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)