Family Health Management

FAMILY HEALTH MANAGEMENT

Reynaldo O. Joson, M.D.

PROBLEM:

What are the general steps in managing a family with a health problem?

FAMILY WITH A HEALTH PROBLEM -------------------------> PHYSICIAN

GENERAL STEPS IN FAMILY HEALTH MANAGEMENT

1. Analysis of the health problem - DIAGNOSIS

What is the nature?

What is the cause?

2. Strategies to solve the health problem - TREATMENT

Planning

Implementation

3. Assessment of outcome of treatment - EVALUATION

4. Health maintenance - HEALTH MAINTENANCE

In individual health management, the physician deals with the health of individual human beings. During the actual management, the physician takes into consideration all the factors that affect the health of the individual, including the family and community factors.

Family health management is essentially similar to individual health management. In family health management, the physician still deals with the health of individual human beings, the members of a family. Family health management is being categorized as such just to subfocus attention on the management of the health of the family as a whole and to emphasize the importance of how the conditions in the family can affect the health of the individual members of the family.

The first thing that a physician must do to a family with a health problem is to determine the nature of the health problem in terms of what is it and what is the cause. In medical parlance, the physician is doing a diagnosis. The diagnosis referable to a family with a health problem can also be termed as family diagnosis.

The usual tools that a physician uses in the diagnosis of a family's health problem are the following:

1. Interview

The physician questioning all the members of the family to get data that will provide clue as to the nature of the problem.

2. Physical examination

The physician using his four senses (looking, palpating, smelling, and listening) to examine all members of the family to get data that will provide clue as to the nature of the problem.

3. Laboratory examination

The physician using equipments and machines to examine the members of the family to get data that will provide clue as to the nature of the problem.

All data gathered from the various diagnostic tools are analyzed by the physician to come out with a diagnosis.

The diagnosis describes the health status of the family. A family is usually said to be healthy if majority of the members of the family are healthy (based on the criteria of a healthy individual, that is, no disease; physical, mental, and social well-being; and socially and economically productive) and the family is socially and economically productive.

A family is sick or has a health problem if it is not socially and economically productive even if majority of the members of the family have no disease.

Members of the family strictly refers to the parents and their children only. However, for practical purposes, members of the family are not confined only to the parents and their children but also to all other human beings living and interacting with them in one house.

The diagnosis describes the nature of the family's health problem and its possible causes. Usually the problems are multiple. In the family diagnosis, the physician describes all of these problems.

If there are multiple problems in the family, the physician decides whether these problems will be tackled simultaneously or sequentially. In the latter decision, he must prioritize the problems in terms of importance, resource, and other bases.

For every diagnosis or health problem, there are usually more than one possible solutions. The physician must select one which he thinks is best for the family. He then implements the plan to solve the family's health problem. At this stage, he is doing treatment.

Treatment modalities for health problems of a family may include actual treatment and rehabilitation of the individual members of the family who are sick, psychosocial treatment, and health education.

After treatment, the physician must assess the outcome or the result of treatment.

There are three possible general outcomes after treatment of a family with a health problem. The family becomes healthy, meaning the health problems have been resolved. The family remains sick, meaning the health problems have not been resolved. The middle ground is that there is improvement in the health problem.

After institution of the treatment, depending on the outcome, the physician continues to solve the health problem of the family if there remains to be a problem or he maintains and promotes a healthy family if the problem has been previously resolved.

*What are the objectives of the physician in managing a family's health?

If the starting point in the management consists of a health problem, then the physician treats and rehabilitates to promote cure after which he tries to maintain the family's health.

If the starting point in the management consists of a healthy family, then the physician tries to maintain the healthy status of the family.

CONCEPT OF HEALTH AND DISEASE IN A FAMILY

Reynaldo O. Joson, M.D.

Scenarios of health and disease in members of the family:

Disease --------------------------------------------------> Death

Health ------------------------------> Disease -----------> Death

Health -------> Disease ----> Recovery -----> Disease ----> Death

Health -------> Disease ----> Disability ---> Disease ----> Death

Interactions of health and disease in a family:

Sick members ---------------------------------------> Sick family

Healthy members ---------------------------------> Healthy family

Healthy family ---------------------------------> Healthy members

Sick family ---------------------------------------> Sick members

Natural history of health and disease in a family:

Healthy family ----------> Sick family ----------> Healthy family

Sick family -----------> Healthy family ------------> Sick family

Criteria in categorizing family as healthy and sick:

Healthy Healthy Sick

Individual Family Family

Majority Majority

of members of members

Disease (-) (-) (+)

Physical well-being (+) (+) (-)

Mental well-being (+) (+) (-)

Social well-being (+) (+) (-)

Family Family

Socially productive (+) (+) (-)

Economically productive (+) (+) (-)

Disease

- Any condition that can kill an individual or person.

- Any condition that can cripple an individual so as to prevent him from being socially and economically productive.

- Any condition that can hurt an individual so as to prevent him from being socially and economically productive.

General causes of health problems in a family:

Degree of Preventability

Genetic causes (-) to (+)

Environmental causes (+)

Self-induced causes (+)

Factors that promote diseases in the family:

Genetic factors

Environmental factors

Self-induced factors

The health practices and beliefs of the family as a whole that have a bearing on disease prevention and promotion.

• • Hygienic practices

  • Drugs

  • Alcohol

  • Smoking

  • Diet

  • Exercises

  • Relaxation

Factors that promote health in the family:

Control of environmental factors that promote disease.

Control of self-induced factors that promote disease.

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