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Cynthia Lazaro-Hipol, MD,MPH,FPAFP

Introduction: Family Medicine


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Family Medicine

y medical specialty

y continuing and comprehensive health

care for the individual and family.y integrates the biological, clinical, and

behavioral sciences.

y

encompasses all ages, both sexes,each organ system, and every disease

entity.


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Family medicine is a three-

dimensional specialty

(1) knowledge,

(2) skill and(3) Process

patient-physician relationship with

the patient viewed in the context ofthe family

relationship is valued, developed,

nurtured and maintained


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Basic Principles of Patient Care in

Family Practice

yPatient - Centered

yComprehensive CareyContinuity of care

yContext of CareyCoordination of care


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Biopsychosocial Model (Patient-

Centered)

y approach patients with sensitivity and

responsiveness to culture, age, gender,

and disabilities

y develops their ability to collect and

incorporate appropriate psychosocial,

cultural, and family data into patient-centered management plans

(Annals of Family Medicine Supplement, March 2004).


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Comprehensive Care (Whole Person

Care)

y emphasizes the importance of caring for

the whole person by providing

opportunities for students to participatey in longitudinal, integrated, preventive

services and treatment of common

acute and chronic medical problemsfor patients and families in all phases

of the life cycle.

(Annals of Family Medicine Supplement,

March 2004).


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Continuity ofCare (Continuous Healing

Relationships)

y values and promotes continuous healing

relationships by

y providing a personal medical home for

patients and their families

y maintaining ongoing responsibility for

the health care of patients and families

y facilitating transitions between theprimary care provider, referral agencies,

and consultants.

(Annals of Family Medicine Supplement, March 2004).


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Context ofCare (Evidence-Based)

y emphasizes the development of patient-

and family-centered treatment plans

yevidence-based, safe, and designed to

produce high-quality outcomes that

enhance functional outcome and

quality of life in a culturally responsivemanner

(Annals of Family Medicine Supplement,

March 2004).


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Coordination / Complexity ofCare

(Integration)

y functions as the integrator of

complex care and collaborates as ahealth care team member in

disease management, health

promotion, and patient education.

(Annals of Family Medicine

Supplement, March 2004).


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Attribute Description

A deepunderstanding ofthe dynamics ofthe whole

person

consider all the influenceson a persons health.integrate rather than

fragment care, involvingpeople in the prevention ofillness and the care of

their problems, diseases,and injuries


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A generativeimpact on

patients

lives

participate in the birth, growth,

and death of their patients and

want to make a difference intheir lives.

family physicians foster personal

growth in individuals and help

with behavior change that may

lead to better health and a

greater sense of well-being


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Attribute DescriptionA talent for

humanizing

the health

care

experience

intimate relationships over time

enable family physicians to connect

with people.

explain complex medical issues in

ways that their patients can

understand.

take into account the culture and

values of their patients, while

helping them get the best care

possible


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A natural

command of

complexity

comfortable with

uncertainty and

complexity.

trained to be inclusive, to

consider all the factors

that lead to health and

well-beingnot just pills

and procedures


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A commitment to

multidimensional

accessibility

not only physically accessible to

patients and their families andfriends,

able to maintain open, honest

and sharing communicationswith all who are involved in the

care process


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Roles of a Family Physician??

yEducator/ Health Advocate

yResearcher

yManager

yCommunity Organizer

yCare-giver


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cancer patients should expect to

receive

y competent general medical care, advice

regardingy treatment, care coordination, pain

management, and

y end-of-life care and emotional supportfrom their primary care physicians.


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Characteristics of the New Model of

Family Medicine

Patient-centered careyPatients are active participants in their

health and health care.

yThe practice has a patient-centered,

relationship-oriented culture that

emphasizes the importance of meetingpatients needs, reaffirming that the

fundamental basis for health care is

"people taking care of people"65


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Family Medicine

Personal medical home

y

The practice serves as apersonal medical home for

each patient, ensuring

access to comprehensive,integrated care through an

ongoing relationship


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Characteristics of the New Model

of Family Medicine

Team approachy

health care is not delivered by anindividual, but rather by a

ymultidisciplinary team approach for

delivering and continually improving

care for an identified population41,67


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Family Medicine

Elimination of barriers to

accessythrough implementation of open

scheduling, expanded office hours,

and additional, convenient optionsfor communication between

patients and practice staff


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Family MedicineAdvanced information systems

y use an information system to deliver and

improve care, to provide effective practice

administration, to communicate with patients, tonetwork with other practices, and to monitor the

health of the community.68

yA standardized electronic health record (EHR),

adapted to the specific needs of family

physicians, constitutes the central nervous

system of the practice


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Family Medicine

Redesigned officesy

Offices should be redesigned tomeet changing patient needs and

expectations, to accommodate

innovative work processes, and to

ensure convenience, comfort, and

efficiency for patients and clinicians


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Family Medicine

Whole-person orientationy integrated, whole-person care

y developing cooperative alliances with services

or organizations that extend beyond thepractice setting, but which are essential for

meeting the complete range of needs for a

given patient population.38

y The practice has the ability to help guide a

patient through the health care system by

integrating carenot simply coordinating it


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Family Medicine

Care provided within a

community contextyA culturally sensitive, community-

oriented, population-perspective

focus


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Family Medicine

Emphasis on quality and safety

ySystems are in place for the

ongoing assessment of

performance and outcomes and for

implementation of appropriatechanges to enhance quality and

safety


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Family Medicine

Commitment to provide family

medicines basket of services

yA commitment to provide patients with

family medicines full basket of

serviceseither directly or indirectly

through established relationships withother clinicians


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Basket of Services in the New Model of

Family Medicine

yHealth care provided to children

and adults

y Integration of personal health care

(coordinate and facilitate care)

y

Health assessment (evaluate healthand risk status)

y Disease prevention (early detection

of asymptomatic disease)


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Family Medicine

yHealth promotion (primary

prevention and health

behavior/lifestyle modification)yPatient education and support for

self-care

y Diagnosis and management ofacute injuries and illnesses

yDiagnosis and management of

chronic diseases


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Family Medicine

ySupportive care, including end-of-life care

y Maternity care; hospital care

y Primary mental health carey Consultation and referral services as

necessary

y

Advocacy for the patient within the healthcare system

y Quality improvement and practice-based

research


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Traditional Model New Model of Practice

Systems often disrupt the

patient-physician relationship

Systems support continuous

healing relationshipsCare is provided to both sexes

and all ages; includes all

stages of the individual and

family life cycles in continuous,healing relationships

Care is provided to both sexes

and all ages; includes all

stages of the individual and

family life cycles in continuous,healing relationships

Physician is center stage Patient is center stage

Unnecessary barriers to

access by patients

Open access by patients

Care is mostly reactive Care is both responsive andprospective

Care is often fragmented Care is integrated


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Paper medical record Electronic health record

Unpredictable package ofservices is offered Commitment to providingdirectly and/or coordinating a

defined basket of services

Individual patient oriented Individual and community

oriented

Communication with practice issynchronous (in person or by

telephone)

Communication with thepractice is both synchronous

and asynchronous (e-mail,

Web portal, voice mail)

Quality and safety of care are

assumed

Processes are in place for

ongoing measurement and

improvement of quality and

safety


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Physician is the main

source of care

Multidisciplinary team

is the source of care

Individual physician-

patient visits

Individual and group

visits involving severalpatients and members

of the health care team

Consumes knowledge Generates newknowledge through

practice-based research

Experience based Evidence based


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A family Physician

MD

Residency Training CME

Diplomate Examination

Felow

Certified Family Physician

2000


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Afamily physician is

yA doctor who graduated in the

1960s; went back to his

hometown; see patients of all ages

and with varied diseases??????

Jose dela Cruz, MD

Physician- Surgeon

False


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yA doctor who graduated

three years ago ; passed theboard; went back to his

hometown and is presentlytreating patients of all

ages????????????

A family physician is

False


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yA doctor who graduated 10

years ago; Completed aresidency training in Pediatrics;

Passed the Diplomate Board;

Sees patients of all ages andwith varied diseases?????????

A family physician is

False

True


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Afamily physician isyA doctor who graduated in the 1970s,

went back to his hometown and

practice. Attended CME activities of the

Philippine Academy of Family Physicianin the 1980 s. Got a certificate as a

Certified Family Physician.

Jose dela Cruz, MDPhysician- Surgeon

?????????????True

False


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yA doctor who graduated in 1975; earned

a Masters degree in Public Health;wentback to his hometown and practice; see

patients of all ages and varied

diseases?

False

False


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yA doctor who graduated in 1985;

Underwent three years training inFamily Medicine; did not take any

diplomate exam; went back to his

hometown and practice.? TrueFalse


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yA doctor who graduated in 1085;

Finished a residency training in

Family Medicine; Passed thediplomate exam; earned a Masters

degree in Public Health.went back

to his hometown and practice.? TrueTrue


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yA doctor who graduated in the

1970s, went back to his hometown

and practice. Attended CME

activities of the Philippine Academy

of Family Physician in the 1980 s.

Got a certificate as a Certified

Family Physician.Passed the

diplomate exam. See patients of all

ages and with different complaints.True

True


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y For nos 6 and 9, refer to the case below:

y Dr. Gloria Grajera is a 60 year old private practitioner. She

had her residency training in Family Medicine.S

he has nowa MD, FPAFP after her name. She admitted a patientsuffering from uncomplicated Myocardial Infarction 2 daysago. She referred the patient to her friend, an internistyesterday for she noted some irregularities in her pulse. Dr.Grajera ordered the dietician to give her patient soft diet forthe next three to five days. Likewise she advised the patientnot to mobilize or move around because it would causemore harm to the patients heart.

y Dr. Grajera is a:

y Internist

y Family Physician

y Specialist

y B and C

y A,B,C


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y For nos 6 and 9, refer to the case below:

y Dr. Gloria Grajera is a 60 year old private practitioner. She

had her residency training in Family Medicine.S

he has nowa MD, FPAFP after her name. She admitted a patientsuffering from uncomplicated Myocardial Infarction 2 daysago. She referred the patient to her friend, an internistyesterday for she noted some irregularities in her pulse. Dr.Grajera ordered the dietician to give her patient soft diet forthe next three to five days. Likewise she advised the patientnot to mobilize or move around because it would causemore harm to the patients heart.

y The role/s performed by the above physician:

y Caregiver

y Researcher

y Manager

y Educator

y Combination of the above


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y Dr. Gloria Grajera is a 60 year old privatepractitioner. She had her residency training inFamily Medicine. She has now a MD, FPAFP afterher name. She admitted a patient suffering fromuncomplicated Myocardial Infarction 2 days ago.She referred the patient to her friend, an internistyesterday for she noted some irregularities in herpulse. Dr. Grajera ordered the dietician to give her

patient soft diet for the next three to five days.Likewise she advised the patient not to mobilize ormove around because it would cause more harm tothe patients heart.

y Most likely, Dr. Grajera is practicing in ay Primary Care hospitaly Secondary Care Hospital

y Tertiary Care Hospital

y Only B or C


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y Dr. Gloria Grajera is a 60 year old privatepractitioner. She had her residency training inFamily Medicine. She has now a MD, FPAFP afterher name. She admitted a patient suffering fromuncomplicated Myocardial Infarction 2 days ago.She referred the patient to her friend, an internistyesterday for she noted some irregularities in herpulse. Dr. Grajera ordered the dietician to give her

patient soft diet for the next three to five days.Likewise she advised the patient not to mobilize ormove around because it would cause more harm tothe patients heart.

y The kind of care given by the above physician:y Comprehensivey Continuousy Coordination of carey A and By A and C


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familyas a unit ofcare

prepared by:

cynthia l. hipol, md, mph, fpafp


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family,definitions

in terms of affinity- group of people related by blood,

marriage or adoption, who live

together in one household*

*UNITED NATIONS


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family,definitions

Household: a group of personsliving under one roof and

sharing the same kitchen and

housekeeping arrangements


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family, definitions, cont.

involve delineation of family

structure, functions,composition, and

affectionalities


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familystrengths,cont.

1. ability to provide for the

familys physical, emotional ,spiritual,and cultural needs

- spiritual : sharing of basic beliefs- cultural : sharing of cultural values


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2. child - rearingpractices and discipline

1. respect each others views anddecisions on child rearing

practices

2. if a single parent, the capacity of a

single parent to be consistent and

effective in raising the children


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3. communication

- the ability to communicateand express a wide range of

emotions and feelings both

verbally and non verbally


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4. support, security, and

encouragement4.1 provide each members with

feelings of security and

encouragement4.2 balance in the pattern of

family activities


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familystrengths, cont.

5. growth :producing

relationships;- the familys ability to maintain

and build friendships and relationships in

the neighborhood


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6. responsible community- relationships: the capacity of

the family members to assumeresponsibility through participations in

social, cultural or community activities


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7. self - help and accepting help

- ability to seek and accept help

when they think they need it8. flexibility of family functions

- and roles: family members ability

to fill in for one another duringtimes of illness or when needed


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9. crisis as a means of

growth-ability to unite and become supportive during

a crisis or traumatic experience

10. family unity, loyalty and

intra- familycooperation

- ability to recognize and use family

traditions and rituals that promote unity and

pride


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familyas a special unit

1. family membership is a lifelong

involvement

2. shared attributes3. sense of belonging

4. social expectations

5. built-in problems6. family endures despite conflicts

and built -in problems


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whyfamilyas a unit ofcare

1. family is the social context for

health care

2. patients problem is the familys

problem

3. family is the greatest ally in

treatment

4. patients family is present in patient

interview


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what is familycare ?

1. taking care of all individuals in the

family one by one2. dealing with family as object of

management

3. influencing family members to

change factors affecting an

individuals health


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what familyphysicians need to

know

aboutfamilies

1. understanding family structure

and function

2. awareness of how familiescommunicate

3. skills in observing how families

operate4. ability to relate family / individual

5. reinforce central function of

family

Family in Stressful2


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Cycle ofFamily Function

y

Functional

Equilibrium

1 life event 2

Family indisequilibrium3

Resources

adequate4

Adaptation

(coping)5

Resources

Inadequate6

Crisis)7

Extrafamilial

resources

8

Maladaptation

(coping)9

Pathological

equilibrium10

Stressful

life event11

Terminal

disequilibrium12

Smilktein


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The Filipino Family

yReliance on the family for love,

support, and refuge has historicallybeen as much an economicnecessity as it is a cultural tradition.

y the relationship to family is not just apractical trade off of autonomy forsocial security.


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The Filipino Family

y transcends socioeconomic, educational,and regional differences and is part of acollectivistic cultural orientation or way ofperceiving the place of the individual in thesocial context (Gochenour, 1990; Santos,1983).

y is the source of one's personal identity and ofemotional and material support; it also is thefocus of one's primary duty and commitment.Dependence on, loyalty to, and solidarity withthe family and kin group are of the highestpriority (Okamura & Agbayani, 1991).


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classification offamilies

according to structure

nuclear family extended family

polygamous family

single - parent family


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families according to structure

1. nuclearfamily

married man and woman with their

offspring (biological/adopted) occupy a separate dwelling not

shared with members of the

family of orientation of either

spouse economically independent


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families according to structure,cont.

2. extended family

includes three generations

shared responsibilities

maintenance of expressive and

emotional relations beyond the

nuclear family


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There are three basic family systems

extended family

y

Unmarried adult daughters and sonstypically remain in their parents' homeand contribute to family support.

yAdditional extended family memberssuch as grandparents, aunts, uncles,or cousins also may live in the samehouse and assume vital roles (Almirol,1982; PAFEF, 1982; Santos, 1983).


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3. single - parent family

may result from:

-

the loss of the spouse from death, divorce,

separation or desertion

from the out of wedlock birth of a child

from the adoption of a child


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4. blended family

includes step parents, andstepchildren

may be caused by separation,

divorce, remarriage


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basic family systems

y nuclear family which consists of ahusband, wife and children

y extended family which brings togetherseveral generations in direct line andkinship ties built by marriage.

y polygamous family which consists of ahusband or wife and several spousesand their children;


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yIn Christian Filipinas, the family

is monogamous, one wife and

one husband at a given timewhilepolygamous or multiple

wives in Muslim Filipino families

is allowed. Nowadays, Muslimsgenerally practice monogamy


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y

Filipino

Family(Mag-anak)


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y

Type of relationshipemphasized

yConjugal : marital bondy

Consanguinal: blood tiesyPersonal virtuesyChoice of marital partner,

friends, godparentsyWeakness/immorality/defects

Muslim Rural Filipino Urban Filipino Western


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Paternal dominance Paternal dominancewith maternaldecision makingsome areas

Paternal dominancewith maternaldecision makingsome areas

Trend towardcomplete equalitybetween husband& wife

Family is theproperty holderand source oflabor

Family is the propertyholder and sourceof labor

Important in property;less effective islabor unit

Economic role minorexcept as unit ofconsumption

Strong discipline of

children

Moderate strong

discipline ofchildren

Combination of

discipline andindulgence oftreatment ofchildren

Trend toward the

equality inparent-childrelationship

Family choice ofmate

Romantic love exaltedsubordinate toparental approval

Individual maritalchoice withparental approval

Romantic love allimportant withparental approval

playing minorrole

No free associationwith oppositesex except forcollege educated

Chaperonage or groupdating

Chaperonage givingway of dating

Little and nochaperonage andno taboos


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Double standard of

morality

Double standard of

morality

Double standard

with queridasbeing challengeby wives

Tendency to a

single standardfor both sexesfor fewertaboos for both.Prostitutionavailable,mistresses rare

Divorce simple forhusband;available for

cause forwife

No divorce; legalseparation withright ofremarriageConsensualmarriage notuncommon

Prostitutionavailable;No divorce. Legalseparationwithout rightof remarriage

Divorce obtainableon manygrounds, butsubject to legalrestrictions andfinancialburdensome

Extended familyoften livetogetherHigh birth rate;high infantmorality rate

Extended family tiesstrong butusually separatedwellings. Highbirth rate; lowinfant mortalityrate

Extended familyweaker than inrural areas. Birthbetween that ofMuslim andWestern infantmortality low

Small familyincludes only 2generations andnot collateralrelatives. Lowbirth rate andlow infantmortality


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familyset - up

1. democraticset upparents respect their childs decisions

and ideas, tolerance, understanding and

permisiveness prevail

2. authoritarian set up

conformity to parental guidance,more punishments than praises


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y

Naming:patronymic vs matronymicy Authority

yPatriarchal

yMatriarchal

yEqualitarian

Rules of ResidenceyNeolocalyMatrilocalyPatrilocal


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y

"Traditional families and other socialsystems are highly authoritarian.Age, power, prestige, and wealthare the chief sources of authority"

(S

antos, 1983, p. 140).

y Within the family, age determines ahierarchical system of authority that

flows downward from oldest toyoungest.


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y

Outside the family, otherfactors such as social class,professional status or official

government affiliation, andecclesiastical positions maysupersede age as

determining factors in thelocus of authority.


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yEgalitarian roles and relationshipsbetween men and women arefurther reflected in family decision

making processes.

yFamily authority is based on respect

for age, regardless of sex.


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yFamily decisions are made only

after a consensus has beenreached to ensure that the ultimatedecision will be representative of

and acted on by all family members.

yFamily disagreements are avoided,

if possible; when disagreements dooccur, they are kept strictly withinthe family (PAPEP, 1982).


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yAlthough the father may be ostensibly

perceived as the main authority figurein the nuclear family, the mother hasconsiderable authority and influence.

yShe generally controls the finances,may work full time (even with manychildren at home), and earns as much

as or more than half the familyincome.


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yWomen enjoy high status in the family

and in the society at large. Bilaterallineage attests to this higher status ofFilipinas compared with women inmore patriarchal Asian countries.

yThe long accepted phenomenon ofthe "working mother" in the

Philippines thus does not pose adrastic role change as it does forother recent Asian immigrant familiesin the United States (PAPEP, 1982).


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basic areas offamily

function

1. biologic 2. economic

3. educational

4. psychologic

5. socio - cultural or socialization


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familyrelationship

and interaction


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y Children are the center of the parent'sconcerns. They are viewed as an extension

of the family and recipients of the family'sgood fortune.

y Parents are expected topersuade a child toaccept their point of view, rather thanimpose their authority on the child withoutconsideration for the child's preferences orwishes.

y

The child, in turn, is expected to showproper respect and obedience, tocompromise, and to maintain goodrelationships with all other family members(PAPEP, 1982).


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y In the Pilipino culture, the birth ofchildren is an expected and desiredoutcome of marriage. Most couplesprefer to have children of bothsexes, and there is typically no

special preference for males overfemales.

yChildren are considered a special

"gift from God," and a large family isproof of God's favor and blessing(Guthrie & Jacobs, 1966).


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I. ordinal position

1. first born - persevering, serious,more responsive to adults, achievement-

oriented

2. middle child - optimistic ,sociable, aggressive and competitive

. 3.youngestchild- demanding,outgoing, narcissistic, though by natureaffectionate

II parent child interaction /


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II. parent child interaction /

familyrelationship

1. rejecting parent

has an insecure, aggressive, sadistic, nervous,stabborn and uncooperative child

2. submissive parentbears an aggressive, careless, disobedient and

uncooperative child


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II. parent - child interactions/familyrelationships,cont.

3. dominating parent gives out an uncooperative, tense, quarrelsome

and disinterested child

4. absent father or mother

home

- child is aggressive, neurotic, jealous,uncooperative, delinquent and less confident in

the future and less able to trust adults


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III. social class pattern of behavior

1.upper

class familyclosely- knit greater concern for

maintaining the family name and prestige

2. middle class family

believes in hard work, self reliance,initiative, independence, responsibility,economic security and self improvementthrough education

3. lowerclass family

largely unemployed, sees life is acontinuous process for survival and givesthe impression of being to a life of frustrationand defeat

Filipinos view education as


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Filipinos view education asy a "passport to good jobs, economic security,

social acceptance, and as a way out of a

cycle of poverty and lower class status, notonly for their children, but for the whole family"(Santos, 1983, p. 146).

y

family concern

y an economic investment toward which familymembers must contribute significant effort andoften personal sacrifice.

y the individual is expected to assume theresponsibility of helping his or her parentsfinance the education of the next child.

major strengths of the Pilipino


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j g p

character:

ypakikipagkapwa-tao (having a regard for thedignity and being of others),( PhilippineSenate commissioned task force in 1988)

y family orientation, joy and humor, flexibility,adaptability and creativity, hard work andindustry, faith and religiosity, and ability tosurvive

(Licuanan, 1988). Each of these characteristics was summarized by Okamura andAgbayani (1991) and has been consistently identified by Church (1986) in areview of other studies on Pilipino personality values or ideals.


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y

Pakikipagkapwa-tao is manifestedamong Filipinos in their basicsense of justice and fairness andconcern for other's well being.

Filipinos recognize the essentialhumanity of all people and regardothers with respect and empathy.


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yPakikisama represents both avalue and a goal that consists ofmaintaining good feelings in allpersonal interactions and gettingalong with others at all costs.

To avoid open displays of conflict and


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To avoid open displays of conflict andstressful confrontations, Filipinos may

yield to

y group opinion (even if it contradicts their owndesires),

y lavish extravagant praise on one another,y use metaphorical language rather than frank

termsy hide negative feelings or depressed spirits

beneath a pleasant demeanor,y

smile when things go wrong, avoid saying"no," and refrain from expressing anger orlosing their temper (Guthrie, 1968; Harper &Fullerton, 1994).

Hi


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Hiyay

commonly translated as "shame,"y a feeling of"inferiority,

embarrassment, shyness, andalienation which is experienced as

acutely distressing" (Guthrie, 1968,p. 62).

y integrally related to the concept of"face" and a preoccupation withhow one appears in the eyes ofothers.

Hi


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Hiya

y inculcated as a necessary part of achild's development and used as ameans to shape approved or

desired behaviors.

y Thus, an individual's capacity forappropriate behavior with authority

figures is a reflection of one's familyand upbringing and the fear of"losing face" (PAPEP, 1982).


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utangna looby also is an integral aspect ofmaintaining group harmony andrelationships that require thebalancing of obligations anddebts

V. filipino values,cultural ideals,cont.


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1.paggalang- respect for the individual

2. pagbabahala- concern for work and other people

3. pananagutan

- accountability for action taken

4. pagbabalikatan

- sharing the burden with others

5.pagbabayanihan -- cooperation with teamwork

6.pagmamalasakit

- solicituous concern for all


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yNice to Know


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THE FILIPINO FAMILY IN MODERN SOCIETY

y

The process of modernization is catching up with theFilipino familyy Change must occur if the family is to survive in a

changing world

The Size of the Familyy In spite offamily planning programs and education efforts

promotedy In spite of the economic difficulties of bringing up children,

y their birth is welcomed;o "Gifts from Godo sent to help their parents obtain a better life through filial love,

participation in income generating activities, insurance for their

parents old age, and sources of strengthening family bonds.y typical family : five children, although three to four (urban) and

four to five (rural) are considered by many parents as the idealfamily size


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y Economic Pressures on the Family

y Effects ofPoverty on the Family

y The kinship system:

y The extended kinship Group:

Changing pattern:compadrazgo.yChanging roles of men and woman

y Double standard of morality

y Filipino Families must prepare


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y Filipino Families must preparethemselves for:y

a serious reexamination of values andpractices.

y they will have to break with the past andadjust to the future. There is enough

evidence of the viability of the Filipino familyto make this adjustment and to ensure itssurvival.

yThe function of the family is being moreand more absorbed by other socialinstitutions such as the church and theschool, but the family will remain as a greatsource of emotional and psychologicalsatisfaction.


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Filipino Family Values

People get strength and stability from their family. Assuch, many children have several godparents, the morethe better.

Concern for the extended family is seen in the

patronage provided to family members when they seekemployment.

It is common for members of the same family to workfor the same company, more likely than not. Jobs arehard to get and you can trust you relatives almost

always.

In fact, many collective bargaining agreements statethat preferential hiring will be given to family members.


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Documents

Print Aug 10 Fam. as a Unit-1