Phillip Green said it best when speaking of family, “it’s all about quality of life and finding a happy balance between work and friends and family.” A family that is strong has the ability to mold both parents and children into substantial individuals and when they are brought together as a unit, the fortitude that they have will be exhibited during adversity, including illness. By utilizing Friedman’s Family Assessment Model, the nurse will be able to assess the whole family system as well as how it interacts as a subunit of society (Kaakinen, Coehlo, Steele, & Robinson, 2018). Family nursing theory will be applied to the Dunphys, a fictional family on “Modern Family.” By introducing the family and its members, as well as providing the family structure and function, a nurse will be able to comprehend the appropriate use of the family nursing theory when providing care to a patient and his family.
“Modern Family” is a show that depicts several interrelated fictional families, one of which is the Dunphy’s. The Dunphy’s are a five-member family. They live in an upper-middle class suburban neighborhood in a two-story home in Cheviot Hills, California. The father, Phil Dunphy and the mother, Claire Dunphy raised three children: Haley, Alexandria or “Alex,” and Luke. Phil is a forty-nine-year-old Caucasian male; he works as a real-estate agent and is the owner of a magic shop. Phil considers himself, the “cool dad,” and tends to exhibit a juvenile attitude, especially when interacting and attempting to bond with his children. He is both a loving father as well as a devoted husband to his wife Claire of twenty-five years. Claire is a forty-eight-year-old Caucasian female; for majority of the children’s lives, Claire was a stay-at-home mother and helped raise the children and maintain their home. Once the youngest child had started high school, Claire started working at her father’s company, Pritchett’s Closet & Blinds. After establishing herself at the company and with her father, Jay, she was promoted to president of the family company when her father retired. Claire is considered the strong matriarch of the family and provides organization and structure. Although competitive and bossy, she only desires what is best for her family and is always supportive of all the dreams of each family member, even sometimes setting her own needs aside to assist in any way she can.
Haley, the eldest daughter of twenty-five years of age, was the stereotypical teenager when the show began as she was frequently embarrassed by her parents. Her goal was to be popular and establish independence from her parents, yet she did not focus on her studies, instead wanting to hang-out with her friends or boyfriend, Dylan Marshall. She is frequently looked at as beauty with no brains and as she grew, she maintained that reputation when she dropped out of college and now continues to live with her parent’s basement. She has recently attempted to turn her life around and found a position, as a style editor at Nerp, in which she flourishes. Alex, the middle child of twenty-one years of age, is the over-achieving and self-reliant intellectual of the family and is currently a student attending Cal Tech University and although she lives on-campus, she visits her family regularly. She has recently begun a relationship with Ben, whom is employed as a firefighter for Los Angeles City. Although this relationship has just begun, Ben has helped Alex learn to relax and take a moment to enjoy life as a young woman in her twenties. Luke is the only son and youngest child of Claire and Phil. Luke is twenty-years of age, single, lives at home, and attends community college. His family considers him simple-minded and believes he has ADHD but has never had the disorder diagnosed by a physician. Although each family member is quite different from one another, the Dunphys are close and each member understands his or her role in the family dynamic, which helps provide structure.
Family Structure and Family Function
There is an ordered set within each family that identifies members that is comprised of and the relationships between each (Kaakinen et al., 2018). According to Friedman, family structure is divided into subsets: communication patterns, power structure, role structure, and family values (Kaakinen et al., 2018). The Dunphys are a nuclear family and have two of their three children residing in their house. Both Phil and Claire are well established in their respective careers, which provides financial stability for the family. Roles were clearly divided earlier in the show when Claire was the stay-at-home mother and Phil was the breadwinner of the family; however, with both parents now working, the roles have been blurred as both are equal providers for the family and each member now assists with maintaining the household. Power structure has also been solidified from the start of the show, with Claire as the head of household, rule maker and upholder. She has been viewed as the strict parent and ensures her children, Haley, Alex, and Luke, are following the rules that had been set forth and if the rules or expectations are not followed, she would make sure each child was disciplined accordingly. Although she would attempt to make majority of the decisions, her husband would remind her of the importance of making joint decisions and each would compromise in the end. Phil takes more a lax approach with his children and uses a dynamic communication style as he prefers to remain friends with his kids; he would also attempt to ease the punishment of the children in hopes to become “buddies.” This approach tends to affect his parenting or “peerenting” as Phil has frequently referred to as his method of teaching his children morals and the “way of life.” Claire leans more towards a controlling communication and conflict resolution style when parenting. Although Claire and Phil have opposite styles of communication, each always had the best interest of their children and each other at heart. The Dunphys may bicker at times, but they do listen to one another, process the information, and determine the best approach to any situation or decision, which helps strengthen their family values and function.
Family function is the impact that each family on one another; “to see the unit as made up of intimate, interactive, and interdependent persons who share some values, goals, resources” (Kaakinen et al., 2018, p. 17). The Dunphys understand the importance of family and exhibit this understanding by maintaining a closeness with one another as well as extended family which epitomizes socialization functions of family. “Family is the first and one of the most influential settings for socialization (Kaakinen et al., 2018, p. 18). The Dunphys will host dinners or family functions at their home or attend family get togethers at Claire’s father and step-mother, Gloria’s, home or her brother, Mitch and his husband, Cam’s home. Also, because of their financial stability, the Dunphys are able to take frequent vacations, with their extended family, to Florida, Australia, Hawaii, and Palm Springs. Claire and Mitch were raised in a household that was characterized by a lack of affection from their parent figures, now as a result, in their own families, they find it difficult to express affection even though they wish to be warmer. Phil, on the other hand, was raised in a household that could be characterized by an over-abundance of affection, now as Phil is a parent, he often tends to overly dote on his wife and children. Together, they fill each other’s gaps and create a balanced and functional parental structure by ensuring their children grow to maintain independence.
Family Health Promotion Theory
Health Promotion Model by Pender was adapted by Loveland-Cherry and Bomar in 2004 to create the Family Health Promotion model (FHPM) which includes three influences that determine whether a family unit will engage in health-promoting behaviors (Kaakinen et al., 2018). The three influences that make-up FHPM are: general influence, health-related influences, and behavior-specific influences which help determine the likelihood of the family taking the time to plan activities as a unit and enhance the overall well-being and cohesion. The values of the Dunphys have always coincided with one another; although the children may waiver at times, the foundation of the Dunphy values always remain the same. Even though the children are now young adults, they always make time to have family dinners and vacations as a unit. By doing so, the family unit is strengthened, and these traditions will be passed down to future generations. This also helps the family have a baseline regarding the health of each member by remaining in continuous contact with one another; if there is a change in condition, the family will be alerted.
It is important the nurse utilize this model when providing care to patients and families. By doing so, the nurse can properly gauge the effectiveness of client teaching. Involving the families will be suitable only if they have a clear understanding of what health is and the perception of their own health status. If there are barriers to health-promoting behaviors, the nurse must understand how to overcome the barriers to achieve the highest level of care and maintain commitment to the planned care. The nurse must use this model to assess the communication and interaction patterns, so she can best discuss the needs of the patient and listen to the concerns of the family, both verbal and non-verbal. By understanding the demographics and patterns of the family, the nurse will have the ability to build rapport with the patient and family to enhance optimal care.
By utilizing Friedman’s Family Assessment Model to assess “the Dunphy” family, the nurse will have a better understanding as to how to approach families and patients during time of illness. The family must be observed to determine the best course of action when providing care. Family structure and function are also vital in understanding how a family will handle difficult situations and how the nurse should communicate so the information will be heard and comprehended so the health of the patient will take precedence.