40 Unit 2 | Psycho-Social-Cultural Assessment of the Child and the Family
Social attitudes began to shift during this time and were re- flected in television and movies. Single parenthood, women’s changing roles, birth control, and divorce were now shown in the media (Television and the Family, 2021). Blended fami- lies, those consisting of remarried parents and the children of their former marriages, first appeared in the media during the 1960s; that included single-p arent and same-sex-partner families. Over the decades, sitcoms like Roseanne and Modern Family reflected the nation’s changing demographics. Although divorce rates have essentially remained unchanged since the 1990s, changes in family structure continue to oc- cur. Children are more likely to live in a single-parent family or a cohabitating family (consisting of unmarried adults and the children of one or both adults) at some time in their lives. According to Kramer (2020) and the Pew Research Center (2015), two-parent families represented 69% of all families, compared with 73% in 2000 and 87% in 1960. Fifteen per- cent of children live with parents who are remarried and 7% of children live with a parent who is cohabitating with a partner (Kramer, 2020). In 2020 one-parent families constituted 26% of all families, compared with 22% in 2000 and 9% in 1960 (Pew Research Center, 2015). Kramer (2020) and the Pew Re- search Center (2015) note that 78% of the children in white households, two-thirds of Latino children, and 84% of Asian children lived in a two-parent household. Conversely, 54% of black children lived with a single parent, with 38% living in a two-parent household. Children in households with a college- educated parent were more likely to be living in a two-parent household (Kramer, 2020; Pew Research Center, 2015). Regardless of family structure, available resources such as goods, services, information, and influences affect a child’s health, development, and ability to adapt to disease and ill- ness. Race, ethnicity, and immigrant status also affect families and children through cultural influences (see Chapter 4 for de- tails). Nurses must be aware of these influences and assist in strengthening the family structure to maintain and support the parenting and family process. Referring the family unit to social services within the institution will assist in helping to identify resources.
SAFE AND EFFECTIVE NURSING CARE: Cultural Competence
● Nuclear family—male and female parents and their children living separately from grandparents ● Extended family (multigenerational family)—three or more generations of family members living within the same house, with children influenced by and interacting with all adults living in the home ● Married—family consists of married parents and their bio- logical or adoptive children ● Single-parent family—family headed by a divorced, widowed, or unmarried biological or adoptive parent ● Grandparents functioning in the role of parents ● Same-sex-partner family—family headed by lesbian or gay partners (Fig. 3–5) ● Adoptive family—family includes a nonbiological adopted member; can be a subset of other family types (Fig. 3–6) ● Blended family—family consisting of members of two or more prior families; can be a result of death or divorce, in addition to other factors ● Cohabitating family—family in which the parents are unmarried ● Solely extended family or no-parent family—a family in which children are cared for by other relatives, such as grandparents or aunts and uncles, rather than parents Types of Family Units The family unit of today varies. Family members do not have to be related by blood to be considered a unit. Families can be nuclear, extended, single-parent, blended, foster, and adoptive. Parents can be of different sexes or the same sex. One family unit is not better than another. The most important thing is for chil- dren to be in a positive, supportive environment so that they can grow and develop to their highest potential.
CLINICAL JUDGMENT Diversity of Families
Family is also defined as the structure or the relationship between individuals that provides the financial and emotional support needed for social functioning (Friedemann, 1989). Nurses should not be judgmental when caring for children and families. We must remember that every family acts as a unique unit.
Family Types and Functions Family structures commonly seen in the United States include: ● Family of origin—family that raises the child ● Family of choice—family formed through marriage or cohabitation
FIGURE 35 This nontraditional family represents the diversity in family types.
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