Résumé
Resumen Las familias, en la actualidad, enfrentan nuevos retos y cambios que comprometen su capacidad de adaptación y su bienestar. Este estudio tuvo como objetivo describir y comparar indicadores de resiliencia familiar y bienestar familiar de 442 familias colombianas ubicadas geográficamente en Bogotá (n = 196), Santa Marta (n = 81) y Cali-Palmira (n = 145). El diseño fue analítico transversal. Las familias diligenciaron el Índice Familiar de Regeneración y Adaptación (FIRA-G) para valorar la resiliencia y el Índice de Bienestar de los miembros de la Familia (FMWB). Los resultados demostraron relaciones significativas y positivas entre bienestar familiar y resiliencia familiar al igual que una relación inversa y significativa entre indicadores de resiliencia negativos como tensión, distrés y tensión familiar con indicadores positivos de resiliencia familiar tales como coherencia, fortaleza y apoyo social. La comparación entre ciudades evidenció divergencias entre las familias de Bogotá y Cali-Palmira, en los niveles de bienestar familiar, estresores familiares y apoyo de parientes y amigos. En el caso de la ciudad de Santa Marta se encuentran diferencias en los estresores familiares con Cali-Palmira y en apoyo social comunitario con Bogotá. La discusión se orienta a mostrar que la resiliencia familiar es resultado de la participación de varios elementos: los recursos familiares adaptativos positivos que le permiten a las familias reducir el estrés y enfrentar las demandas del ambiente, la presencia de los dos padres en familias sin indicadores clínicos que hace que la carga de estrés sea compartida -lo cual abona el terreno para la resiliencia familiar-, y el apoyo social manifestado en ayudas externas al núcleo familiar por parte de la comunidad, los parientes y los amigos.
Abstract Currently, modern families are coping with different stressful situations. The family studies are focused on the conceptual perspective, political perspective and methodological topic and they leave aside the familiar dynamics and functioning. This paper was interested in describing and comparing indicators of family resilience and family welfare of 442 Colombian families. This study had three hypotheses: The first one is focused on differences in well-being family dimension per location; the second hypothesis was focused on significant differences in family resilience per location, and the third one was interested in significant relations in family resilience and family well-being. The theoretical support to this research is the McCubbin and Patterson's resilience model called Double ABCX and Family Adaptation and Adjust Response Model by Patterson. The family well-being is considered a result of internal family functioning and is measured by the family member perception about the concern about health problems, fears, anger and sadness. Family resilience is understood as the capacity to recover from adversity. This capacity strengthens families and improves their resources. In this theoretic resilience approach the resilience is a dynamic result to the adaptation phase and the family well-being is the final adjustment. The design was cross-sectional analytical with a convenience sample. The families were interviewed in their homes, from each family both parents and a child between 9 and 17 years old participated. They are located geographically in Bogotá (n = 196), Santa Marta (n = 81) and Cali-Palmira (n = 145). Families completed the Family Member Well-being Index (FMWB) and the Family Regeneration and Adaptation Index (FIRA-G) to assess resilience. Families residing in Bogotá showed significant differences with those of Cali-Palmira in the dimension of family well-being, family stress and support from friends and family. While families located in Santa Marta showed differences with respect to the families located in Cali-Palmira in family stress and in community and social support. The father correlations between the family resilience index and the well-being family index is strong and inverse with the family stress and the family well-being summarized. The mother well-being family perception is significant associated with family resilience, and these correlations was strongest with family well-being summarized. The family stress index, strains and distress exposed moderate and inverse relations with the positive resilience family summarized. The discussion deals with family resilience as a product of the dynamic interaction in the hole family system and is oriented to the fact that the presence of support from family and friends reduces the burden of family stress, promotes support in the face of crisis and, in general, improves the well-being and family adaptation. In general, the differences reflect varied resilience trajectories that depend on the challenges posed by the close context of the city where they live. An approach to this result leads us to think as a hypothesis not yet widely explored, in the mobility factor of cities, which limits contact with close family networks. In big cities like Bogotá, its internal mobility compromises the times and spaces of daily life, and thus allows or prevents families from organizing their relationships in the different areas of their social life. Resilience occurs through positive adaptive family resources that included social support and family coherence and allow families to reduce stress and meet the demands of the environment. On the other hand, the presence of the two parents in families without clinical indicators shows that the burden of shared stress helps family resilience, which is also fed by the presence of external aids to the family nucleus, such as the support of the community, family and friends.
Résumé
Se efectuó una intervención comunitaria en 47 familias con pacientes diabéticos del Consejo Popular Sueño, perteneciente al Policlínico Docente "Armando García Aspurú" de Santiago de Cuba, desde enero del 2009 hasta febrero del 2010, con vistas a instruirles en algunos aspectos fundamentales relacionados con la diabetes mellitus. Antes y después de aplicadas las técnicas educativas en los familiares (durante 6 sesiones de trabajo), se les realizó una encuesta, y luego de 6 meses se entrevistó a los afectados. La información fue procesada de manera computarizada y se emplearon el porcentaje y el test de Mc Nemar como medidas de resumen y comparación, respectivamente. Posterior a la instrucción diabetológica, se obtuvo un incremento del apoyo familiar, lo cual favorecería el logro de una mejor atención a estos pacientes y un mayor control de la enfermedad.
A community intervention was performed in 47 families with diabetic patients of Sueño People's Council, belonging to "Armando García Aspurú" Teaching Polyclinic of Santiago de Cuba, from January 2009 to February 2010, in order to educate them in some fundamental aspects related to diabetes mellitus. Before and after educational techniques were applied in the family (during 6 working sessions), they were surveyed, and after 6 months patients were interviewed. The information was computerized and the percentage and the McNemar's test as summary measures and comparison were used respectively. After diabetes education there was an increase of family support, which would encourage the achievement of better care for these patients and a greater control of the disease.
Résumé
De acuerdo con los estándares internacionales, los Estados deben actuar oportuna y eficazmente ante las situaciones de vulneración de derechos. En este artículo presentamos los hallazgos de un estudio de caso sobre el funcionamiento del Sistema Nacional de Bienestar Familiar de Colombia, en el restablecimiento de derechos vulnerados. Analizamos los logros, dificultades y problemas, así como el nivel de cumplimiento y aplicación del Código de la Infancia y la Adolescencia, concluyendo que aún en la capital del país, donde hay una alta concentración de recursos y programas, falta bastante para llegar a una protección integral efectiva y a una respuesta contundente en el restablecimiento de los derechos.
De acordo com as normas internacionais, os Estados devem atuar de forma oportuna e eficaz diante de situações de vulneração dos direitos das crianças e dos adolescentes. Em este artigo apresentamos os achados de um estudo de caso sobre o funcionamento do Sistema Nacional de Bem-Estar Familiar da Colômbia no restabelecimento dos direitos vulnerados. Analisamos os logros, dificuldades e problemas, assim como o nível de cumprimento e aplicação do Código da Infância e da Adolescência, concluindo que ainda na capital do país, onde há uma concentração alta de recursos e programas, falta muito para chegar a uma proteção integral efetiva e a uma resposta contundente no restabelecimento dos direitos.
According to the international standards, States must act timely and effectively in situations of violation of children´s rights. In this article we present the resaults from a case study about the functioning of the Colombian National Family Welfare System in restoring violated rights. We analize the achievements, difficulties and problems, as well as the level of compliance and implementation of the Code for Children and Adolescents, concluding that even in the capital, where there is a high concentration of resources and programs, somehow there is a long way to reach an integral protection and an convincing and effective response in restoring rights.