Observación y análisis "en vivo" de comidas familiares de pacientes con trastorno alimentario / Observation and analysis "in vivo" of family meals of patients with eating disorders

Resumen Involucrar a la familia en el tratamiento de los trastornos del comportamiento alimentario (TCA) es una recomendación clave de las guías de práctica clínica para adolescentes. El objetivo de este estudio fue analizar los patrones de interacción y roles familiares, sus estilos de respuesta emocional y las características del menú traído a una sesión de comida terapéutica familiar (CTF). Participaron las familias de 13 pacientes con TCA, de entre 12 y 29 años de edad, asistentes a un programa ambulatorio intensivo. Dos terapeutas llenaron de manera independiente una matriz de observación de la sesión de CTF e hicieron anotaciones de campo; además fueron utilizadas estrategias de triangulación de datos, considerando diferentes fuentes (contenidos de las sesiones individuales y grupales) y técnicas (observación en vivo y entrevista familiar). El análisis realizado reveló, independientemente del tipo de TCA o de la edad de las pacientes, la predominancia de comportamientos evitativos en las familias; en menor medida, y principalmente en los padres, los patrones agresivos, retadores o de amenaza también estuvieron presentes. No obstante, resultó evidente la discordancia entre el comportamiento observado en la CTF vs. el reportado por las pacientes y sus terapeutas. En general, estuvieron ampliamente presentes patrones comportamentales que pueden contribuir al mantenimiento de la enfermedad.

Abstract Inclusion of the family members in eating disorders (ED) treatment is a key recommendation of clinical practice guidelines for adolescents. The aim of this study was to observe and analyze roles, interaction patterns, and emotional response styles of family and patients, as well as the features of a menu brought to a family meal session (FMS). A total of 13 patient's families from the intensive outpatient program for ED participated, patients aged among 12-29 years. Two therapists filled out a family meal observation matrix and took field notes. To improve validity, data triangulation strategies were used, including different sources of information (individual and group sessions contents) and triangulation of techniques (observation in vivo of FMS and a subsequent session with participants was carried out). The analysis of thematic contents revealed that regardless the type of ED and age of the patient the presence of avoidant behaviors in relatives and to a lesser extent, and especially in parents, aggressive, challenging or threatening patterns. However, the discrepancy between the behavior observed in the FMS and the one reported by the patients and their therapists was evident. In general, was observed that behavioral patterns may contribute to the maintenance of the disease.

Technostress, Career Commitment, Satisfaction with Life, and Work-Family Interaction among Workers in Information and Communication Technologies

Technostress occurs when individuals experience negative psychosocial effects of technology usage and also demonstrate negative valence associated with ICT use. It is composed of four dimensions (Disbelief, Fatigue, Anxiety, and Ineffectiveness), which describe two aspects of technostress (Technoanxiety and Technofatigue). This study aimed to investigate the relation between technostress dimensions, career commitment, life satisfaction, and work-family interactions among ICT professionals. Variables including gender, age and length of employment were also considered. The sample was composed of 234 Brazilian individuals. It was found that work-family and family-work conflicts were associated with increased technofatigue and technoanxiety, and decreased career resilience. Age and gender differences were also identified. These differences emphasize the role of organizations and society in what refers to reduce inequalities in workplace and to support better preventive actions.

El Tecno-estrés se produce cuando las personas experimentan efectos psicosociales negativos por el uso de la tecnología y también demuestran valencia negativa asociada con el uso de las TIC. Se compone de cuatro dimensiones (incredulidad, fatiga, ansiedad, e ineficacia) que describen dos aspectos del tecno-estrés (tecno-ansiedad y tecno-cansancio). El objetivo de este estudio fue investigar la relación entre las dimensiones del tecno-estrés, compromiso con la carrera, satisfacción con la vida y la interacción trabajo-familia entre los profesionales de las TIC. También se consideraron variables como el sexo, la edad y la antigüedad en el empleo. La muestra se compuso de 234 individuos brasileños. Se encontró que el conflicto trabajo-familia y familia-trabajo se asociaron con una mayor tecno-fatiga y tecno-ansiedad, y una menor resiliencia en la carrera. También se detectaron diferencias de edad y género, lo que enfatiza en el papel de las organizaciones y la sociedad en reducir las desigualdades en el lugar de trabajo y apoyar mejores acciones preventivas.

Application of self care interactive mode in clinical nursing of patients with thoracolumbar fracture / 中国基层医药

Objective To explore the influence of self care interaction mode on the health behavior of the patients with thoracolumbar fracture.Methods 127 cases of thoracolumbar fracture were randomly divided into the observation group (62 cases)and the control group (65 cases)according to random digital table method.The patients of the observation group were given self nursing interactive nursing.The patients of the control group were given rou-tine nursing.The comparative study of the following indicators of the two groups of patients:(1)activities of daily liv-ing (ADL);(2)bedridden patient self -care skills of and self -care knowledge assessment;(3)satisfaction,compli-cations,the average length of days and discharged patient telephone visit the initiative.Results The discharge self nursing ability raise,health behavior change,self -care knowledge and self -care skills of the observation group were significantly better than the control group,there were statistically significant differences(P <0.05);after discharge from the hospital,bed incidence of complications (6.5%)of the observation group was significantly lower than the control group (18.1%),the difference was statistically significant (χ2 =4.16,P <0.05)and satisfaction degree (91.7 ±6.5)was higher than the control group (87.3 ±7.5),with statistically significant difference (t =3.59,P <0.05),and the average hospitalization day (16.11 ±7.61 )d was lower than that of the control group (19.95 ± 11.55)d,there was statistically significant difference (t =2.20,P <0.05).Conclusion Self care interactive mode is conducive to mining the self -care ability of patients,improve the self -care ability of patients,and has good social benefits.

Relación entre desarrollo cognitivo y contextos de interacción familiar de niños que viven en sectores urbanos pobres / Relationship between cognitive development and family interaction contexts of children living in poor urban sectors

Este artículo relaciona el desarrollo cognitivo de 405 niños de 3, 4 y 5 años, que viven en sectores urbanos pobres de Cali y Santa Marta (Colombia), con dimensiones que describen sus contextos de interacción familiar. Como indicador de desarrollo se utilizaron las estrategias de clasificación que utilizan individualmente los niños en la resolución de un problema, y como descriptores de los contextos de interacción, el nivel de pobreza de la familia y las prácticas y expectativas de los padres. Los resultados muestran que el desarrollo cognitivo alto no se relaciona con el nivel de pobreza de la familia, como dimensión aislada, sino con niveles altos de prácticas de formación, entretenimiento, protección y regulación del comportamiento.

This article relates the cognitive development of 405 children aged 3, 4 and 5, living in urban poor in Cali and Santa Marta (Colombia), with dimensions that describe their contexts of family interaction. As an indicator of development were used strategies classification used in solving a problem, and as descriptors of contexts of interaction, the level of poverty, practices and parental expectations. The results show that cognitive development is not related to high poverty levels, as isolated dimension, but with high levels of practices training, entertainment, protection and regulation of behavior.

O subsistema fraterno na família recasada / The sibling subsystem in remarried families

O recasamento tem ocorrido com bastante frequência, principalmente como decorrência do número de separações e divórcios. Nesta pesquisa, buscou-se compreender a percepção dos filhos ante as mudanças ocorridas em suas vidas devido ao recasamento, de um ou de ambos os genitores, especialmente, no que tange ao subsistema fraterno. Trata-se de uma pesquisa qualitativa, da qual participaram quatro pessoas (uma adolescente e três jovens adultos). Eles responderam a uma entrevista composta de questões referentes ao relacionamento com os irmãos e aos dados sociodemográficos. As respostas à entrevista foram analisadas com base na Análise de Conteúdo Temática. Pode-se concluir que nas fratrias formadas pelos irmãos biológicos as alterações não foram expressivas; no entanto, as fratrias mistas, que são formadas pelos irmãos políticos (filhos do padrasto ou da madrasta, sem vinculo biológico) e os meio-irmãos (irmãos por parte de mãe ou de pai) exigiram várias readaptações

Remarriage has occurred quite frequently, mainly as a result of the number of separations and divorces. This research sought to understand the perception of the children before the changes in their lives due to the remarriage of one or both parents, especially concerning the fraternal subsystem. It is a qualitative research whose participants were four teenagers or young adults. They responded to an interview consisting of questions about siblings relationship and their socio-demographic data. Their answers to the interviews were analyzed based on the thematic content analysis. It can be concluded that in fraternities formed by biological siblings the changes were not significant, however, mixed fraternities, which are formed by political siblings (sons of his stepfather or stepmother with no biological ties) and half-siblings (brothers by part of the mother or father) required several re-adaptations

Psychosocial effect and economic burden on parents of children with locomotor disability.

Objective. To assess the social and financial burden on parents of children with locomotor disability. Methods. A cross-sectional study was conducted in the Institute for Physically Handicapped (IPH), Delhi, where parents of 100 locomotor disabled children of age group 6 to 15 years were interviewed to estimate the socioeconomic burden of caregiving their children. Results. The study observed that the parents of the disabled children were severely burdened in terms of financial burden and mental health. Conclusions. There is an urgent need for support activities for such families at a national level in order to curb the huge economic and social burden of care-giving. Counselling should be an integral part of rehabilitat ion for such families.

Construção e confiabilidade das escalas de qualidade na interação familiar / The construction and reliability of the quality familiar interaction scales

Atendendo à necessidade de instrumento brasileiro para avaliar aspectos da interação familiar, as Escalas de Qualidade na Interação Familiar (EQIF) foram desenvolvidas e submetidas a análises estatísticas para teste de confiabilidade. O instrumento, direcionado para a criança/adolescente, responde sobre os comportamentos de seus pais, contém 40 itens agrupados em nove escalas (envolvimento, regras e monitoria, comunicação positiva dos filhos, comunicação negativa, punição corporal, clima conjugal positivo, clima conjugal negativo, modelo parental, sentimento dos filhos). Uma amostra de 2.173 participantes com idade entre 9 e 20 anos respondeu ao instrumento EQIF. As análises foram feitas por meio da combinação do valor do alfa de Cronbach com a análise exploratória de componentes principais, o que possibilitou a redução de itens de cada escala e a alteração da estrutura do instrumento até chegar à versão apresentada neste trabalho. A confiabilidade do instrumento, estimada pelo alfa de Cronbach, apresentou-se adequada para as nove escalas (entre 0,6715 e 0,9235). Foram delimitados pontos de corte para o instrumento, o que permitiu investigar famílias com melhor e pior qualidade de interação familiar, ou seja, famílias em situação de proteção (23,7 por cento dos participantes) e famílias em situação de risco (24,1 por cento dos participantes). O EQIF demonstrou boas propriedades psicométricas e pode ser considerado como uma medida válida de qualidade de interação familiar

Given the need for Brazilian instrument to evaluate aspects of the family interaction, the FamilyInteraction Quality Scales (EQIF) were developed and subjected to a statistical analysis ofreliability. This instrument was designed to collect information from children and adolescentsabout their parent's behavior, and it contains 40 items grouped in nine subscales (involvement,rules and monitoring, children's positive communication, negative communication, corporalpunishment, positive marital climate, negative marital climate, parental models, children's feelingstoward parents). Participants were 2173 children and adolescents, aged between 9 and 20 years,who completed the EQIF. The combination of the Cronbach's alpha and a principal componentsanalysis was used. It made possible to reduce the number of items in each scale and to change thestructure of the instrument until the current version was agreed upon. The reliability of theinstrument, estimated by the Cronbach's alpha, was acceptable for all subscales (ranging from0.6715 to 0.9235). Instrument cut-points were defined, allowing to create categories of familieswith better and worse interaction, in other words, families in a protective situation (23.7%) andfamilies in a risk situation (24.1%). The EQIF showed good psychometric properties and can beconsidered a valid measure of the family interaction quality

Depressão materna e a interação triádica pai-mãe-bebê / Maternal depression and father-mother-baby triadic interaction

O presente estudo examinou as eventuais diferenças na interação triádica (pai-mãe-bebê) e diádica (mãe-bebê, pai-bebê e mãe-pai) em famílias com e sem depressão materna, com bebês de um ano de idade, durante uma sessão de interação livre. Participaram do estudo 19 famílias, das quais 9 de mães deprimidas e 10 de mães não-deprimidas. Foram investigados os padrões de interação triádico e diádico através de um protocolo envolvendo diversas categorias. Contrariando a hipótese do estudo, não houve diferenças estatisticamente significantes nas interações triádicas entre as famílias com e sem depressão materna. Já nas interações diádicas, dentro de cada grupo de famílias, apareceram diferenças estatisticamente significantes no grupo sem depressão materna. Nas famílias com depressão materna, apenas a categoria estimulação cognitiva obteve significantemente maior incidência, indicando que, embora deprimidas, as mães conseguiam prover uma estimulação adequada para seus bebês. No conjunto, os dados sugerem que a depressão materna pode acarretar mudanças, ainda que sutis, no padrão familiar.

This study examined the eventual differences in triadic (father-mother-baby) and dyadic (mother-baby, father-baby and father-mother) interaction in families with and without maternal depression, with one-year old babies, during a free-play session. Nineteen families participated in the study, 9 with maternal depression and 10 without. The triadic and the dyadic patterns of interaction were examined using a protocol with several categories. Contradicting the hypothesis of the study, there were no significant differences in the interactions among families with and without maternal depression. But when analyzing the dyadic interactions, in each group of families, there were some significant differences only in the group without maternal depression. In families with maternal depression, only the cognitive stimulation category was significantly more intense, indicating that despite the depression, the mother could provide adequate stimulation for their babies. On the whole, the results suggest that maternal depression may cause changes, even subtle, in the family pattern of interaction.

Patrones de interacción familiar de madres y padres generadores de violencia y maltrato infantil / Family interaction patterns of mothers and parents generators of violence and child maltreatment

This study assessed thirteen mothers and eight fathers who were accused of child mistreatment; the assessment having taken place at two semi-structured interviews. A pilot study was conducted with a mother accused of mistreatment, with the aim of dismissing or including coding categories that were deemed significant. The feelings and beliefs categories were included in the interaction cycles, and these categories were applied throughout the research. The study was intended to confirm the feasibility of the theoretical proposal which states that child mistreatment can be understood as related to life cycle and situational crises and to dysfunctional interaction patterns, like the conceptualization of pathological triangles presented by many authors. It was found that both the mistreating mothers and fathers’ background and their present interaction patterns are consistent with the aforementioned theoretical construct. The results suggest that child mistreatment is related to upbringing patterns that use physical violence as a punishment and to alcoholism. Furthermore, the study revealed a tendency among families to maintain violence-generating interaction chains, which are related to life cycle and situational crises. In the legal area, a systemic, cognitive and behavioral intervention is possible, with the end in view of breaking up such redundant cycles, thereby encouraging favorable changes in the family, namely as concerns the control of rage.

El presente estudio evalúa a trece madres y ocho padres que fueron denunciados por maltrato infantil; siendo valorados mediante dos entrevistas semiestructuradas. Se realizó un estudio piloto con una madre denunciada por maltrato, a fin de descartar ó incluir categorías de codificación que se consideraran importantes. Se incluyeron las categorías sentimientos y creencias en los ciclos de interacción; mismas que se aplicaron a lo largo de la investigación. Se verificó la viabilidad de la propuesta teórica que afirma que la violencia infantil puede ser entendida en términos de crisis del ciclo vital y situacional, y por patrones de interacción disfuncionales; así como la conceptualización de triángulos patológicos que hacen varios autores. Se encontró que los antecedentes de las madres y padres maltratadores, y sus patrones de interacción en el presente, son congruentes con la fundamentación teórica. Los resultados sugieren que el maltrato infantil esta relacionado a patrones de crianza que emplean el castigo físico como correctivo, y alcoholismo en los padres; también se encontró una tendencia familiar a sostener cadenas de interacción generadores de violencia,asociadas a crisis en el ciclo vital y situacionales. En el campo legal es posible una intervención familiar sistémica, cognitivo y conductual con la finalidad de romper dichos ciclos redundantes y posibilitar el cambio familiar favorable, principalmente en el control de la ira.