theories serve as a foundation for assessment and health promotion of families

erstanding Families and Health PromotionBy Sue Z. Green

“The greatest wealth is health.”—Virgil (Nurse Advocate, 2018)

Essential Questions

· Which theories serve as a foundation for assessment and health promotion of families?

· How does the nurse analyze a family for health needs? are common concerns for health promotion of family populations?


Health is personal wealth for individuals and families. Assessing families incorporates the family as a whole system and the individuals within the system. Every family has strengths and areas that need support. Understanding the family’s structure and related health concepts allows the nurse to assess the family’s unique characteristics and identify problem areas. Nurses are highly respected professionals whose knowledge and expertise are helpful in providing health promotion guidance to families.

Family Structures and Family Health


A traditional definition of a family is the parents and offspring living together as a societal or social unit with the same ancestry. The U.S. Census Bureau (2015) considers family to be those residing in a housing unit related by birth, marriage, or adoption; however, these definitions of family by bloodline or household cannot encompass the components of modern families, leading to a variety of terminology in use. For example, the term family of origin refers to the bloodline or genetic relationship among family members. In the past, a nuclear family was defined as a basic social grouping or unit with a married male-female couple and their offspring.

indication of gender

Today’s use of the term usually denotes a couple and their children, without indication of gender, marriage, or biological relationships. In contrast, a single-parent family is household in which only one parent is present with a child or children. Last century, the term blended family emerged to describe families where one or both parents have children from a previous marriage. More recently, the term family of choice emerged. Family of choice indicates people chosen by an individual to care, love, and trust rather than the family of origin. Today’s family reaches beyond the traditional definition and encompasses societal units of single-parent families; lesbian, bisexual, gay, transgender, queer, and questioning (LBGTQ+) families; children raised by grandparents or other relatives; multigenerational units; and people who are together out of friendship and love, not bloodlines.

Pets, often part of a household, may acquire the status of “family” members. Thus, family tends to connote a complex, diverse, and dynamic unit, often consisting of parents and children related by legal, genetic, or emotional ties. In fact, the Institute of Medicine (2014) defines family broadly for end-of-life care as “not only people related by blood or marriage, but also close friends, partners, companions, and others whom patients would want as part of their care team” (p. 28). For example, the Calgary family assessment model defines family using the family’s own conception of the term, or the “family is who they say they are” (Wright & Leahey, 2013, p. 55).