FAMILY STRESS THEORY
Group 4
By:
Delly Arfa
Karina Megasari
Tita Septi
Sukardin
Family Stress Theory Begin with Hill’s Model in 1949: Three element that cause crisis, i.e family
issues (stressor), family resources, point of view about the issues
Especially related to health care situation because of the effluent illness that lead into stress family event (Artinian, 1994 in Fridman, 2003)
Original based of work is nuclear family
Stressor
It’s refer to the initiating or the precipitating agents that activate the stress process, are:Life eventsEnvironmentalEconomicSocioculture eventsExperience
Coping
Coping is a effort to solve the problem
Family Coping
Process which the family create the family empowerment, build the new behavior and find some family resources to determine the stressor
Hill’s Model (1949) A : variable that stimulates to the event or
stressor with its adversity B: variable refers to what do family have to cope
with their problem, such as family resources.
For example, religion, economic condition,
social support, health, litheness of family, coping
mechanism C: Variable that shows family point of view about their
problems; family perception about stressor in one
event. X: Variable that shows sum of family ineffectiveness or
incapability to prevent changes that related to
stressor events; X variable is a crisis
Variable A, B, and C combination influence the family’s ability to prevent changes associated with stressor events.
Figure 1. Hill’s ABCX Model
Developmental of Theory
The Double ABCX Model Expand by Mc. Cubin & Patterson (1983a in
Fridman 2003) They Develop Hill’s Theory about ABCX
Model Mc. Cubbin & Patterson modify Hill’s ABCX
components by adding post crisis concept
(Mc. Cubbin&Patterson, 1983 in Liehr & Smith, 2008)
A: Stressor
C: Perception
B: Resources
X:Crisis
aA.Pile up
bB.Existing and New
Resources
cC.Perception
Bonadaptation
X. Adaptation
Mal adaptation
Postcrisis
Time
Pre crisis
Figurre 1.2 Family Stress and Adaptation
Coping
Illustration Case There is a family with autism child (6th
years old). He is the older son of the family. The parents told nurse that they are not well informed about autism; they have heard that autism is being abnormal. They overhelmed by their children’s behaviour; they try to keep their family problem to environment. This family is come from good socioeconomic class. Family comes to clinic and ask to counsel the nurse about their child condition.
ABCX Model by Hill
A : Stressor in family
Children with autism, environment opinion, shameful feeling,
B : Family Resources
Good socioeconomic class
C: Family Point of View
At first, family do not want to accept their child condition, after that
family want to improve their child condition to be more autonomous
X: Crisis in Family
Inadequate family knowledge to take care autism chiild
Double ABCX Model by Mc. Cubinn & Patterson (1983)
aA Factor: Family is adjust the stressor to be accumulative issues
Family hidden their autism child from environment and did not do anything
bB Factor: New resources in Family
i.e: Self reliance from Family
Family integration: improve
communication pattern in family
Continued cC Factor: Perception of stressor Family opinion about their problems and their
new resources will minimize pshycological effect from the crisis.
Family try to comprehend their situation having autism child, and get to know more about autism child –> coping mechanism
xX Factor: Family Adapt the situation
Bonadaptation or maladaptation
Family stress strategies
Cognitive strategiesNormalizingControl the meaning of the problem by
reframing and passive appraisalJoint problem solvingGaining of information and knowledge
Communication strategiesBeing open and honestUse of humor and laughter
External family coping:
Community strategies : maintaining active linkages w/ the community
Social support
Spiritual strategies
Assumptions of the family stress model include (Artinian, 1994 in Fridman, 2003):Unpredicted issuesIssues that comes from inside families (internal
issues)Knowledge insufficiency about stressor affairAmbigous or unclear stressor events
Example of Nursing Care Plan Create trust relationship with family Assess stressor in family Assess family resources Assess family point of view about their
issues Assess family coping mechanism Develop short and long term care plan based
on concept and theory
Conclusion Family Stress Theory begin with Hill’s model
(1949) that divided 3 components to lead crises, such as stressor, family resources, and family perception about issues/ stressor
Hill’s Model has an ABCX Model Mc. Cubin and Peterson (1983) develop Family
Stress Theory to be Double ABCX Model that added post-crisis concept.
Nurse should understand about the concept and family stress theory when give family nursing services
Need to develop short and long term care plan based on family stress theory
References Fridman, M., Bowden, V., Jones, E. (2003). Family Research Nursing:
Theory & Practice (5th Ed.). New Jersey: Pearson education Inc.
Liehr, P., Smith, M . (2008) Middle Range Theory for Nursing (2nd ed.).
Retrieved from http://books.google.co.id/books?id=BxrrFVwW4PgC&pg=PA225&dq=application+of+family+stress+theory&hl=id&sa=X&ei=cw-zUJa4NMXnrAfFsoCACw&ved=0CDYQ6AEwAw#v=onepage&q=application%20of%20family%20stress%20theory&f=false (November, 24, 2012)
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