50 CHAPTER 2: ASSESSMENT IN FAMILY HEALTH NURSING PRACTICE Araceli S. Nlaglay a FAMILY PERSPECTIVE IN COMMUNITY HEALTH NURSING PRACTICE Communi ty health nurse>s io 111::iny purls of the world lwve been using the fo1Tiily persps. >etivp 111 a<ldrl'!'. " individual clients· he;ilth nccdt. or prvblcms and enhance family functjoning for grriwth and dc,·clo1m1e11t. coping-with illness or los;.. m1Jbi 1 i7. ing r~"VUn. 'e$ :ind mainrnin ing an en,;ronmcnt that support wellr1e,:s and health. Even in the western,,·nrld. lik, the USA. whtre managed care s~·stcm is l Jic: stn. 1ct,. ire for patient cnrt' d,lin--ry (such a. bcallh rrrninlt:mmce organi7. ations and i11dcpe11 dcnt prnctjce a.-osociations ) renewc,d focus on the family is emerging ::ts institution-b:ised health =re js sl1-,'llj Jjcant ly decre;:i. si ng and home care is r"1pidly gro";ng. ·111ere an sc-..:?ral reasons for focusin~ on the family in community health nursing prat-ti. ". <. '. ba,-c,d,rn it" characteristic as an npen :md developing system of interacr-ing pen:on:ihties. with a i,,,n1cture and process en:1dcd i11 rcla1it1nsh ips ;imnng inclividtwl mt·mber-;. regul:lte<l b\' re!i,:mrce-; and stressors, and cxic;ting \,;thin tlw larger oonrnntnity (1'1aurer ;. i;,d !'imith 2005, p. 275). The family prr-ven L-;. 11,enerate.,;, LOlc11-atc:< and corn'rt. <s h<'alth pn>hlt:c11s umong i Ls membe rs (Fn:em:. 111 and Heinrich 1981, p. 81'1). It is a pow"rful influence on values. beliefs and practices on hc;ilth llnc1 illnes:-. For txample. based on studie.., on diabcte!i (C:1mphell 1987), pw11 <liab. :tic contt·,,I ~ a_,.,~·. iatt:tl wi Ll1 chronic fan;ilv contlil'l :mcl poor org~ini;,,atiull. but the studie~ dj:s-a Rr~'t" a.,, t<J wliet J11:r tlt~c families h:. ive low l)r high cohe:-ion. Ouhamel (198-:-) t;>x.,mined fr1mih· interactio n,md livpcrtern~ion and generated :1 significant hyp<1thcsi~ that hypcrtc. nshc 11alicnl S Sllflpt:ess anger and hostility. ·n,c s11pprc'ssion of th~e foelinp, l~d. s to unrc. snlve:c. l 1110:rital cnnfllct:, thal rccipr,,cally reinfu1-c-<' I he suppre;;.-:ion of iin~cr anc. l ho<:tilitv. Ikea use the fnmilyoper;1 Les as a system. dysfum:tion in;, mt;>ml>er na,w lw,elat<·d tc, disturhn nct. : in thf. ' \,·holl' f:. 1111ily, Family i11fon11;1 tion and part. ner<. hip ~ffe tt M·<l in trat·king d11w11 the occurrence and incidence of discnses, criri,:;ll in pn. :,\. '11ting thc,;prcad afc,m1 11111nic.,blc:,:w,e. <: (J\l:1111·er& Smith. p. 274). ·n1e family is a critic,--u rc Foun·c in maintaining health and delivery ofl11. :altl1 care because il is tlw loc11s,,f dcci. sion-11rnking 11n use of mnnpow(r n nd etonornic i-11pport, e. <:pedally during ill11c.,,_~ or crisis. The familv c;111 b,: the n-ic,st,·ffr-c-live ;,nd c,fflt:ic:nt link with the cnlin· L·o111mu11ily if orga11i1. ed a,. :'1i1Jn a. 11d p;,rtnc. :rship,11·r,,,, he· rs1:ihlishc·d lo create ancl ::. u.... 1. ai11 :m cnvironment t I,;, I promote l1c:d thy Ii fc.,tylc ur ca rly. ::i~c Ii nd i ng, prompt and ;1pprupriat!' t reatmcnt nf di!<em:C'c S. Chapter 18 dtsc-rihcs a t hi11y-111u11th l!Xpcrienee with familir:s in,J n1ral,illage in 0,111glns 1\.-1 u11ic-ipnli1y. Abra Province. where fr1 milies cn..--alt'd mccl1anism. s for malaria prevention and cont T'Cil usin~ 1hc part. icipat. ory action methodology. 