Effectiveness of family-focused intervention in patients with schizophrenia in family and community practice – A meta-analysis study

Background@#Schizophrenia is a pervasive, chronic mental disorder that negatively impacts the biological, socioeconomic and family well being of the patient. Active involvement of family members and other significant individuals appears to benefit overall management.@*Objective@#To determine the effectiveness of family-focused intervention in improving symptoms of schizophrenia.@*Methods@#The authors searched for eligible clinical trials in the PubMed, Cochrane Central Register of Controlled Trials, Research Gate, Google Scholar and grey literature databases. Participants should be patients diagnosed to have schizophrenia and interventions should involve the family or be labeled as ‘family therapy.’ The primary outcome considered was symptom improvement based on the Positive and Negative Symptom Scale (PANSS). Secondary outcomes included quality of life, family functioning and subjective experience of the treatment process. The authors used the RevMan 5.4 software for data analysis. Bias, subgroup and sensitivity analyses were performed. Strength of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework.@*Results@#A total of 1,794 trials were initially identified, of which three publications were included in the review. Two studies used psychosocial approaches whereas one used cognitive behavioral therapy in conjunction with family intervention. Meta-analysis revealed the studies to be heterogeneous based on p values <0.10 and I2 >50%. Subgroup analysis by type of intervention showed no difference between the intervention and control groups, although there was a positive trend in favor of psychosocial intervention for improvement in PANSS score. Family-based intervention had a significant positive effect on quality of life. @*Conclusion@#Family-based interventions are effective in the management of schizophrenia, helping to improve quality of life, potentially reducing symptom burden and serving as an adjunct to health institution-based management.

Evaluation of family interventions among children with allergic rhinitis undergoing immunotherapy / 预防医学

Objective@#To evaluate the effectiveness of family interventions among children with allergic rhinitis receiving immunotherapy, so as to provide insights into improvements of allergic rhinitis treatment.@*Methods@#A total of 80 children with allergic rhinitis admitted to The First People's Hospital of Linping District from July 2018 to July 2021 were enrolled and randomly assigned into the control and intervention groups, of 40 participants in each group, and all children underwent immunotherapy. Children in the control group received routine interventions, while participants in the intervention group were given family interventions for 3 months, including health education, psychological counseling, and periodical follow-up. Parental awareness of allergic rhinitis was investigated using self-designed questionnaires, and the compliance to immunotherapy was evaluated. The clinical symptoms were evaluated using the symptom scores and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and the prognosis was evaluated using the Sino-Nasal Outcome Test-20 (SNOT-20).@*Results@#There were no significant differences between the intervention and control groups in terms of gender, age, course of disease or disease severity (P>0.05). The scores for parental awareness of etiology [(9.56±0.25) vs. (7.45±0.85)], inducement factor [(8.84±0.62) vs. (6.76±1.36)], medication management [(9.56±0.25) vs. (7.97±0.85)] and daily life management of allergic rhinitis [(9.14±0.55) vs. (8.14±0.46)] were significantly higher in the intervention group than in the control group (P<0.05). The proportion of participants' compliance to immunotherapy was significantly higher in the intervention group than in the control group (92.50% vs. 75.00%, P<0.05). The scores for clinical symptoms [(3.12±0.94) vs. (3.96±1.23)], RQLQ score [(3.31±0.87) vs. (3.87±1.02)] and the SNOT-20 scores for nasal symptoms [(6.54±2.14) vs. (8.22±2.45)], sleep disorders [(4.11±0.58) vs. (5.24±1.03)], associated symptoms [(5.29±1.52) vs. (6.34±2.01)] and emotional consequences [(7.52±1.85) vs. (9.19±2.69)] were significantly lower in the intervention group than in the control group post-interventions (P<0.05).@*Conclusion@#Family interventions are effective to improve the compliance to immunotherapy, clinical symptoms, prognosis and quality of life among children with allergic rhinitis

Intervención Familiar, Clínica Psicológica e Intervención Psicosocial. Trazos para la Comprensión de una Complementariedad / Family Intervention, Psychological Clinic and Psychosocial Intervention Stroke for the Understanding of a Complementary / Intervenção Familiar, Clínica Psicológica e Intervenção Psicossocial. Traços para a Compreensão de uma Complementaridade

Resumen Introducción. Los estudios de familia en Colombia, como campo disciplinar que aplica teorías, conceptos y metodologías de otras disciplinas, evidencia, desde su apuesta epistemológica, el reconocer a la familia como un objeto de conocimiento científico que apropia y produce conocimiento. Objetivo. de este artículo es analizar el método de generación de conocimiento en la intervención familiar, la clínica psicológica y la intervención psicosocial en un grupo de veinte profesionales de las Ciencias Sociales de las ciudades de Medellín y Manizales. Materiales y Métodos. investigación cualitativa, con enfoque hermenéutico. Se privilegió la entrevista semiestructurada para la producción de información; la sistematización y análisis se realizó con el software Atlas Ti, versión 6.0. Resultados. el entrecruzamiento de las categorías intervención familiar, clínica psicológica, intervención psicosocial y generación de conocimiento, permite vislumbrar una apuesta educativa y complementaria, que ofrece un acompañamiento desde y para las familias, en la cual reconocen capacidades y recursos para afrontar su cotidianidad. Conclusión. la intervención familiar, la intervención psicológica y la intervención psicosocial, como apuesta ético - política del profesional de las Ciencias Sociales, debe permitir el desarrollo de procesos críticos - reflexivos en los cuales las familias son agentes de su propio cambio.

Abstract Introduction. Family studies in Colombia, as a disciplinary field that applies theories, concepts and methodologies of other disciplines, shows, from its epistemological commitment, the recognition of the family as an object of scientific knowledge that appropriates and produces knowledge. Objective. of this paper is to analyze the methods of generation of knowledge in familiar intervention, psychological clinic and psychosocial intervention with a group of professionals of Science Social of Medellín y Manizales of Colombia. Materials and methods. Qualitative research, with focus on hermeneutics. It was used the semi-structured interview was used to produce information. The analysis it was made with the software Atlas-Ti, versión 6.0. Results. the dialog of the category familiar intervention, psychological clinic, psychosocial intervention and generation of knowledge permit disern an educational conviction and complement, for offer an accompanying from the families. For this is necessary recognice capacities and resources for confront the reality. Conclusion. familiar intervention, psychological clinic and psychosocial intervention as focus ethical-political of the professional of Science Social must allow the development of critical in which the families are agents of its chance.

Resumo Introdução. Os estudos da família na Colômbia, como campo disciplinar que aplica teorias, conceitos e metodologias de outras disciplinas, mostra, desde seu compromisso epistemológico, o reconhecimento da família como objeto de conhecimento científico que se apropria e produz conhecimento. Objetivo. deste artigo é analisar o método de geração de conhecimento em intervenção familiar, clínica psicológica e intervenção psicossocial em um grupo de vinte profissionais das Ciências Sociais das cidades de Medellín e Manizales. Materiais e métodos. pesquisa qualitativa, com abordagem hermenêutica. A entrevista semiestruturada foi privilegiada para a produção de informações; a sistematização e análise foram realizadas com o software Atlas Ti, versão 6.0. Resultados. o cruzamento das categorias intervenção familiar, clínica psicológica, intervenção psicossocial e geração de conhecimento, permite vislumbrar uma aposta educativa e complementar, que oferece suporte de e para famílias, na qual reconhecem capacidades e recursos para enfrentar seu cotidiano. Conclusão. a intervenção familiar, a intervenção psicológica e a intervenção psicossocial, como compromisso ético-político do profissional das Ciências Sociais, devem permitir o desenvolvimento de processos crítico- reflexivos em que as famílias sejam agentes da sua própria mudança.

Evaluation of a group family-based intervention programme for adolescent obesity: the LITE randomised controlled pilot trial

INTRODUCTION@#This study aimed to evaluate the LITE (Lifestyle Intervention for TEenagers) group programme, a family-based behavioural lifestyle intervention for overweight and obese adolescents.@*METHODS@#We conducted a two-arm randomised controlled trial that recruited overweight and obese adolescents who attended a tertiary care weight management clinic. Participants were randomised to the LITE programme or usual care. The primary outcome assessed was body mass index (BMI) z-score. Secondary outcomes of anthropometric measurements, metabolic profile, parenting and adolescents' perception of family support were measured at baseline, three months and six months. Feasibility and acceptability of the LITE programme were also evaluated.@*RESULTS@#61 adolescents were enrolled, with 31 in the LITE programme and 30 in usual care. At three months, participants in the programme had a greater reduction in weight (-0.18 ± 2.40 kg vs. 1.48 ± 1.97 kg; p = 0.107), waist circumference (-1.0 ± 3.1 cm vs. 2.4 ± 2.7 cm; p = 0.016), waist-height ratio (-0.01 ± 0.02 vs. 0.01 ± 0.02; p = 0.040) and systolic blood pressure (-3.8 ± 13.7 vs. 5.7 ± 13.1; p = 0.119) compared to the usual care group. There was no significant difference in BMI z-score. At six months, there were significant improvements in adolescents' perception of family support for eating habits in the LITE group compared to the usual care group. The LITE programme had a good attendance rate of 67.7% and was well received.@*CONCLUSION@#The LITE programme showed feasibility and short-term clinical effectiveness in improving some clinical outcomes and improved adolescents' perception of family support.

Feasibility of the Strengthening Families Program for Brazilian Families: A Mixed Method Study / Viabilidade do Strengthening Families Program para Famílias Brasileiras: Um Estudo com Métodos Mistos

Abstract The objective of this study was to examine the feasibility (limited effectiveness, acceptability and practicality) of the Strengthening Families Program, a universal preventive intervention, for Brazilian families. A pre-experimental study was carried out, with pre-test, post-test, 6- and 10-12-month follow-ups. 74 adolescents and their parents participated. Scales on academic, parenting, and health outcomes were applied to adolescents at the four assessment times. Direct observation of implementation fidelity and families engagement in the intervention and telephone interviews with facilitators were used to investigate acceptability and practicality. The results show significant increase in parental supervision and learning self-efficacy. High levels of fidelity and parent/guardian engagement as well as moderate levels of adolescent engagement were found. The facilitators found the intervention had acceptable goals, but procedures excessively structured and unsuitable for families with low educational level. Practical implications are discussed.

Resumo Este estudo teve por objetivo examinar a viabilidade (efetividade limitada, aceitabilidade e praticidade) do Strengthening Families Program, uma intervenção preventiva universal, para famílias brasileiras. Conduziu-se um estudo pré-experimental, com pré-teste, pós-teste, 6 e 10-12 meses de follow-up. Participaram 74 adolescentes e seus pais. Escalas sobre desfechos acadêmicos, parentais e saúde foram aplicadas nos adolescentes nos quatro tempos de avaliação. Observação direta da fidelidade da implementação e do engajamento familiar na intervenção e entrevistas por telefone com facilitadores foram usadas para investigar aceitabilidade e praticidade. Identificou-se aumento significativo em supervisão parental e autoeficácia para a aprendizagem. Altos níveis de fidelidade e engajamento parental foram encontrados, bem como engajamento moderado dos adolescentes. Os facilitadores consideraram a intervenção aceitável em suas metas, mas com procedimentos excessivamente estruturados e inadequados para famílias com baixo grau de instrução. Implicações práticas são discutidas.

Comunicación en familias que acompañan a pacientes en la clínica psiquiátrica "Nuestra Señora del Sagrado Corazón" (Medellín-Colombia) / Communication in families that accompany to patiens in the Psychiatry Clinic "Nuestra Señora del Sagrado Corazón" (Medellín-Colombia)

Resumen Este artículo se propuso interpretar la comunicación de familias de pacientes vinculados a intervenciones grupales en una Clínica Psiquiátrica de Medellín (Colombia). Se utilizó el enfoque cualitativo y se desarrolló a partir de las propiedades vinculadas a la dimensión de comunicación familiar. Este estilo de investigación se mantiene en la tradición hermenéutica, que siguiendo a Galeano (2004) da prioridad a los relatos de los participantes para captar las interpretaciones que ellos hacen de sus propias realidades. Los resultados sugieren que la comunicación en el acompañamiento familiar a pacientes se sostienen en tres dimensiones: "La paradoja comunicativa", "Otras alternativas de comunicación" y "Los tiempos narrativos referidos a la enfermedad mental". Se concluye que los síntomas del paciente involucran a la familia como sistema y éstos fueron construcciones intersubjetivas.

Abstract The aim of this study was to understand the communication in families of patients participating in group interventions in a Psychiatric Clinic of Medellin (Colombia). This was a qualitative research, and we carried it out according to the family communication construct. Results suggest that communication in family support towards patients have three dimensions: "Communicational paradox", "Other communication alternatives" and "Narrative times about mental illness". We concluded that the symptoms presented by the patient involve the family as a system and these were subjective constructions.

Application of ICF-CY in Family Rehabilitation of Children with Duchenne Muscular Dystrophy / 中国康复理论与实践

Objective To explore the feasibility of assessments of functional and environmental factors in children with Duchenne mus-cular dystrophy (DMD) under the frame of International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY). To execute family intervention and to evaluate its effects. Methods A 6-year-and-5-month-old boy with DMD was enrolled to the study. Functional and environmental factors were assessed with the North Star Ambulatory Assessment (NSAA), time tests, hand-held dyna-mometry assessment, body mass index and family interview. Plans of family intervention were settled and executed for one year and at the end of intervention, the boy received all the above assessments to compare the effects of intervention. Results After one-year family inter-vention, the muscle strength was improved or maintained in most muscles except abductors of hip and the body mass index did not change. For the activities, the scores of NSAA increased and maintained, and the result of time tests improved. Otherwise, attitude and execution of parents were improved. Conclusion It is feasible to execute family intervention under the frame of ICF-CY in children with DMD. Both children and their family may benefit from the intervention.

Effect of community family nursing intervention on glycemic control of type 2 diabetic patients / 现代临床护理

Objective To explore the effect of community family nursing intervention on glycemic control of type 2 diabetic patients. Methods Ninety-two patients with type 2 diabetes after discharge in 6 communities of Tianhe District in Guangzhou were divided into a study group and a control group , 46 cases in each . The control group received routine care , while patients in the study group received additional community family nursing intervention, including personalized health education, diabetes family day and sharing, telephone follow-up and family home visits. The fasting plasma glucose, 2h-postprandial glucose and glycosylated hemoglobin A1c were compared. Results There were no significant differences in fasting plasma glucose, 2h-postprandial glucose and glycosylated hemoglobin A1c (all P>0.05). After intervention, there were significant differences in the three eridoxes between the two groups(all P<0.05). Conclusion The community family nursing intervention is of great importance to control the blood glucose, improve the therapeutic compliance and self-management ability in patients with type 2 diabetes.

Tratamiento con intervenciones psicosociales en la fase aguda y de mantenimiento del paciente adulto con diagnóstico de esquizofrenia / Psychosocial Interventions in Acute and Maintenance Treatment of Adult Patients Diagnosed With Schizophrenia

Objetivos: Determinar cuáles son las estrategias psicosociales efectivas para mejorar los desenlaces en adultos con esquizofrenia tanto en la fase aguda como de mantenimiento de la enfermedad, con el fin de realizar recomendaciones dentro de la Guía de Atención Integral para el diagnóstico, tratamiento e inicio de la rehabilitación psicosocial de los adultos con esquizofrenia. Método: Se elaboró una guía de práctica clínica bajo los lineamientos de la Guía Metodológica del Ministerio de Salud y Protección Social para identificar, sintetizar, evaluar la evidencia y formular recomendaciones respecto al manejo y seguimiento de los pacientes adultos con diagnóstico de esquizofrenia. Se adoptó y actualizó la evidencia de la guía NICE 82, que contestaba la pregunta acá planteada. Se presentó la evidencia y su graduación al grupo desarrollador de la guía (GDG) para la formulación de las recomendaciones siguiendo la metodología propuesta por el abordaje GRADE. Resultados: La psicoeducación y la intervención familiar mostraron ser eficaces en comparación con el tratamiento usual para prevención recaídas y hospitalizaciones, disminuir la carga familiar y mejorar la adherencia al tratamiento. El entrenamiento en habilidades sociales fue eficaz para mejorar síntomas, funcionamiento social y calidad de vida. No obstante, la calidad de la evidencia fue baja. No había suficiente evidencia sobre la eficacia de la terapia ocupacional, pero al considerar las preferencias de los pacientes y que es una intervención altamente empleada, se sugirió su inclusión en la atención. Conclusión: Se recomienda ofrecer para el tratamiento de la esquizofrenia, psicoeducación, entrenamiento en habilidades sociales e intervenciones familiares. Además, se sugiere el uso de terapia ocupacional en el contexto hospitalario o ambulatorio.

Objectives: To determine the effectiveness of the psychosocial strategies designed to improve the outcomes in adults with schizophrenia in both, acute and stable phase of the disorder. This evidence is used to propose recommendation in the guidelines of integral attention for the diagnosis, treatment and psychosocial rehabilitation of adults with schizophrenia. Methods: A guideline for clinical practice was developed using the methodological framework of the Ministerio de la Protección Social to collect evidence and grading recommendations. A search, evaluation and synthesis of evidence were carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. Results: The psychoeducation and family intervention showed higher efficacy, compared with the usual treatment, to prevent relapses and hospital readmissions, to reduce family burden and to improve adherence to treatment. The social skill training was effective to improve symptoms, social functioning and quality of life. However, the quality of evidence was low. There was not enough evidence about the efficacy of occupational therapy, but considering patients preferences and its wide clinical utilization, the GDG suggested its inclusion. Conclusion: Psychoeducation, family intervention and social skill training are recommended to be offered for the treatment of schizophrenia. Furthermore, occupational therapy is suggested for inpatients and outpatients with the disorder.

Apontamentos e reflexões sobre programas de apoio familiar que favorecem a competência social da criança / Notes and reflections on family support programs that foster the social competence of children

A harmonia nas relações familiares tem um impacto positivo para todos os seus membros e, em especial, para o desenvolvimento da competência social da criança. Com base nos conhecimentos científicos atuais, a proposta deste artigo é examinar os critérios de qualidade necessários aos programas de apoio psicossocial que visam intervir junto às famílias, no intuito de diminuir os problemas de comportamento das crianças e melhorar sua competência social. Os programas abordados nesse artigo são Incredible Years, High Scope e Fast Track (Estados Unidos), ELEM e Fluppy (Canadá). Constata-se que as intervenções familiares com base nesses conhecimentos atendem a altos padrões de eficácia e ética. Porém, conclui-se que pesquisadores e profissionais ainda encontram obstáculos em protocolos onde a baixa coerência entre a avaliação e a intervenção pode comprometer a qualidade do apoio oferecido às famílias numa perspectiva de saúde pública.

Harmony in family relationships has a positive impact on all its members and especially on the development of the social competence of the child. Based on current scientific knowledge, the scope of this article is to examine the quality criteria required for psychosocial support programs aimed at intervening together with families in order to reduce the behavioral problems of children and enhance their social competence. The programs discussed in this article are Incredible Years, High Scope and Fast Track (United States), ELEM and Fluppy (Canada). It is revealed that family interventions based on this knowledge meet high standards of efficacy and ethics. However, the conclusion reached is that researchers and professionals still face obstacles in protocols where the low coherence between assessment and intervention may compromise the quality of support offered to families from a public health perspective.

Influence of professional family intervention on family cohesion and adaptability of patients with breast cancer / 现代临床护理

Objective To study the influence of the professional family intervention on cohesion and adaptability of breast cancer patients.Methods One hundred and twenty-eight breast cancer patients were randomly divided into control group and intervention group in equal number.The control group was given conventional nursing and the intervention group interventions including nursing instruction for their families and caregivers,mental instructions,and regular follow-ups in terms of life and rehabilitative instructions.A Family Adaptability and Cohesion Scale(FACESII-CV)was used for assessment before and after intervention.Result After intervention,the score on cohesion and adaptability of the intervention group were significantly higher than those of the intervention group before intervention and the control group(P<0.05).Conclusion The professional family interventions can effectively improve the family cohesion and adaptability of breast cancer patients.

Influence of family intervention mode in patients with schizophrenia characterized by negative symptoms / 中国实用护理杂志

Objective To evaluate the influence of family intervention mode in patients with schizophrenia characterized by negative symptoms.Methods A total of 120 cases of hospitalized patients with schizophrenia characterized by negative symptoms were randomly divided into the observation group and the control group with 60 cases in each group.The observation group received treatment through family intervention mode based upon routine care,while the control group used routine care.Influences were assessed with Nurses’ Observation Scale for Inpatient Evaluation (NOSIE) and the Scale for Assessment of Negative Symptoms (SANS) before treatment and at the end of 6th,12th week treatment.Results No significant difference of NOSIE score or SANS score were found upon admission between the observation group and the control group.At the end of the 6th week or the 12th week,total and all factors’ scores of the NOSIE and SANS of both groups were better compared with pretreatment,the observation group was significantly better than the control group.Conclusions Family intervention model could significantly relieve the negative symptoms of schizophrenia,improve the patients’ clinical efficacy and is an effective adjunctive therapy for schizophrenia.

Application effect of family intervention model in early Alzheimer's disease patients' family / 中国实用护理杂志

Objective To investigate the impact of Friedman family intervention model on the personal life ability and psychological status of caregivers of early Alzheimer's disease patients.Methods 66 Alzheimer's disease patients,according to the random sequence,were divided into the study group and the control group with 33 patients in each group respectively.The control group received routine geriatric care,the study group was given Friedman family intervention model on the basis of routine geriatric care.Two groups were estimated with Life Scale Index and ADL before intervention and two months after intervention respectively,and the matching caregiver were evaluated with Symptom Checklist-90 (SCL-90).Results Compared with the control group,the quality of daily life after the intervention of the study group was significantly improved,and the differences of daily living skills between two groups were statistically significant.The differences of the SCL-90 total score and depression,anxiety,somatization,interpersonal factor scores of caregivers between the two groups were statistically significant after two months of intervention.Conclusions The application of Friedman family intervention model plays a significant role in the improvement of the quality of daily life and daily living skills in patients with Alzheimer's disease,and can improve the psychological status of the caregivers of AD patients.

Rehabilitative effect of simulated family intervention on hospitalized depression patients / 现代临床护理

Objective To investigate the rehabilitative effect of simulated family intervention on hospitalized depression patients.Methods One hundred depression patients in hospital were evenly randomized into the experiment group and control group:Both groups were treated with traditional antidepressant therapy and beside,the experiment group were taken care of by family members by way of simulated family intervention and the control group by isolated nursing intervention.The two groups were compared in therapeutic effect by survey using HAMD before intervention and 3 months after that.Result After 3 months of treatment,the score by HAMD in the experiment group was significantly lower than that in the control group(P<0.05).Conclusion The simulated family intervention by family members in hospital may be effective in improving the rehabilitation of depression patients and good for their resumption to the communities.

Effect of family-based intervention on the prevention of falls in elderly hypertensive patients / 现代临床护理

Objective To evaluate the effect of family interventions on the prevention of falls in elderly hypertensive patients. Methods One hundred elderly hypertensive patients were divided into the experiment group and the control group in equal number. The control group returned for regular visits after discharge while the experiment group received the family intervention including cognitive,psychological,behavioral and environmental intervention.The two groups were compared in terms of fall rate and degree of injury.Results The incidence of falls in the experiment group was significantly lower than that of the control group,the incidence of soft tissue injury after a fall in the experiment group was significantly lower than that of the control group(both P<0.05).Conclusion Family intervention is effective in prevention of falls in elderly hypertensive patients for it may reduce the incidence of falls and the degree of fall injuries.

Efectos de una intervención a familiares de consumidores de alcohol en una región indígena en México / Effects of intervention on relatives of alcohol consumers in an indigenous community in Mexico

The 2008 National Addictions Survey reports that dependence on alcohol consumption is higher in Mexico's rural and indigenous communities (10.6%) than in urban areas (9.5%), and that its consequences for the social and health environment are correspondingly greater. This is compounded by the marginalization and poverty of these regions and the scant resources available for dealing with health, particularly alcoholism. The study was carried out in the indigenous zone of El Mezquital in the state of Hidalgo. In this state, the National Addictions Survey (2008) reports that daily consumption is 1.4% and habitual consumption is 6.6% while the index of abuse and dependence is 6.8%, all of which are above the national mean of 0.8%, 5.3% and 5.5%, respectively. One of the consequences is having a mortality rate for hepatic cirrhosis of 40.2 for every 100 000 inhabitants, making this the area with the highest mortality rate from this cause in Mexico, which has an average rate of 26.3 cirrhosis-related deaths for every 100 000 inhabitants. The family is the most immediate group affected by the alcoholism of one of its members, which has severe implications for the psychological and physical health of the other members. Since little is known about the way families in Mexico's indigenous or rural zones deal with this problem, a research project was carried out to find out more about the situation. To this end, an ethnographic study was undertaken to identify the role of alcohol in everyday life and determine families' needs for support and the cultural challenges that must be overcome to undertake an intervention. The results of the ethnographic exploration showed that alcohol consumption is a deeply-ingrained custom in the community that provides group identity and solidarity, particularly for men. Its consumption is closely linked to work, particularly agricultural activities and construction. One important aspect was women's complaints that they did not know what to do about the consequences of excess alcohol consumption on the family's health and economy. In addition to this, a powerful patriarchal influence was identified that prevented women from seeking psychological assistance for the problem of alcohol abuse, which is essentially male. Poverty is one of the characteristics of the desert area of El Mezquital where this study was carried out. It constitutes yet another obstacle to seeking and requesting help, partly because of the adverse geographical conditions that limit transport. In addition to the scant transport services, there are communities in which the nearest health center is just over an hour's walk away. Moreover, families' scant resources are used to cover basic needs, ignoring both physical and mental health aspects. On the basis of an ethnographic study, an intervention program was linguistically and culturally adapted to provide support for families. This resulted in a specialized manual suitable for the region, designed to train health professionals to help relatives cope with a family member's excess consumption. This intervention was carried out between 2008 and 2009 and the results are presented in this study. Intervention model This brief intervention, based on the stress-coping-health model, is designed to help relatives find means of coping with their relatives' consumption in a more beneficial way for their health and to establish or strengthen support networks on the basis of their needs. Three coping styles have been documented: committed, tolerant and independent. The intervention consists of five steps that can be carried out in approximately five sessions. These involve: 1. Exploring family concerns; 2. Providing essential information on the effects of alcohol consumption; 3. Analyzing the coping styles used; 4. Exploring social support networks; and 5. Referring family members to specialized care, where necessary. Through these five stops, the intervention seeks to: a) Reduce the presence of physical and psychological symptomatology; b) Improve coping styles in a way that will benefit the relative's mental health and c) Reduce the presence of depressive symptomatology. Method Objective: The purpose of this study was to evaluate the effects of the brief intervention on relatives of a person who consumes excess amounts of alcohol and to compare these results with relatives who, despite having the same problem, refused to participate in the intervention program. Procedure: the intervention was carried out by two psychologists (facilitators). Health center personnel referred relatives to the facilitators (group that experienced the intervention). The intervention ended when the women felt confident enough to be able to use the new coping styles, which took between 4 and 6 sessions (which lasted from 6 to 8 weeks). The <

El consumo de alcohol en la región indígena del Estado de Hidalgo representa un problema de salud importante. Según la ENA 2008, el consumo diario es de 1.4%, el consuetudinario de 6.6% y el índice de abuso y dependencia de 6.8%, todos por encima de la media nacional de 0.8, 5.3 y 5.5%, respectivamente. Hidalgo presentó en 2007 una tasa de mortalidad por cirrosis hepática de 40.2 por cada 100 000 habitantes, primer lugar del país, que en promedio tiene una tasa de 26.3 habitantes por cada 100 000. La familia es el grupo más inmediato que se ve afectado por el consumo de alcohol, con implicaciones graves para la salud psicológica y física de sus miembros. Para conocer cómo enfrentan esta situación las familias en zonas indígenas del Estado de Hidalgo, se llevó a cabo un estudio etnográfico donde se encontró que el consumo de alcohol es una costumbre arraigada en la comunidad, que proporciona identidad y solidaridad de grupo. Un resultado relevante del estudio fue la queja de las mujeres de no saber qué hacer frente a las consecuencias que tiene el consumo excesivo de alcohol en la familia, así como la fuerte influencia patriarcal que limita a las mujeres para solicitar apoyo psicológico. La pobreza, las difíciles condiciones geográficas, transportes insuficientes y la prioridad de resolver necesidades básicas limitan la búsqueda de apoyo profesional. Como resultado de la exploración etnográfica, se identificó la necesidad de atención a las familias para encontrar mejores formas de enfrentar la problemática; por ello se adaptó un programa para ofrecer acciones de apoyo a familias indígenas. La intervención se llevó a cabo entre 2008 y 2009, los resultados se presentan en este trabajo. Modelo de atención: La intervención breve tiene como meta ayudar a los familiares a encontrar formas de enfrentar las situaciones de consumo de manera más benéfica para su salud y establecer o fortalecer redes de apoyo. Consta de cinco pasos: 1. Escuchar la problemática del familiar, 2. Brindar información relevante, 3. Analizar los estilos de enfrentamiento utilizados, 4. Búsqueda de fuentes de apoyo y 5. Canalización en caso de requerir atención especializada. Éstos se llevan a cabo en aproximadamente cinco sesiones. Material y método Objetivo: Evaluar los efectos de la intervención breve sobre la presencia de sintomatología física y psicológica, los estilos de enfrentamiento utilizados y la presencia de sintomatología depresiva, en personas que conviven con un familiar con consumo excesivo de alcohol. Muestra: 60 mujeres entre 18 y 65 años con problemas por el consumo de alcohol de un familiar (esposo o padre). Se integraron dos grupos, uno con intervención y otro sin ella. Para formar el primero, el personal de los centros de salud canalizó a los familiares con las orientadoras (dos psicólogas) para recibir atención, que concluía una vez que las mujeres manifestaban confianza para utilizar nuevos estilos de enfrentamiento, lo que ocurrió entre las sesiones cuatro y seis. El <

Influence of comprehensive family intervention on family function among HIV-infected injection drug users / 中国实用护理杂志

Objective To examine the effects of comprehensive family intervention on family function among HIV-infected injection drug users (IDUs). Methods Ninety-eight HIV-infected IDUs in 3 AIDS treatment sites in Hunan Province were selected by random cluster sampling and were randomly divided into the intervention group (50 cases) and the control group (48 cases). Subjects in the intervention group were given a 9-month comprehensive family intervention, while those in the control group received standard treatment and care. When the study was completed, APGAR questionnaire was used to analyze the effects of comprehensive family intervention. Results Before the intervention ,the scores of family function were not significantly different the intervention group and the control group. After the intervention, the scores of family function among the control group were(4.26± 3.73) points and the intervention group was (6.53± 4.29) points, the scores of family function were significantly different between the two groups. Conclusions The comprehensive family intervention is an effective model to improve the family function of HIV-infected injection drug users.

Educar é punir?: Concepções e práticas educativas de pais agressores / Is educate punishing?: Parents' childrearing practices and conceptions

A violência física de pais contra filhos é um dos tipos de violência doméstica e constitui um problema de saúde pública. Buscando colaborar para a compreensão do problema e para estratégias de intervenção com famílias, este trabalho tem o objetivo de investigar concepções sobre o educar e as práticas educativas de pais denunciados. Os entrevistados são pais/mães denunciados ao Conselho Tutelar. Utilizou-se o modelo de entrevista “História de vida temática”, constituída pelo relato da história de vida do entrevistado, complementada por um conjunto de tópicos previamente definidos. Foram realizadas seis entrevistas, sendo gravadas, transcritas e analisadas qualitativamente. Os resultados apontam inconsistências entre concepções e práticas educativas, dificuldades em utilizar recursos alternativos à punição física para colocar limites; a falta de suporte em rede social como fatores de risco, e a necessidade de implementar programas de intervenção que promovam a integração entre suas concepções e práticas como educadores.

Domestic violence is a known public health problem. This research intends to investigate conceptions and childrearing practices of parents that use physical violence against their children. Interviews with three mothers and three fathers from different families were made. Qualitative methodology was used, through semi-structured interview called “Thematic Life History”, where participants expose their personal history since childhood, followed by a previously defined list of topics. Interviews were recorded, transcribed and qualitatively analyzed. Data analysis revealed that parent’s conceptions are not corresponding to their every day actions with their children; the difficulty of parents at using non-violent chidrearing practices and a cultural naturalization of physical punishment to establish limits. It also points out parents` low social and economical support as a risk factor, as well as the necessity of changes in intervention programs to offer possibilities of joining parents conceptions and practices, aiming the improvement of child`s positive global development.

Centros de apoio familiar e aconselhamento parental: proposta de um modelo global de organização / The centers for family support and parental counseling: proposal of a global organization model

Os Centros de Apoio Familiar e Aconselhamento Parental constituem, no panorama dos serviços sociais portugueses, uma tipologia relativamente recente de serviços de apoio familiar dirigidos a crianças e jovens em situação de risco e suas famílias. No entanto, tendem a operar de formas muito distintas, carecendo ainda de enquadramento técnico e legal adequado. No presente artigo, revêem-se os objetivos dos CAFAP e apresenta-se uma proposta de um Modelo Global de Organização destes serviços, para que se apresentem como recursos eficazes de apoio ao trabalho solicitado pelos Tribunais e pelas Comissões de Protecção de Crianças e Jovens, bem como de suporte à própria comunidade, na protecção e promoção do bem-estar das famílias, crianças e jovens. O modelo apresentado pretende oferecer um enquadramento de base que permita uniformizar práticas e metodologias e facilitar o desenvolvimento de esforços futuros de investigação e avaliação da eficácia dos serviços prestados.

The Centros de Apoio Familiar e Aconselhamento Parental (CAFAP, Center for Family Support and Parental Counseling) correspond, in the Portuguese reality of Portuguese services, to a category of services designed to support families with at-risk children and youth. However, these services tend to operate in many different ways, still without legal and technical framing. In the present article, one aims to review the CAFAP's objectives and present a Global Organization Model for these services, so they can operate as effective support resources for the activities of the courts, the child protection services and the community in the protection and promotion of families', children's and youth's well-being. With the purpose of creating common practices and methodologies, the proposed model offers a basic framework for the development of future research and evaluation efforts in regard to the efficacy of the services provided.

Application Research on Early Family Intervention in Prevention and Treatment of Cerebral Palsy / 国际中医中药杂志

Objective To explore the effect of family early intervention on development of infants with prematurity and hypoxic ischemic encephalopathy(HIE).Methods 136 cases of premature infants,moderate and severe HIE infants were randomly divided into a treatment group and a control group.Every region of intelligence development was detected by Gesell Developmental Schedules at 16 weeks,28 weeks and 12 months respectively.Results Motor behavior,adaptive behavior,language behavior and personal social behavior increased obviously in the treatment group,while the incidence rate of cerebral palsy markedly decreased,showing a significant difference compared with the control group.Conclusion Early family intervention can efficiently improve the development of premature infants or infants with HIE,and prevent cerebral palsy from occurrence.