The Friedman Family Model - Essay Example

? The Friedman Family Assessment Model The Friedman Family Assessment Model Family health requires nursing interventions that influence the family assessment by health care providers. Friedman (2003) developed an assessment model that helps nurses collect family information necessary for determining family health. Nurses use open-ended questions to conduct thorough assessments of the family health history, its ability to grow, care for itself, and its contribution to the society. These questions give the interviewee the opportunity to explain and expand their answers. The family represents the primary social group and influences or is influenced by other institutions and people in the society. Each family has culturally related health beliefs and values that influence the family structure, health-seeking behavior, and relationships with health providers. These factors affect the state of both maternal and child health. The family is viewed as a system within a larger social framework, and each family belonging to this framework employs a different approach to health care provision. Every family acts as a support system for its members and transmits fundamental elements of culture to every member. Some of these beliefs and structures may provide challenges or barriers to types of health provisions and treatments (Spector, 2004). Different types of families exist in modern society, and every member has a predefined role primarily determined by cultural beliefs. Family types include nuclear, extended, binuclear, single-parent, reconstituted, and homosexual families. Friedman (2003) describes the following family functions: reproductive, pertaining to socialization, affective, economic, and health care functions. Health care functions deal with the provision of food, shelter, clothing, and health care. A family genogram provides vital information about a family and can be utilized in a nursing care plan (Spector, 2004). It informs us about the relationships of family members for the previous three generations. By using the FFAM, nurses can address health concerns specific to an individual, which make him/her take action regarding their own health issues. The wide diversity of families within a given society leads nursing practitioners to develop assessments that also address psychological issues related to each family. The Friedman Family Assessment Model outlines six assessment categories, but the two most relevant to the Morrison family are family structure and family functions (Friedman, Bowden, & Jones, 2003). When the parents die, the children are left to take care of themselves, with some assistance from neighbors such as Mrs. Stanovich. Prior to the parent’s death, Mr. Morrison had received some education that had enabled him to get employed at a local bank. He was the head of the family and took care of his mother, brothers, and sisters. After the death of their parents, Mart and Luke have taken over as the heads of the family and have had to provide for their younger sisters. Luke gives up his teaching training to take care of his sisters. He had hardly noticed the existence of Bo when their parents were alive, but after their demise he takes over the role of her father. In a family where siblings have a large age difference, there is a minimum interaction between them according to Friedman et al. (2003). The elder children feel threatened by the birth of other children and show rivalry towards the newborns. Matt is also forced to work for the Pye family, their neighbors, in order to supplement the family income (Lawson, 2002). Matt acts as an idol to Kate due to his academic excellence, but when he makes Marie pregnant and is unable to join the university, Kate considers him to be a loser. Older boys in a family serve as stimulators or models (Friedman, Bowden, & Jones, 2003). There are several explosions of anger and frustration between Matt and Luke, which make Kate be withdrawn. This makes her unable to communicate with Matt despite their tight bond immediately after the death of their parents. Older children build a relationship that provides the younger ones with opportunities for behavior modeling that cannot be provided by parents or teachers. Elder siblings become responsible for the majority of initiations for the younger children (Friedman, Bowden, & Jones, 2003). Bo is a toddler, and there are little expectations from her. She spends most of her time banging saucepan lids and stamping on spiders. The Morrison family has a motto “thou shalt not emote” that governs their beliefs and values. This enables them to find all possible means of survival and make sacrifices in order to help the family get the basic needs and funds for the young sisters to receive education. The family functions category is also very significant within the Morrison family. The father was the main provider for both the nuclear and extended families. Luke and Matt take over the role of family providers after the death of their parents. The elder brothers make sure their younger sisters have the most important things such as shelter and healthy meals. Luke regularly changes and cleans Bo’s nappies and makes sure Kate has a school lunch. This is in line with the family function of providing protection for its members. Parents and older children are responsible for protecting the younger ones in every family (Friedman, Bowden, & Jones, 2003). Their neighbors help them get meals by bringing gifts such as honey, pies, pickles, birthday cakes, and perch to their doorstep. Matt is Kate’s role model forming a close alliance until he impregnates Marie and is unable to join the college. Luke acts as a father to Bo, and they also bond as a unit. Kate withdraws from Matt after he drops out of school and views him as a loser. This affects their relationship, and she is ashamed even of attending Simon’s birthday party in the company of Daniel (Lawson, 2002). Matt is also responsible for meeting the needs of Marie and Simon even after the falling out with Kate. Kate completes her education, becomes a professor, and falls in love with a fellow professor, Daniel. Due to the lower social class of Crow Lake residents, she is ashamed of bringing him to Simon’s birthday party. Due to her repressed feelings of grief and guilt, she is unable to fall in love, and Daniel is her first lover. The repression serves as a survival mechanism to help her cope with her parents’ death and the bitter relationship with Matt. The weather at Crow Lake is very cold during winter and very hot during the summer. This limits the amount of time children can spend playing during winter, and the family spends most of the time indoors. The ponds also provide a bonding site for Matt and Kate, but when the mating season is over, they visit them less often. The short version of the FFAM can be used to collect data regarding the Morrison family. A nurse can utilize this model and the novel to collect information about the family structure and functions. Family structure Communication Patterns Communication is crucial for family cohesion, and a healthy family has mutual and peaceful communication channels. This does not involve violence and provides a platform for discussion before making conclusions. Luke hardly notices the existence of Bo before the death of their parents but becomes a father to her after their death. Matt and Kate also have a tight bond since they spend most of the time together at the ponds and he carries her on his shoulders as they walk towards the ponds. Dysfunctional communication is experienced between Matt and Luke, who often quarrel and fight. This can be attributed to the sudden responsibilities and expectations placed upon them by the death of their parents. The relationship between Kate and Matt breaks up when he gives up his education due to Marie’s pregnancy. Kate views him as a failure and is ashamed of coming back for Simon’s birthday. They keep away from each other, and Kate becomes withdrawn throughout her school life. Power structure Mr. Morrison is the overall head of the family, but after his death Luke and Matt become the heads of the family. The older children, especially sons, have more power conferred on them and have to take care of the younger ones (Friedman, Bowden, & Jones, 2003). They make decisions within the family, and they sometimes fight due to misunderstanding. Kate and Bo are not part of the decision-making due to their tender age, but the elder brothers ensure that their basic needs are taken care of. Decision made by the elder brothers to quit their education does not meet with severe resistance but affects the family bond. Role structure The father has the role of providing for the family and other dependants such as his brothers and sisters. When the parents pass on, the older children take over the role of providing for the younger children and taking care of them. Luke and Matt have to work in the neighboring farms in order to ensure Kate and Bo have the most important things. Luke becomes a father to Bo and Matt becomes a role model to Kate due to his academic excellence (Lawson, 2002). Kate also has to work at the neighbor’s flower garden to supplement the income generated by her elder brothers. When Marie becomes pregnant, Matt has to quit his education in order to take care of her and the child. Family values Morrison’s family values education. The parents have to struggle so that the children complete school. When Matt receives a scholarship, his parents travel to the city to buy him a suitcase. Their grandmother believed in learning to such an extent that she fixed a book on her spinning wheel so she might read while spinning. Following the death of their parents, Luke and Matt have to work so that their sisters can obtain the necessary education. Kate works hard in school until she becomes a professor at a university in Toronto. The family also has a motto to suppress emotions, which makes Kate believe she cannot fall in love. This motto helped her overcome excess grief after the demise of her parents. The land in Crow Lake is infertile, and the area experiences hostile climate. The Morrison family believes farming is a bitter burden and education is the only delivery. Family Functions Affective function Luke and Matt have to work on the farms to ensure the family has a healthy meal. The kitchen is in disorder, but Luke ensures Kate gets food for lunch in school. Matt and Kate spend time lying by the ponds, and he teaches her about different creatures living in them. This forms her interest in living things and until she becomes a professor in zoology. They spend most of the time by the pond and woods. Luke and Bo also have a mutual closeness since he takes over the father figure in her life, and he ensures she is clean by washing and changing her nappies regularly. The family struggles to live together instead of separating to live with different relatives. Families have a status in the society, and each unit has to struggle to ensure its survival. Socialization function It is the responsibility of the parents to take care of the children, and the older children take up that responsibility when their parents pass away. Families have to educate or socialize their young ones and transfer the culture and religion (Spector, 2004). The Morrison family seems unfit for child rearing, but they struggle to remain together, and the elder brothers struggle to provide for their younger sisters. Crow Lake is a low class residential place and Kate finds it difficult to bring Daniel when she is invited for Simon’s birthday. Matt values the presence of children in the society and has to quit school after impregnating Marie in order to take care of her and the child. Luke also takes up the responsibility of taking care of Bo as her father. The ponds provide an adequate environment for Kate and Matt to play, relax, and learn and form part of the most important childhood memories (Lawson, 2002). Health care function Luke has to ensure the family has a healthy meal every day by working on the farms. The neighbors also supplement their healthy meals by giving them honey, peach, hams, and pickles. Katie becomes emotionally disturbed by the events experienced by the family and believes she cannot fall in love with any man. The sour relationship between her and Matt also fills her with guilt, and she is uneasy about meeting him again. The above assessment makes communication patterns, affective functions, and social functions the most prioritized nursing diagnoses. In every family, communication is the most important thing for peaceful coexistence among the members. Different communication patterns such as functional and dysfunctional communication exist in the family. Bo is too young to have a verbal communication with the rest, but the fatherly figure taken up by Luke is vital for family bonding. When the bond between Kate and Matt breaks up, she continues visiting the ponds alone, but the feeling is different. This makes it hard to communicate with him, and she is filled with guilt, which she suppresses throughout her education life. Bo is also very frightened when she finds Matt and Luke fighting, and she is even unable to move. Unhealthy communication among family members can have adverse psychological effects on some of them, especially the young ones. When Kate, Matt, and Daniel revisit the ponds, she feels some relief that makes her realize breaking up with Matt was the worst tragedy to happen in the family. A nursing practitioner can help improve family health by improving the effective communication within a family. Affective functions are necessary in a family since they determine the closeness or separateness between family members. Family bonds have different impacts on the health of family members and determine the psychological wellbeing of individual members. Kate develops a lot of grief when her parents die in a car accident. Kate regards Matt as the best teacher since he teaches her about water creatures and develops a passion for zoology. In the university, she tries to create a similar bond but is unable to have the same influence on her students. Due to her higher education, she neglects Matt, and this fills her with guilt. Suppressed grief and guilt make it hard for Kate to have a relationship with men, and she is doubtful about her relationship with Daniel (Lawson, 2002). The elder brothers also have to take care of their younger sisters so that the family can remain together. This involves a lot of sacrifice for Luke and Matt, who drop out of college to look after Bo and Kate. Affective functions in a family ensure the family members meet the basic human needs. Social functions are the responsibilities expected from the elder members of the family regarding child rearing (Friedman, Bowden, & Jones, 2003). Parents are mostly expected to take care of the children, and this role is passed over to the elder children in the absence of the parents. The community can also assist an orphaned family in child rearing. Morrison’s neighbors bring fruits and gifts to the family to ensure that they have access to a healthy meal. Luke has to quit college and look for a job so that the family can have adequate and healthy meals. Matt also has to quit school and look for a job in order to take care of Marie and Simon. The devotion and sacrifice by Luke and Matt ensures the family remains together instead of separating to live with different relatives. The difference in the social class affects Kate when she is invited for Simon’s birthday. Crow Lake is a poor rural location where Matt lives with his family, and Kate is an established professor at a university in Toronto. The social differences make her reluctant to invite Daniel so that Matt does not feel intimidated by her educational achievements. Both Matt and Luke value the children and have to do everything within their means in order to meet their needs. The Friedman Family Assessment Model is a simple tool that can be applied to different categories of families. It helps nurses and family members to work together to ensure the successful adaptation of health responses by family members. The model can be used to identify major strengths and weaknesses within a family that influence the health of their members. The collected data helps nurses determine the best response to improve the family health. The Morrison family can also be subjected to this model to determine the effect of the death of their parents on their family. The elder brothers take over the responsibility of providing for the younger sisters and work hard to ensure they have the basic requirements and education. These family bonds are necessary for improving the family’s health and eliminate psychological disturbances. Different family beliefs and expected roles of family members determine the existence of the family in the absence of their parents. References Friedman, M., Bowden, V., & Jones, E. (2003). Family nursing: Research, theory and practice (5th ed.). Stamford, CT: Appleton & Lange.  Lawson, M. (2002). Crow Lake. Toronto: Vintage Canada. Spector, R. (2004). Cultural diversity in health and illness (6th ed). Upper Saddle River: Prentice Hall Health. Read More