Chapter 3 | Family Dynamics and Communicating With Children and Families 41
FIGURE 37 Sibling rivalry.
FIGURE 36 Adoptive family.
● The youngest are more immature and tend to have self- centered communication patterns (Miscioscia et al, 2017). With more than three children, these roles tend to overlap. ● A same-sex parent and child or opposite-sex parent and child may interact with stronger alliances with the same sex, re- sulting in improved family interactions and communication (Miscioscia et al. 2017). Stressors on Families Families can become stressed by many environmental factors, such as: ● Overwhelming concern for the child ● Feelings of neglect of other children and family structure ● Loss of income ● Impact on social status ● Employment constraints like unemployment or underem- ployment ● Insurance issues, including being underinsured or uninsured ● Poverty ● Homelessness ● Mental illness, chronic physical illness, or catastrophic illness or injury in the family unit ● Addition of family members placing a strain on finances ● Lack of support systems ● Cultural and religious constraints ● Inadequate coping skills ● Societal pressures, HIV, suicide ● Inadequate public education ● Time at work necessitating the use of day care and nonfamily care providers Family Reaction to a Child’s Illness Families have a range of emotional reactions to learning their child has an acute or chronic illness. These may include: ● Disbelief ● Frustration
● Dyad family—A couple living together without children ● Communal families ● Foster families (legal implications)
Roles and Developmental Tasks of the Family
Families provide for a child’s physical needs, such as shelter, food and water, and clothing, in addition to economic needs. Beyond these basics, families also provide nurturing, a sense of love and belonging, financial organization, and boundary management. Coping strategies help families deal with stresses of life and pro- vide a nurturing environment. Role strain and time constraints because of dual-career demands present problems for families. Communication may need expansion to meet the emotional and behavioral needs of the child. Socialization of the family is necessary to meet the demands of society and facilitate the assumption of values, morals, and socially acceptable behavior (Duvall, 1985). Family Dynamics Nurses should be aware of family dynamics that may affect com- munication. For example: ● Family members interact and participate in activities together. ● A single adult may function as the disciplinarian. ● Children in the home interact and learn skills from each other. ● Sibling rivalry may occur (Fig. 3–7). ● The birth order of children—their ordinal place—influences communication, personality, relationships, and careers. ● First-born and only children have more exposure to adults, so they tend to be motivated perfectionists who are more direct in their communication (Miscioscia et al, 2017). ● Middle children develop as conflict avoiders, mediators, or balanced with avoidance communication patterns (Misci- oscia et al, 2017).
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