Struktur dan Fungsi Keluarga

Theoretical Framework
Theory

Friedman Family Assessment Model (FFAM):

• Long form assessment
• Short form assessment

1Friedman, Bone & Jones (2003)

2,3National Family Planning Board (2008; 2014)

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Framework: Friedman Family Assessment Model

8 items: family name, address and phone, family composition,

1. Identification type of family form, cultural (ethnic) background, religious
data identification, social class status, social class mobility
2. Developmental 4 items: family’s present development stage, extent of family
stage and history of developmental tasks fulfillment, nuclear family history, history
the family of family of origin of both parents
4 items: characteristics of home, characteristics of
3. Environmental neighborhood and larger community, family’s geographical
data mobility, family’s associations and transactions with
community
FFAM1
4 items: communication patterns, power structure, role
4. Family structure structure, family values

5 items: affective, socialization, health care, economic,

5. Family functions
reproductive function

4 items: family stressors, strengths, and perceptions, family

6. Family stress and
coping strategies, family adaptation, tracking stressors, coping,
coping
and adaptation over time

FFAM is based on the structural-functional framework and developmental and systems theory2
1Friedman, Bone & Jones (2003). 2Kaakinen et al. (20015). 3
Framework: Friedman Family Assessment Model
Friedman’s Family Assessment Model (FFAM)1:
• Based on the structural-functional framework and
developmental and systems theory.
• Commonly used when the family-in-community is the
setting of care.
Assumptions of FFAM2:
• A family is a society system with functional requirements.
• A family is a small group possessing certain generic
features common to all small groups.
• The family is a social system accomplishes functions that
serve the individual and society. Family as component of society1
• Individuals act in accordance with a set of internalized
norms and values that are learned primarily through Consists
socialization.

Six broad categories of interview questions2:

Concrete, global family
1. Identification data
assessment guide that
2. Developmental stage & history of the family
looks primarily at
3. Environmental data
families in the larger
4. Family structure
community →
5. Family functions
Qualitative
6. Family stress and coping
1Kaakinen, J.R et al. (2015)
2Friedman, Bowden, Jones (2003) 4
 Development of FFAM as Conceptual Framework

• Family structure4 • Limited access information

• Family communication5 and low knowledge of ARH8
• Family microsystem6 ARHs’ Needs • Never communicated ARH
• Family connectedness7 with parent9

Culture and norms, the social

FFAM
environment & religion3
Family as component society2

Provide ARH needs Parents in as

during puberty family context1
Qualitative interview
assessment
• Strengthening of family structure
• Functionalization of family functions
FFAM A scale of family structure
& family function in ARH
• Affection
• Communication (FSF-ARH)
• Socialization
• Power
• Health care
• Value Promoting
• Economic
• Role adolescents’
• Reproductive
4Wamoyi
health in RH
& Wight (2014)
5Coetzee et al. (2014) 1Drake& Ginsburg (2012)
6Lindberg & Maddow-Zimet (2012) 8Susanto, Wuryaningsih, Rahmawati et al. (2016) 2Friedman,
Bowden, Jones (2003)
7Markham et al. (2010) 9Susanto, Saito, Syahrul et al. (2016) 3Utomo & McDonald (2009)
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Framework: Friedman Family Assessment Model

• FFAM is commonly used when the family-

in-community is the setting of care.
• FFAM is used family as component of
society for unit of analysis1

Concrete, global family assessment

guide that looks primarily at families in
the larger community and used in all of
population setting of care

Six broad categories of interview questions2:

1. Identification data
2. Developmental stage & history of the family
3. Environmental data
4. Family structure
5. Family functions
1Kaakinen, J.R et al. (2015)
6. Family stress and coping 2Friedman, Bowden, Jones (2003)
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Development of FFAM as Conceptual Framework

Family as component Provide ARH needs

of society 1 during puberty

• Strengthening of family structure

• Functionalization of family
functions
FFAM
Family structure and
family functions2:
• Communication • Affection
• Power • Socialization
• Value • Health care
A scale of family structure
• Role • Economic
& family function in ARH • Reproductive
(FSF-ARH)

1Kaakinen, J.R et al. (2015)

2Friedman, Bowden, Jones (2003)
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Framework: Friedman Family Assessment Model

Conceptual scheme of
family as legal systems in
community1

Family as
component society1

Six broad categories of interview questions2: Family assessment guide in all

1. Identification data of population setting of care
2. Developmental stage & history of the family
3. Environmental data
4. Family structure
5. Family functions
6. Family stress and coping 1Kaakinen, J.R et al. (2015)
2Friedman, Bowden, Jones (2003) 8
Name of model Family Assessment and Intervention Friedman Family Assessment Calgary Family Assessment

Comparison of Family Assessment Models Developed by Family Nurses

Model and the
Family System Stressor-
Model and Intervention Model

Strength Inventory (FS3I)

Citation Berkey-Mischke & Hanson Friedman, Bowden, & Jones Wright & Leahey (2013)
(1991) (2003)
Hanson (2001)
Purpose Concrete, focused measurement Concrete, global family assessment Conceptual model and multidimensional
instrument that helps interview guide approach to
families identify current that looks primarily at families families that looks at the fit
family stressors and builds in the larger community among family functioning,
interventions based on in which they are embedded affective, and behavioral
family strengths aspects
Theoretical underpinnings Systems: Developmental Systems:
Family systems Structural-functional Cybernetics Communication
Neuman systems Family stress-coping Change Theory
Model: Environmental
Stress-coping theory
Level of data collected Quantitative: Qualitative: Qualitative:
Ordinal and interval Nominal Nominal
Qualitative:
Nominal
Settings in which primarily Inpatient Outpatient Outpatient
used Outpatient Community Community
Community
Units of analysis Family as context Family as client Family as system
Family as client Family as component
Family as system of society
Family as component
of society
Strengths Short Comprehensive list of areas Conceptually sound
Easy to administer to assess family
Yields data to compare
one family member with
another family member
Assess and measure
focused presenting
problem
Weaknesses Narrow variable Large quantities of data Not concrete enough to be
that may not relate to the useful as a guideline unless
problem the provider has studied this
No quantitative data model and approach in detail
Approached to family nursing
Family as context Family as client

Family as system Family as component of society 10

Variables that Influence Family Health Care

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Family Structure and Family Functions in FFAM
Variable No. Items No. Sub items
Communication 7 20
Power 7 18
Value 8 8
Role 15 18
Affection 7 15
Healthcare 16 94
Economic 5 5
Socialization 8 8
Reproductive 4 4
77 190
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Tools of Family Nursing
McMaster Family Family Assessment North Carolina Family Functioning
Assessment Device Measure (FAM): Family Assessment Index (FFI):
(FAD): • Task Scale (NCFAS): • Intrafamily
• Problem-solving accomplishment • Environment communication
• Communication • Role performance • Parental • Cohesiveness
• Roles • Communication capabilities • Decision making
• Affective • Affective • Family • Marital
responsiveness expression interactions satisfication
• Affective • Involvement • Family safety • Happiness
involvement • Control • Child well-being • Closeneness
• Behaviour control • Values and norms (Martens & Kirk, (Pless & Satterwhite,
• General functioning • Social desirability 2002) 1973)
(overall health, • Defensiveness
pathology of family) (Skinner, Steinhauer &
APGAR Family:
(Epstein, Baldwin & Santa Barbara, 1983)
• Adaptability
Bishop, 1983)
• Partnership
• Growth
• Affection
• Resolve
(Smilkstein, G 1978)
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