Family-Oriented Primary Care

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Family-Oriented Primary Care

By
Innocent Besigye
MBChB, MMed
What is a family?

An intimate nurturing group sharing the past,


present & future bound biologically or legally
or socially.
Why family in family medicine?
• A family is the immediate physical, psycho-
social & economic context for the interplay
between health &illness
• Place where disease/illness &
healing/recovery occurs
• Helps to identify family-related factors that
promote health & provide support
• Factors that may undermine the health care
plan
• Causes of lifestyle diseases can be found in
the family
• Genetic factors are well known: genetic tests
& counseling
• Risky beliefs & behaviors
• Shift in the burden of disease from acute
infectious to chronic lifestyle diseases
Practicing FOPC
• Always think family!
• Considers family as an integral part of
information gathering, clinical reasoning &
patient care
• Relevant in primary care due its nature of
uncertainty and dealing with undifferentiated
clinical conditions
5 Helpful Questions when thinking
family
• Has anyone else in the family had a similar
problem?
• What do family members believe caused the
problem & how do they think it should be
treated?
• Who in the family is most concerned about
the problem?
• Have there been any other recent changes or
stresses in your life? Are you or any members
of your family experiencing any difficulties at
present?
• How can your family or friends assist you with
this problem?
Necessary Tools
• Genogram
• Ecomap
• Family Circles
Genogram
• Systematic method of recording important
information on patient’s context
• Relevant for continuity of care
• May help to identify patterns of organic as well
as psychosocial & interpersonal problems
• Preventive tool by drawing attention to the
consequences of health risks in previous
generations
• Helps identify complex family problems that
need referral to counselor/family therapist
Symbols used in drawing
genogram
Ecomap
• Diagrammatically documents & explores broader
social systems within which the family operates
• Household is placed at the centre & drawn
within a circle using genogram symbols
• A number of other circles are drawn around
representing the typical parts of a larger system
• Connections are then drawn between the
systems & the household
Sample
Ecomap for Miss. T
Systems Theory
Human needs
Any Questions?

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