20141217040021_07. mpu3313 mpu2313 topic 3

8/10/2019 20141217040021_07. MPU3313 MPU2313 Topic 3

1/11

INTRODUCTION

In this topic, we will start the discussion on health with the aspect of how itaffects the individual, family and community. No individual can live on his ownwithout any support from the family and community. Community support isimportant, especially in current times where the cost of medical care hasescalated and in-patient care has been limited only to patients who really need it.Community health personnel require the cooperation of individuals, familymembers and the community to help the patients to resume their productive lifein the community.

TTooppiicc

33 Personal,

Family andCommunityHealth

LEARNING OUTCOMES

By the end of this topic, you should be able to:

1. Define personal, family and community health;

2. Discuss the roles of the individual and family in contributing tohealth;

3. Discuss the communitys roles in health; and

4. Identify the activities in community health.

8/10/2019 20141217040021_07. MPU3313 MPU2313 Topic 3

2/11

TOPIC 3 PERSONAL, FAMILY AND COMMUNITY HEALTHY 31

PERSONAL, FAMILY AND COMMUNITYHEALTH

We will begin by discussing personal, family and community health.

3.1.1 Personal Health

What is personal health?

Personal health or also known as individual health, includes the physical andpsychosocial needs of the individual.

Taylor, Lillis, LeMone and Lynn (2008)

These needs, which are also known as basic needs, are common to all individualsand the difference will be the way an individual prioritises these needsaccordingly. The basic needs of the individual range from physiological needs toself-actualisation needs as proposed by Abraham Maslow. The theory coined byMaslow states that human needs are arranged according to a hierarchy and itdepends on an individuals need at that time. The five levels of needs are:

(a) Physiological Needs

This need refers to the core needs of an individual like oxygen, water, food,temperature, rest, physical activity and sexuality which must be minimallyachieved to sustain life. Imagine if one is unable to breathe or does not havefood and water for a period of time. Try to hold your breath and time howlong you will be able to sustain before your brain automatically pushes youto breathe in air (oxygen). How long can one last without food and water?It has been stated that one can last for weeks without food, but can only lastover a week without water.

In terms of the need for rest, one needs at least six to eight hours of sleep to

be able to carry on their normal activities. For a person who has beendeprived of sleep for more than 48 hours, they will become irrational. It isalso the same with temperature the extremes of cold and hot can changethe action of an individual.

An example of an individual who cannot fulfil his or her basic needs issomeone who keeps two jobs to sustain his living expenses. He will notconsider owning a house to meet the ideal safety and security needs butwill be content to just have a roof over his head.

3.1

8/10/2019 20141217040021_07. MPU3313 MPU2313 Topic 3

3/11

TOPIC 3 PERSONAL, FAMILY AND COMMUNITY HEALTHY32

(b) Safety and Security NeedsThis category of needs includes both physical and emotional elements.Safety means having a safe and secure place to live in and a safe

environment where one can shield himself from any danger. This can betranslated differently by different individuals. For some who do not havethe means, safety may mean just to have shelter from the rain and sun,while for others it may mean a comfortable house with all the gadgetsneeded to keep away unwanted visitors. Likewise, emotional security maymean, having neighbours whom you can trust, or colleagues who aresupportive.

An example of a basic safety need is to have a house. For some people,there are other issues to be considered in owning a house, for example,

location, type of house, furnishings and neighbourhood. For others, havinga rented house in a proper housing area is better than just living in asquatter area.

(c) Love and Belonging NeedsAll humans need to be loved and belong. Having someone to shower oneslove on and from whom to receive love, like a friend, family or significantother, is the third level of needs, after fulfilling physiological and safetyneeds. This is considered a higher level of needs, and there are thoseindividuals who would not fulfil this third level of needs because theycannot fulfil their basic needs. On the other hand, individuals who have

fulfilled their basic needs but are unable to fulfil their safety and securityneeds will not consider this third level of needs. For example, someone whohas difficulty in attending to their basic needs and safety needs will notsettle down and get married just yet as this will incur additional expensesand makes it difficult to maintain his lifestyle.

(d) Self-esteem NeedsThis is considered the next highest priority of needs. It is about the need tofeel good, a sense of accomplishment and respect about oneself. Before

being able to think about this level of needs, one has to fulfil all the earlier

needs. Take for example someone who has fulfilled his physiological andsafety needs and is also able to feel a sense of love and belonging, throughhaving a family who reciprocates his love. In addition, this person hasnothing to fear and all is in order at work and at home. Thus, he will nowstart to think of how to improve his life further. Consider your own

8/10/2019 20141217040021_07. MPU3313 MPU2313 Topic 3

4/11


example, as a person currently pursuing further education. You are able todo so, as the first three level of needs have been fulfilled and now you wishto go up the next level to accomplish something, which when attained, will

widen your job scope, provide promotion and perhaps improve the respectyou receive from colleagues and the community. A positive self-esteem willpropel you to further achieve a much higher level of needs, which is thelevel of self-actualisation.

(e) Self-actualisation NeedsThis is the highest level of needs and not everyone can achieve this. Somepeople may dream to achieve this but it takes a lot of effort to do so. Anexample is when someone who has minimal qualifications aspires to landhimself the highest ranking post in his organisation. Should he depend on

projecting himself as an excellent worker, he will still not able to attain thepost of his dreams. However, if he projects excellent work attitudes whilepursuing academic qualifications relevant to the desired job, and with supportfrom those around him, it is not impossible for him to achieve his goal.

An individual who has reached the third level of needs as mentioned above hasthe potential to move into the fourth and the fifth level, if he works hard at it.Therefore, every individual has a different interpretation of his personal orindividual health and how he will achieve it in life if he gauges it throughMaslows needs hierarchy.

When a person is able to perform all his usual activities in life and does not sufferfrom any illness, whether physical or mental, he is considered healthy or inpossession of health. For another individual, personal health may meansomething different, based on his current physical and mental status. Let usconsider the example of someone who has always suffered from toothachewhenever he drinks iced water. After he follows some advice orrecommendations to minimise the pain, he no longer experiences pain. In thiscase, the person would say he has achieved good health. For those who havedebilitating conditions, any improvement to the current situation is considered asachieving improved health.

An individual shall decide up to which level of needs he must achieve beforemoving on to the next level. There are some who will decide to achieve the firstlevel and then move to the third level. This is because he feels that he can foregothe second level of needs. You can use the different levels mentioned and chartyour own hierarchy of needs.

8/10/2019 20141217040021_07. MPU3313 MPU2313 Topic 3

5/11


3.1.2 Family Health

What is family health?

It is not only in the absence of sudden illness or sickness in any family memberthat a family is considered healthy, but there are other factors like inheritedconditions that a family must be aware of as well. An example would beThalassemia or Haemophilia, both of which are blood disorders and are inheritedconditions. Another inherited condition is asthma, a respiratory condition.Families with inherited health conditions may consider various options so thatthe disease minimally impacts the member affected by it. For example, they cantake precautions to prevent exacerbation of the condition either with regularmedical check-ups and food supplements or they can even prepare financially bytaking health insurance to minimise the financial and emotional impact of any

future medical issues.. Planning is critical to ensure that each family membersneeds are catered for in the event of illness or disease.

The interpretation of family differs from one individual from another. Whilemany consider immediate family members as those related to them by blood,such as their father, mother, siblings and children, some may also include theirgrandparents, if they are staying with them. Other people may include in theirfamily persons not related by blood, for example, in-laws and helpers who livewith them as family members. It is very important that the family is definedaccording to ones culture and beliefs. It is important that one knows how eachfamily member defines health for the other family members so they can identifythose dos and donts to maintain their health.

Family health means that all the members considered as family are able tocarry on their life and daily activities without any assistance or anycomplaints related to health. Each family has their own values, beliefs andstrengths that they practice so they can continually carry out the activities oftheir life.

Potter and Perry (2005)

ACTIVITY 3.1

If your child was diagnosed with dermatitis, a skin condition, and he orshe is allergic to chemicals found in detergents and soap, how wouldyou plan to prevent the condition from recurring?

8/10/2019 20141217040021_07. MPU3313 MPU2313 Topic 3

6/11


Within the family unit, the individuals that make up the family may reactdifferently in their practices relating to health. While some family members

believe that drinking coffee before bedtime helps them to get a good nights

sleep, another family member may have the opposite opinion. A family memberwho is sick or ill can impact on the well-being of other family members. When afather who is the breadwinner becomes ill or sick, the effect includes financialincapability, as well as support usually provided to other family members liketransport assistance and others. Likewise, when a mother is ill or sick, the caringresponsibilities in a family are affected, especially if there is a small childinvolved and those responsibilities related to cleaning and cooking may also beaffected.

Other variables that are associated with family health are emotional and

psychological concerns. The emotional and psychological factors that affect afamily member can in turn affect how he or she behaves toward other membersof the family. Emotional factors include the behaviour of a family membertoward another family member who is considered as a burden in terms of energyas well as financially. This behaviour, if allowed to continue, may eventually leadto psychological impact like stress and anxiety, which can cause very seriousconsequences to the individual and the family members. This may lead to manyincidences of abusive behaviour and violence among family members. Theaffected members are usually those who are not able to defend themselves likethe elderly or the very young.

What are the challenges faced by a family? Challenges for a family are affectedby the structure in which the family is built. The types of family structure arenuclear family, single-parent family, blended family or other family structures.

A nuclear family, also called a traditional family, consists of the husband, thewife and the children. In the modern society, the parents can be heterosexual orhomosexual, legally married or in a committed relationship or de-factorelationship. In a traditional nuclear family, the breadwinner is the father whoprovides the economic needs while the mother stays home to look after thechildren, providing emotional and security needs.

When there are family members like grandparents, uncles and aunts livingtogether with the nuclear family, it is called extended family. Extended familymay live together or in close proximity to the nuclear family and will be able toprovide support when needed. Nowadays, there are more people opting to livewith their extended family, especially if the nuclear family is still young and doesnot have the financial security to live on their own or support to look after theiryoung children.

8/10/2019 20141217040021_07. MPU3313 MPU2313 Topic 3

7/11


A single-parent family occurs when a parent is absent due to death or divorce orwhen a single person adopts a child. There is an increasing number of people whochoose to adopt a child without being married. In Malaysia, a thorough screening

is done by the welfare department before a single person is allowed to adopt achild. Some of the potential problems with a single parent are financial andsecurity issues as well as emotional problems. As the child grows, the challengesfaced by a single parent are more intense, for example, abuse and emotionalproblems for the child who may question the parents status and integrity.

A blended family is formed when a parent brings in children from a previousmarriage or adopts children to live with the current family. This type of familyalso faces challenges when children from two marriages stay together and cannotget along. Financial constraints will be one of the biggest issues, especially when

these children are in school or college, where there is a tendency for divorcedpartners to question the allocations for their children. Usually, a divorced wifewill demand that her children get higher allocation than the children from thewoman whom her divorced husband marries. Other family structure includescohabiting adults, where couples stay together without being married. They mayor may not have children or bring children from previous relationships to livewith them. In Malaysia, this arrangement is not acceptable by all religions, butthere may be cases where this occurs but the authorities are not in-the-know.

Each of the above family structures has their own challenges due to the differentsetups and individuals involved and responsibilities expected of the individual

and family. The major challenges are financial and family responsibilities,especially in terms of custodial rights when an illness affects the children.Sometimes, children are subject to abuse by the partner of their parent, especiallywhen very young children are involved.

Changes in economic status have a major impact on the behaviour of an individualto his family. Aggressive behaviour can occur when there are financial constraints.

3.1.3 Community Health

Community health is a term often used by health care providers to meanapproaches to improve the overall health status of people living in a country. Itcould also mean a group of people with a common personal or environmentalcharacteristic. An example of a common personal characteristic is a group orcommunity for the blind where all the blind people will share a common interestor concern. An environmental characteristic may include all those living in anurban area or developed residential area. Different characteristics of a group orcommunity will ascribe to specific needs, and the purpose is for all its membersto benefit from the activities planned.

8/10/2019 20141217040021_07. MPU3313 MPU2313 Topic 3

8/11


Any activities organised have financial implications and if an activity is privatelyorganised with no sponsors, it will not be successful. This is because there will beno available budget to support the activities. Some activities need the rightsupport material, the right staff and the right equipment in order to be carriedout.

Let us take a look at the example of a gotong-royong to destroy mosquitobreeding grounds.

A key person to initiate the activity is needed and this person has to be someoneinfluential in the community. The message to all community members must bespread so there will be participants for the activity. Necessary equipmentincludes shovels and rubbish bags. In addition, staff from the municipalityshould be involved to help dispose of the rubbish. Refreshments need to beidentified and, importantly, the date and time must be one that is agreeable tomost people.

So who should initiate such activities? Matters related to health are best left tohealth care professionals as they are the experts in this area. If you look aroundyou, the Ministry of Health has ensured that there is one public health facilityavailable at every district, town or rural area. The community leader, or anyoneelected as a representative for the community, should be the resource person toidentify the activity and engage other community members to form a team andorganise the activity. If the support of the health department is needed, an officialletter requesting for the support should be sent and a follow-up ensued to ensurethere is support available. When a community leader of group informs the healthdepartment about an initiative related to health and safety, the health

department usually will provide the necessary support in terms of finance andguidance. The community needs to identify the human support so that theprogramme can be conducted as scheduled. On their own, the health personnelwill not be able to conduct the activity and will require the assistance of thecommunity. This is where teamwork among the different sectors of thecommunity is highly encouraged for a successful outcome.

There may be people from different sectors in the community and their influenceis instrumental to an activity planned for the community. Political influence can

be an added value for communities in rural areas, where political influence is

ACTIVITY 3.2

Do you remember an activity related to health that was initiated in yourresidential area in the last six months?

8/10/2019 20141217040021_07. MPU3313 MPU2313 Topic 3

9/11


high. The public should be made aware that the political leaders voted torepresent them should be involved in any activities proposed by the communityhe/she represents. The political representative will be able to request a budget

from their own political sector as this will be one of the social responsibilitiesthey need to shoulder, in order to garner support from their constituents.

Another group that the community can request assistance from is religiousgroups in their community. Where there are various religious groups in acommunity, it is up to the members to group and seek their assistance. They toocan request funds from their main department to support any activities as part oftheir social obligations to the community. When religious groups from different

beliefs get together for a common community activity serving the differentcommunity groups, it creates ethnic harmony. Religious people also have their

circles of influence and people from certain professions like teachers, police andhealthcare professionals that are part of the religious group. These members willbe able to use their influence to make an activity successful.

ROLE OF INDIVIDUALS IN CONTRIBUTINGTO COMMUNITY HEALTH

As mentioned, an individual will not be able to single-handedly organise anactivity within a community if he does not get assistance from others. Anindividual needs to be able to identify the relevant push and pull factorsprior to organising any health activity in a community.

The individual must consider the push factors, like the age of majority of thepopulation in the community, the anticipated stress levels based on theoccupation or work-related stress among the group, the focus on certain healthissues such as heart disease, diabetes and hypertension, also more commonlycalled non-communicable diseases (NCDs), or the impact of obesity amongchildren and many other factors.

An individual who has concern for the community he/she lives in will be the

initiator or stimulus in organising an activity. If the majority of the communitymembers where he lives are in the senior age group or retirees, he can initiateactivities related to health for senior citizens, for example healthy lifestyle andexercise or healthy diet consumption. This idea can be informed to the groupmembers when they have their meeting and he can provide the assistanceneeded or suggest to whom the proposal can be presented for a successfulactivity.

3.2

8/10/2019 20141217040021_07. MPU3313 MPU2313 Topic 3

10/11


The pull factors include the benefits that can be gained from such activities andthe recognition to the community as a result of the activities. Having the activitypublicised by the local media and inviting prominent people to officiate can add

value to the activity, as well as increase the probability of getting financialsupport from the authorities.

For all activities to be successfully implemented, planning, execution andevaluation of the activity must be measured so improvements can be initiated forrepeated activities. The success stories of one community can be a stimulus forother communities to follow. A few years ago, in the state of Selangor, there wasa competition among the different villages to showcase the beauty and activitiesof the village and their people. The added value to this activity is it became anattraction for people to visit their village, thus enhancing the economy of thepeople in the village. In addition, every community member will ensure theirhealth and hygiene are well-taken care of.

The health aspects that affect individuals are personal, family andcommunity health.

There are five levels of needs according to Maslow (1968), which arephysiological needs, safety and security needs, love and belonging needs,self-esteem needs and self-actualisation needs.

This topic has explored the possible ways an individual can contribute to the

health and well-being of himself, his family and the community.

If all community members believe in the motto that Health is Wealth, andparticipate in any activities planned and organised, the nation will have ahealthier population. This will eventually impact on the nationsproductivity, realising the leaders vision of a healthy and high-incomenation which will benefit all communities.

ACTIVITY 3.3

Are you able to identify some possible health-related activities that canbe done by a community?

8/10/2019 20141217040021_07. MPU3313 MPU2313 Topic 3

11/11

4

P

T

TO0

ommunity

amily healt

aslow, A. (Nostran

otter, P. A.,Fundam

aylor, C., Lilart and

IC 3 PERSO

ealth

968). Towa-Reinhold.

& Perry, A.entals of nur

is, C., LeMocience of nu

AL, FAMILY A

d a psychol

G. (2005).ing(pp. 91

e, P., & Lynsing care. Ph

ND COMMUN

Persona

gy of being

ealth and05). USA: El

, P. (2008).ladelphia: Li

ITY HEALTHY

health

(2nd ed.).

ellness. In Sevier Mosby

undamentalsppincott.

ew York: V

. Epstein (E.

of nursing:

n-

.),

he

20141217040021_07. mpu3313 mpu2313 topic 3

Documents