & school –age children:

  1. Monitor of early childhood development.
  2. Counselor on nutrition & exercise
  3. Teacher in problem solving issues regarding health habits.
  4. Teacher of mental care hygiene.
  5. Facilitator interpersonal relationships.

D. Family with adolescents:

  1. Teacher of risk factors of health.
  2. Teacher in problem –solving issues regarding alcohol, smoking, diet & exercise.
  3. Direct supporter, counselor or referral to mental health resources.
  4. Counselor or family- planning.
  5. Referral for sexually transmittable disease.

E. Family with young or middle –age adults:

  1. Participants in community organizations on disease control habits.
  2. Teacher in problem –solving issues regarding lifestyle & habits.
  3. Participant in community organizations for environmental control.
  4. Screen for hypertension, Pap smear, breast examination, cancer signs, mental health & dental care.
  5. Counselor on menopausal transition.

F. Family with older adults:

  1. Facilitator in interpersonal relationship among family member.
  2. Refer for work & social activity, nutritional programs, homemakers, services, & nursing home.
  3. Monitor of exercise nutrition, preventive service & medications.
  4. Counselor on safety in the home.
  5. Supervisor of immunization.


Tasmin Tamanna ,

Ex Lecturer , TMMC,NU