Impact of Childbearing and Child Rearing on the Family
The Childbearing and Kid-Rearing Family
Learning Objectives
Subsequently studying this affiliate, you should be able to
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No factor influences a person equally greatly every bit the family. Families protect and promote a child's growth, development, health, and well-being until the kid reaches maturity. A salubrious family provides children and adults with dearest, amore, and a sense of belonging and nurtures feelings of self-esteem and self-worth. Children need stable families to grow into happy, functioning adults. Family unit relationships proceed to be important during adulthood. Family relationships influence, positively or negatively, people'southward relationships with others. Family influence continues into the side by side generation equally a person selects a mate, forms a new family, and oftentimes rears children.
For nurses in pediatric practice, the whole family unit is the patient. The nurse cares for the child in the context of a dynamic family system rather than caring for but an infant or a child. The nurse is responsible for supporting families and encouraging good for you coping patterns during periods of normal growth and evolution or illness.
Family-Centered Care
Family-centered maternity care and family-centered child care are integral to the comprehensive intendance given by maternity and pediatric nurses. Family-centered care can be divers as an innovative arroyo to the planning, delivery, and evaluation of health care that is grounded in a mutually beneficial partnership among patients, families, and health care professionals (O'Malley, Brown, & Krug, 2008). Some of the barriers to constructive family unit-centered care are lack of skills in communication, role negotiation, and developing relationships. Other areas that interfere with the full implementation of family-centered care are lack of fourth dimension, fear of losing office, and lack of support from the health intendance system and from other health care disciplines (Harrison, 2010). Conspicuously, at that place is a need for increased didactics in this area, based on prove, to help nurses and other health intendance professionals implement this concept.
Family Construction
Family unit structures in the United States are changing. The number of families with children that are headed by a married couple has declined, and the number of single-parent families has increased. In improver, roles have inverse within the family unit. Whereas the role of the provider was once almost exclusively assigned to the male parent, both parents now may be providers, and many fathers are active in nurturing and disciplining their children.
Types of Families
Families are sometimes categorized into three types: traditional, nontraditional, and high adventure. Nontraditional and high-hazard families oft demand care that differs from the care needed by traditional families. Unlike family structures tin can produce varying stressors. For example, the single-parent family has equally many demands placed on it for resources, such every bit time and money, every bit the two-parent family. But 1 parent, withal, is able to run across these demands.
Traditional Families
Traditional families (also called nuclear families) are headed past two parents who view parenting as the major priority in their lives and whose energies may not exist depleted by stressful conditions such equally poverty, affliction, and substance abuse. Traditional families can exist single-income or dual-income families. Generally, traditional families are motivated to learn all they tin can about pregnancy, childbirth, and parenting (Figure iii-1). Today a family structure composed of ii married parents and their children represents 66% of families with children, down 4% from the terminal report. Twenty-six percentage of children live with i parent and 44% with no parents. The remaining per centum of children live with two parents who are not married (Forum on Child and Family unit Statistics, 2011).
Single-income families in which one parent, usually the male parent, is the sole provider are a minority among households in the United states. Most ii-parent families depend on two incomes, either to make ends see or to provide nonessentials that they could not afford on 1 income. I or both parents may travel as a work responsibility. Dependence on two incomes has created a great deal of stress on parents, subjecting them to many of the aforementioned problems that unmarried-parent families face up. For example, reliable, competent child care is a major issue that has increased the stress traditional families experience. A loftier consumer debt load gives them less absorber for fiscal setbacks such equally job loss. Having the time and flexibility to attend to the requirements of both their careers and their children may exist difficult for parents in these families.
Nontraditional Families
The growing number of nontraditional families, designated as "complex households" by the U.Due south. Census Bureau, includes single-parent families, composite families, adoptive families, unmarried couples with children, multigenerational families, and homosexual parent families (Effigy three-2).
Single-Parent Families
Millions of families are now headed by a single parent, most often the mother, who must function as homemaker and caregiver and also is frequently the major provider for the family's fiscal needs. Factors contributing to this demographic include divorce, widowhood, and childbirth or adoption amongst single women. Among the 26% of children who alive with one parent, 23% live with their mothers (Forum on Kid and Family unit Statistics, 2011).
Unmarried parents may feel overwhelmed by the prospect of assuming all child-rearing responsibilities and may exist less prepared for disease or loss of a job than 2-parent families.
Blended Families
Blended families are formed when single, divorced, or widowed parents bring children from a previous union into their new relationship. Many times the couple desires children with each other, creating a contemporary family unit structure unremarkably described as "yours, mine, and ours." These families must overcome differences in parenting styles and values to form a cohesive blended family. Differing expectations of children'south behavior and development as well as differing beliefs nigh discipline often crusade family unit conflict. Financial difficulties can result if one parent is obligated to pay child support from a previous human relationship. Older children may resent the introduction of a stepmother or stepfather into the family unit system. This can cause tension betwixt the biologic parent, the children, and the stepmother or stepfather.
Adoptive Families
People who prefer a child may take problems that biologic parents do not face up. Biologic parents accept the long period of gestation and the gradual changes of pregnancy to aid them accommodate emotionally and socially to the birth of a child. An adoptive family, both parents and siblings, is expected to make these same adjustments of a sudden when the adopted child arrives. Adoptive parents may add pressure level to themselves by having an unrealistically high standard for themselves every bit parents. Additional problems with adoptive families include possible lack of noesis of the kid's health history, the difficulty assimilating if the kid is adopted from another country, and the question of when and how to tell the child well-nigh existence adopted. Adoptive parents and biologic parents need data, support, and guidance to prepare them to intendance for the babe or kid and maintain their own relationships.
Multigenerational Families
The multigenerational or extended family unit consists of members from three or more generations living under one roof. Older adult parents may live with their developed children, or in some cases developed children return to their parents' home, either because they are unable to support themselves or because they desire the additional support that the grandparents provide for the grandchildren. The latter arrangement has given rise to the term boomerang families. Extended families are vulnerable to generational conflicts and may need teaching and referral to counselors to prevent disintegration of the family unit.
Grandparents or other older family unit members, because of the disability of the parents to treat their children, at present head a growing number of households with children. More than than half of children who exercise non alive with either parent alive with a grandparent (Forum on Child and Family Statistics, 2011). The strain of raising children a second time may cause tremendous concrete, fiscal, and emotional stress.
Aforementioned-Sexual practice Parent Families
Families headed past aforementioned-sexual practice parents accept increasingly become more mutual in the U.s.. The children in such families may be the offspring of previous heterosexual unions, or they may exist adopted children or children conceived by an artificial reproductive technique such as in vitro fertilization. The couple may face many challenges from a community that is unaccustomed to culling lifestyles. The children's adaptation depends on the parents' psychological adjustment, the caste of participation and support from the absent biologic parent, and the level of customs support.
Communal Families
Communal families are groups of people who have chosen to live together equally extended family unit groups. Their relationship to one some other is motivated past social value or financial necessity rather than by kinship. Their values are often spiritually based and may be more liberal than those of the traditional family. Traditional family roles may not exist in a communal family unit.
Characteristics of Healthy Families
In full general, healthy families are able to adapt to changes that occur in the family unit unit of measurement. Pregnancy and parenthood create some of the virtually powerful changes that a family experiences.
Healthy families exhibit the following mutual characteristics, which provide a framework for assessing how all families part (Cooley, 2009):
Factors that Interfere with Family unit Functioning
Factors that may interfere with the family'south ability to provide for the needs of its members include lack of financial resources, absence of adequate family support, birth of an infant who needs specialized care, an sick kid, unhealthy habits such equally smoking and abuse of other substances, and disability to brand mature decisions that are necessary to provide treat the children. Needs of aging members at the fourth dimension children are going through boyhood or the expenses of higher add together pressure on eye-aged parents, often called the "sandwich generation."
High-Risk Families
All families encounter stressors, but some factors add to the usual stress experienced past a family. The nurse needs to consider the additional needs of the family unit with a higher hazard for existence dysfunctional. Examples of high-risk families are those experiencing marital conflict and divorce, those with adolescent parents, those affected by violence against one or more of the family members, those involved with substance abuse, and those with a chronically sick child.
Marital Conflict and Divorce
Although divorce is traumatic to children, enquiry has shown that living in a home filled with conflict can also be detrimental both physically and emotionally (Kelly & El-Sheikh, 2011; Lindahl & Malik, 2011). Divorce can be the result of many years of unresolved family conflict. Information technology tin can result in continuing conflict over child custody, visitation, and kid back up; changes in housing, lifestyle, cultural expectations, friends, and extended family relationships; diminished self-esteem; and changes in the physical, emotional, or spiritual wellness of children and other family members.
Divorce is loss that needs to exist grieved. The conflict and divorce may affect children, and young children may be unable to enunciate their distress. Nurses can assist children through the grieving process with age-appropriate activities such as therapeutic play (see Chapter 35). Principles of active listening (encounter Chapter 4) are valuable for adults as well as children to help them express their feelings. Nurses can too assist newly divorced or separated parents through listening, encouragement, and referrals to support groups or counselors.
Adolescent Parenting
The teenage birth rate in the United states decreased past more than one-3rd from 1991 through 2005 but increased by v% over the next 2 years. Current data testify another downward trend, reaching a historic low of 39.1 per k teen births. Adolescent nascence rates vary by race; nevertheless, there has been a steady decline in teen birth rates for all racial and ethnic groups. The nascence rate for Hispanic teenagers showed the largest decline of all race and ethnicity groups. From 2008 to 2009, the charge per unit declined by eleven% (National Center for Health Statistics, 2011).
Teenage parenting often has a negative effect on the health and social outcomes of the unabridged family. Adolescent girls are at increased risk for a number of pregnancy complications, such as preterm birth, low birth weight, and death during infancy (Ventura & Hamilton, 2011). Those who get parents during adolescence are unlikely to achieve a high level of education and, as a result, are more probable to be poor and oftentimes homeless. An boyish father oft does not contribute to the economical or psychological support of his kid. Moreover, the cycle of teen parenting and economic hardship is more likely to be continued because children of adolescent parents are themselves more than probable to become teenage parents.
Violence
Violence is a abiding stressor in some families. Violence can occur in any family of any socioeconomic or educational status. Children endure the psychological pain of seeing their female parent victimized by the man who is supposed to love and intendance for her (run across Affiliate 24). In addition, considering of the role models they see in the adults, children in violent families may echo the cycle of violence when they are adults and become abusers or victims of violence themselves.
Abuse of the child may be concrete, sexual, or emotional or may have the form of neglect (see Chapter 53). Oft one child in the family unit is the target of abuse or neglect, whereas others are given proper intendance. As in adult corruption, children who witness corruption are more likely to repeat that behavior when they are parents themselves, considering they take not learned constructive means to deal with stress or to discipline children.
Substance Abuse
Parents who abuse drugs or alcohol may neglect their children because obtaining and using the substance(s) may accept a stronger pull on the parents than does care of their children. Parental substance abuse interrupts a child's normal growth and development. The parent's ability to meet the needs of the child are severely compromised, increasing the child's risk for emotional and wellness bug (Children of Alcoholics Foundation, 2011).
The child may be the substance abuser in the home. The drug habit can lead a child into unhealthy friendships and may result in criminal activity to maintain the habit. Schoolhouse achievement is likely to plummet, and the older boyish may drop out of schoolhouse. Children, too as adults, can die as a outcome of their drug action, either directly from the drugs or from associated criminal activity or hazard-taking behaviors.
Child with Special Needs
When a child is born with a nativity defect or has an illness that requires special care, the family unit is nether additional stress (see Chapters 36 and 54). In about cases their initial reactions of shock and disbelief gradually resolve into credence of the child's limitations. Nonetheless, the parents' grieving may be long term as they repeatedly see other children doing things that their child cannot and perhaps will not e'er practise.
These families often suffer financial hardship. Health insurance benefits may quickly attain their maximum. Even if the child has public assistance for health care costs, the family often experiences a decrease in income because one parent must remain home with the sick child rather than piece of work exterior the domicile.
Strains on the union and the parents' relationships with their other children are inevitable nether these circumstances. Parents take fiddling time or energy left to nurture their relationship with each other, and divorce may add yet another strain to the family. Siblings may resent the parental time and attention required for care of the ill child all the same experience guilty if they express their resentment.
The outlook is non always pessimistic in these families, however. If the family learns skills to cope with the added demands imposed on information technology by this situation, the potential exists for growth in maturity, pity, and strength of grapheme.
Good for you Versus Dysfunctional Families
Family unit conflict is unavoidable. It is a natural issue of a perceived unequal exchange or an imbalance in the use of resources by individual members. Conflict should not exist viewed as bad or confusing; the management of the disharmonize, not the conflict itself, may be problematic. Conflict can produce growth and improve family performance if the outcome is resolution every bit opposed to dissolution or continued conflict. The following iii ingredients are required to resolve conflict:
Dysfunctional families have problems in whatsoever one or a combination of these areas. They tend to go trapped in patterns in which they maintain conflicts rather than resolve them. The conflicts create stress, and the family must cope with the resultant stress.
Coping with Stress
If the family is considered a balanced system that has internal and external interrelationships, stressors are viewed as forces that change the balance in the organization. Stressful events are neither positive nor negative, but rather neutral until they are interpreted by the individual. Positive, as well as negative, events tin can cause stress (Smith et al., 2009). For example, the birth of a child is ordinarily a joyful event, but it tin can also be stressful.
Some families are able to mobilize their strengths and resources, thus finer adapting to the stressors. Other families autumn apart. A family crisis is a state or catamenia of disorganization that affects the foundation of the family (Smith et al., 2009).
Coping Strategies
Nurses tin can help families cope with stress past helping each family place its strengths and resources. Friedman, Bowden, and Jones (2003) identified family coping strategies every bit internal and external. Box iii-1 identifies family coping strategies and farther defines internal strategies as family human relationship strategies, cognitive strategies, and communication strategies. External strategies focus on maintaining active community linkages and using social support systems and spiritual strategies. Some families conform quickly to extreme crises, whereas other families go chaotic with relatively minor crises. Family functional patterns that existed before a crisis are probably the best indicators of how the family volition respond to it.
Cultural Influences on Maternity and Pediatric Nursing
Civilisation is the sum of the beliefs and values that are learned, shared, and transmitted from generation to generation by a particular group. Cultural values guide the thinking, decisions, and deportment of the group, particularly regarding pivotal events such every bit nativity, sexual maturity, illness and decease. Ethnicity is the condition of belonging to a particular group that shares race, language and dialect, religious faiths, traditions, values, and symbols likewise as nutrient preferences, literature, and folklore. Cultural beliefs and values vary among dissimilar groups and subgroups, and nurses must exist aware that individuals oftentimes believe their cultural values and patterns of behavior are superior to those of other groups. This belief, termed ethnocentrism, forms the basis for many conflicts that occur when people from unlike cultural groups have frequent contact.
Nurses must be aware that civilisation is composed of visible and invisible layers that could be said to resemble an iceberg (Figure iii-3). The observable behaviors tin can be compared with the visible tip of the iceberg. The history, traditions, behavior, values, and religion are non necessarily observed but are the subconscious foundation on which behaviors are based and can be likened to the large, submerged office of the iceberg. To comprehend cultural behavior fully, one must seek knowledge of the subconscious beliefs that behaviors limited. This knowledge comes from experiencing caring relationships with people of different cultures within the context of common respect and a sincere desire to understand the role of culture in some other's "lived experiences" (Bearskin, 2011). I must also have the desire or motivation to appoint in the process of condign culturally competent in order to be effective in caring for diverse populations.
Nurses must first understand their ain culture and recognize their biases before beginning to acquire the knowledge and understanding of other cultures. Applying the knowledge completes the process (Galanti, 2008).
Religious and spiritual beliefs often have a strong influence on families as they face the crunch of illness. Specific beliefs about the causes, treatment, and cure of illness are important for the nurse to know to empower the family equally they bargain with the immediate crisis. Table iii-one describes how some religious beliefs affect health care.
TABLE iii-1 RELIGIOUS BELIEFS AFFECTING HEALTH CARE
RELIGION AND Bones BELIEFS PRACTICES Christianity Christianity is generally accepted to be the largest religious group in the globe. There are three major branches of Christianity and a number of religious traditions considered to be Christian. These traditions have much in mutual relative to beliefs and practices. Conventionalities in Jesus Christ as the son of God and the Messiah comprises the primal core of Christianity. Christians believe that it is through Jesus' death and resurrection that conservancy can be attained. They also believe that they are expected to follow the case of Jesus in daily living. Study of biblical scripture; practicing faith, good works, and sacramental rites (e.chiliad., baptism, communion, and others); and prayer are common amid near Christian faiths. Christian Scientific discipline Based on scientific system of healing.
Beliefs derived from both the Bible and the volume, Science, and Health with Key to the Scriptures.
Prayer is the ground for spiritual, physical, emotional, and mental healing, as opposed to medical intervention (Christian Science, 2011). Healing is divinely natural, not miraculous. Birth: Employ md or midwife during childbirth. No baptism ceremony.
Dietary practices: Alcohol and tobacco are considered drugs and are non used. Coffee and tea also may be declined.
Death: Autopsy and donation of organs are ordinarily declined.
Wellness care: May refuse medical treatment. View health in a spiritual framework.
Seek exemption from immunizations but obey legal requirements.
When Christian Science believer is hospitalized, parent or client may request that a Christian Scientific discipline practitioner be notified. Jehovah's Witness Expected to preach house to house about the good news of God.
Bible is doctrinal authority.
No distinction is fabricated between clergy and laity. Baptism: No infant baptism. Developed baptism past immersion.
Dietary practices: Use of tobacco and booze discouraged.
Death: Autopsy decided by persons involved. Burial and cremation acceptable.
Birth command and abortion: Use of nativity command is a personal decision. Abortion opposed on basis of Exodus 21:22-23.
Health care: Claret transfusions not immune. May accept alternatives to transfusions, such as utilise of non-blood plasma expanders, conscientious surgical technique to minimize claret loss, and use of autologous transfusions.
Nurses should check an unconscious patient for identification that states that the person does not want a transfusion.
Jehovah's Witnesses are prepared to dice rather than pause God'southward police force.
Respect the wellness care given by physicians, but look to God and His laws equally the last authority for their decisions. The Church of Jesus Christ of Latter-Day Saints (Mormon) Restorationism: True church of Christ concluded with the first generation of apostles but was restored with the founding of Mormon Church.
Manufactures of faith: Mormon doctrine states that individuals are saved if they are obedient to God's divine ordinances (faith, repentance, baptism by immersion and laying on of hands).
Holy Communion: Hospitalized patient may desire to have a member of the church's clergy administer the sacrament.
Scripture: Word of God can be found in the Bible, Book of Mormon, Doctrine and Covenants, Pearl of Great Price, and current revelations.
Christ volition return to rule in Zion, located in America. Baptism: Past immersion. Considered essential for the living and the dead. If a child older than 8 years is very sick, whether baptized or unbaptized, a member of the church building's clergy should be called.
Anointing of the sick: Mormons frequently are anointed and given a approval before going to the hospital and afterward access by laying on of hands.
Dietary practices: Tobacco and caffeine are not used. Mormons eat meat (limited) merely encourage the intake of fruits, grains, and herbs.
Death: Prefer burial of the torso. A church elder should exist notified to aid the family.
Nascence control and ballgame: Abortion is opposed unless the life of the mother is in danger. Only natural methods of birth control are recommended. Other means are used just when the physical or emotional health of the mother is at stake.
Other practices: Believe in the healing ability of laying on of easily.
Cleanliness is important. Believe in salubrious living and adhere to wellness care requirements.
Families are of great importance, so visiting should be encouraged.
The church maintains a welfare system to help those in need. Roman Catholicism Belief that the Word of God is handed downwardly to successive generations through scripture and tradition, and is interpreted past the magisterium (the Pope and bishops).
Pope has final doctrinal authority for followers of the Catholic religion, which includes interpreting important doctrinal issues related to personal practice and health care. Baptism: Infant baptism by affusion (sprinkling of water on caput) or total immersion. Original sin is believed to exist "washed abroad." If death is imminent or a fetus is aborted, anyone can perform the baptism by sprinkling water on the brow, saying "I baptize thee in the name of the Male parent, Son, and Holy Spirit."
Anointing of the Sick: Encouraged for anyone who is ill or injured. Always done if prognosis is poor.
Dietary practices: Fasting and abstinence from meat optional during Lent. Fasting required for all, except children, elders, and those who are ill, on Ash Wednesday and Good Friday. Abstention of meat on Ash Wednesday and on Fridays during Lent strongly encouraged.
Death: Organ donation permitted. Amish Christians who practice their religion and beliefs inside the context of strong customs ties.
Focused on salvation and a happy life after death.
Powerful bishops brand health care decisions for the community.
Problems solved with prayer and discussion.
Primarily agrestal; eschew many modernistic conveniences. Baptism: Tardily teen/early adult. Must ally within the church.
Decease: Do not normally use extraordinary measures to prolong life.
Other practices: May have a language issue (modified German or Dutch) and need an interpreter.
At increased risk for genetic disorders; refuse contraception or prenatal testing.
May announced stoical or impassive—personally humble.
Reject health insurance; rely on the Church building and community to pay for health care needs.
Utilise holistic and herbal remedies, merely accept western medical approaches. Hinduism Belief in reincarnation and that the soul persists even though the body changes, dies, and is reborn.
Salvation occurs when the cycle of death and reincarnation ends.
Nonviolent arroyo to living.
Congregation worship is not customary; worship is through private shrines in the domicile.
Disease is viewed holistically, only Karma (cause and upshot) may be blamed. Circumcision is observed by ritual.
Dietary practices: Dietary restrictions vary according to sect; vegetarianism is not uncommon.
Decease: Decease rituals specify practices and who can touch corpse. Family must be consulted, every bit family members often provide ritualistic care.
Other practices: May use ayurvedic medicine—an arroyo to restoring rest through herbal and other remedies.
Aforementioned-sex activity health providers may exist requested. Islam Belief in one God that humans can approach directly in prayer.
Based on the teachings of Muhammad.
Five Pillars of Islam.
Compulsory prayers are said at dawn, noon, afternoon, subsequently sunset, and after nightfall. Dietary practices: Prohibit eating pork and using booze. Fast during Ramadan (ninth month of Muslim year).
Death: Oppose autopsy and organ donation. Death ritual prescribes the treatment of corpse by just family and friends. Burial occurs as soon as possible. Judaism Behavior are based on the Old Testament, the Torah, and the Talmud, the oral and written laws of religion.
Belief in one God who is approached directly.
Believe Messiah is still to come.
Believe Jews are God'southward chosen people. Circumcision: A symbol of God's covenant with Israel. Done on eighth solar day after nascency.
Bar Mitzvah/Bat Mitzvah: Ceremonial rite of passage for boys and girls into adulthood and taking personal responsibility for adherence to Jewish laws and rituals.
Death: Remains are washed according to Jewish rite by members of a group chosen the Chevra Kadisha. This group of men and women prepare the body for burial and protect it until burial occurs. Burial occurs as soon as possible later on death.
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