Family Health as Function
Most health care practitioners view family health from functional perspectives with the greatest focus on innate personal characteristics or personality traits or in terms of person-to-person interactions. The Family Health Model suggests that the functional interactions be viewed from bi-directional perspectives. Family functioning refers to the individual and cooperative processes used by persons to engage with one another and their embedded contextual systems over the life course. (See Figure 2 in the "Family Health as Structure" section.) These interactive processes can assist individuals, family sub-systems, and families as a whole to attain, sustain, maintain, and regain health. Individuals act independently, but also interact with one another through dyadic and triadic relationships to potentiate, mediate or negate family health. The core family processes of caregiving, cathexis, celebration, change, communication, connectedness, and coordination especially affect individual and family health over the life course.
Functional interactions or processes include such things as roles, relationships, power structures, values, beliefs, communication, decision-making, socialization, and coping. The functional dimension includes actions occurring within the family relevant to family health. The functional domain includes individual factors (e.g., values, perceptions, coping, spirituality, motivation, roles), family process factors (e.g., cohesiveness, resilience, individuation, boundaries), and member processes (e.g., communication, coordination, caregiving, control). Family interactions or processes are powerful socializing mechanisms through which family identity is constructed, de-constructed, and reconstructed.
While family identity has ties to the family context, it is primarily the dynamic ways developing members view the microsystem and collectively interpret memories and meanings of unique affiliations and attachments to persons, places, and things. Relationships between family identity and family health may not immediately be clear, but the ways members view themselves and family ultimately affect values, attitudes, and patterned health behaviors. Some things affecting family identity include: (a) new information and experiences with diverse environments, (b) maturation and change, and (c) the character of personal and environmental relationships over the life course. Family identity evolves and affects the well-being, processes of becoming, and health.
Families of origin values influence those of the family of procreation. Individual bonding or failure to bond into dyads and triads influences opportunities to share, refute, modify, and negotiate health beliefs, knowledge, and behaviors. Prior parental learning about health, illness, and disease is shared and influenced by developing family members. Beliefs, knowledge and behaviors are modified as members interact with one another and diverse contexts. These interactions result in fluid evolving family identify from which they socially construct a lived household experience of family health.
Social construction can be described as an up-to-date interpretation of all that has gone before. In other words, values, beliefs, attitudes, knowledge, traditions, and behaviors go through many incarnations as they are interpreted into the present family experience. Things such as effectiveness, potency, type, and length of relationships between family members and contextual systems have potential to affect health. Things such as bio-physical attributes; psychological, emotional, and intellectual functioning; social wholeness; inter-personal integrity; personal need fulfillment; tradition-keeping; spiritual attainment; and vocational direction all have functional and contextual aspects affiliated to health. Families develop unique health paradigms that are aligned with family identity.
A Family health paradigm defines the ways individuals, family sub-systems, and families interpret the meaningfulness of complex health factors and collectively engage in patterned health behaviors. As individual identify behaviors as meaningful, the likelihood of specific actions being repeated and incorporated into definitions and practices of individual and family health are increased. While diverse family groups have some commonalities in these definitions and practices, discrete differences occur based on family characteristics (e.g., education, culture, ethnicity, race, economics). Family health paradigms are most resilient when (a) beliefs and practices are viewed as meaningful by family members, (b) new knowledge is supported by values and beliefs, (c) the embedded context provides support for values and beliefs, and (d) family processes are congruent with the embedded contexts. The family health paradigm is the sum of beliefs, attitudes, values, knowledge, and behaviors of member interactions with one another and the embedded context.
Dr. Denham discusses the Functional Aspects of the Family Health Model
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Diabetes: A Family Matter
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