Résumé
Abstract Family relationships seem to have a relevant contribution to the etiopathogenesis of eating disorders (EDs), which makes the international treatment guidelines recommend family participation. This study aimed to synthesize and reinterpret the findings of primary qualitative studies about the perception of family of people with EDs about treatment. The search strategy was organized using the SPIDER tool, and the analyzes were carried out by two independent reviewers. From 1115 studies originally retrieved from six databases (CINAHL, LILACS, PsycINFO, PubMed, Scopus and Web of Science), 19 articles were selected. The results converge to the recognition that the family is part of the process and also needs to be considered as a care recipient, not just as a coadjuvant/companion for the patient. Since family dynamics have a relevant contribution in the development and maintenance of EDs, it is necessary to invest in the transformation of family relationships so that more effective and lasting gains in treatment can be obtained.
Resumo Relações familiares parecem ter uma contribuição relevante na etiopatogenia dos transtornos alimentares (TAs), o que faz com que as diretrizes internacionais de tratamento recomendem a participação da família. Esta metassíntese teve como objetivo sintetizar e reinterpretar os resultados de estudos qualitativos primários sobre a percepção de familiares de pessoas com TAs acerca do tratamento. A estratégia de busca foi organizada utilizando-se a ferramenta SPIDER e as análises foram realizadas por dois revisores independentes. A partir de 1.115 estudos originariamente recuperados de 6 bases de dados (CINAHL, LILACS, PsycINFO, PubMed, Scopus e Web of Science), foram selecionados 19 artigos. Os resultados convergem para o reconhecimento de que a família é parte do processo saúde-doença e precisa ser considerada como destinatária de cuidados, não apenas como coadjuvante/acompanhante no cuidado à pessoa acometida. Como a dinâmica familiar tem contribuição relevante no desenvolvimento e na manutenção dos TAs, é necessário investir na transformação das relações familiares para que se possam obter ganhos mais efetivos e duradouros no tratamento.
Résumé
@#Objective To explore the effects of assertive community and family treatment on family environment and compliance of patients with schizophrenia. Methods A total of 122 patients with schizophrenia discharged from January, 2014 to September, 2015 along with their families were enrolled and divided into intervention group (n=61) and control group (n=61). The intervention group received comprehensive intervention including family treatment by a professional team in the assertive community treatment model, while the control group received routine follow-up, for twelve months. They were evaluated with Positive and Negative Symptoms Scale (PANSS), Insight and Treatment Attitude Questionnaire (ITAQ), Family Environment Scale-Chinese Version (FES-CV), duration of pharmaceutical treatment and relapse rate before, and six and twelve months after intervention. Results There were statistically significant differences between the intervention group and the control group in total score of PANSS, score of ITAQ and FES-CV six and twelve months after intervention (FGroup>1.760, P<0.05); 16 patients in the control group and seven patients in the intervention group relapsed during the observation period (χ2=4.340, P=0.037). Kaplan-Meier survival analysis showed statistically significant difference between the two groups in duration of pharmaceutical treatment (χ2=6.338, P=0.012). Conclusion Assertive community and family treatment can improve intimacy between patients with schizophrenia and their family members, reduce high emotional expression, improve medication compliance, and reduce relapse.