Family psychotherapy in patients with uncontrolled hypertension. Preliminary study.

BACKGROUND: Family psychotherapy has been shown to have a positive impact on the evolution of patients with psychosomatic disorders, and in those with arterial hypertension it could improve the level of control of the disease. OBJECTIVE: To evaluate the impact of an intervention in family psychotherapy in patients with uncontrolled systemic arterial hypertension. METHOD: Study with comparative groups. 15 uncontrolled hypertensive patients, assigned to 2 groups: an intervention group of 10 patients who received family psychotherapy and a control group of 5 patients. In both groups, the pharmacological treatment indicated by experts was continued. Both groups were compared before and after the intervention regarding quality of life (InCaViSa), family functioning (Family Functioning Scale), systolic and diastolic blood pressure, body mass index and glucose, cholesterol, triglycerides, uric acid and creatinine. RESULTS: There was qualitative improvement in the domains of the InCaViSa scale to estimate quality of life in the intervention group and there were no statistically significant changes between the groups in family functioning or in body weight. Among the biochemical variables, only cholesterol showed a significant reduction (p = 0.47). Greater mobility of the family towards more functional behaviors was found in the group that received the intervention, and also in this group, systolic and diastolic blood pressure values decreased (p < 0.001), and the use of antihypertensive, anxiolytic and antidepressant drugs, as well. CONCLUSIONS: Family psychotherapeutic intervention can favor the control of blood pressure, reduce the doses of antihypertensive, anxiolytic and antidepressant drugs and it can help to transition to better functionally family states.

ANTECEDENTES: La psicoterapia familiar ha demostrado tener un impacto positivo en la evolución de enfermos con trastornos psicosomáticos, y en aquellos con hipertensión arterial arterial pudiera mejorar el nivel de control de la enfermedad. OBJETIVO: Evaluar el impacto de una intervención en psicoterapia familiar en pacientes con hipertensión arterial sistémica no controlada. MÉTODO: Estudio con grupos comparados. 15 pacientes hipertensos no controlados, asignados a dos grupos: un de intervención, con 10 pacientes que recibieron psicoterapia familiar, y otro de control con 5 pacientes. En ambos grupos se continuó con el tratamiento farmacológico indicado por expertos. Se compararon ambos grupos antes y después de la intervención respecto a calidad de vida (InCaViSa), funcionamiento familiar (Escala de Funcionamiento Familiar), presión arterial sistólica y diastólica, índice de masa corporal, glucosa, colesterol, triglicéridos, ácido úrico y creatinina. RESULTADOS: Hubo una mejoría cualitativa en los dominios de la escala InCaViSa para estimar la calidad de vida en el grupo de intervención y no hubo cambios estadísticamente significativos entre los grupos en cuanto a funcionamiento familiar y peso corporal. Entre las variables bioquímicas, solo el colesterol mostró una reducción significativa (p = 0.47). Se encontró una mayor movilidad de la familia hacia comportamientos más funcionales en el grupo que recibió la intervención, y también en este grupo disminuyeron las cifras de presión sistólica y diastólica (p < 0.001), así como el uso de antihipertensivos, ansiolíticos y antidepresivos. CONCLUSIONES: La intervención psicoterapéutica familiar puede favorecer el control de la presión arterial, reducir las dosis de antihipertensivos, ansiolíticos y antidepresivos, y ayudar en la transición a estados de mejor funcionalidad familiar.

No association between perception of family functioning and treatment modality for chronic renal disease secondary to diabetes mellitus.

INTRODUCTION: This work was undertaken with the aim of studying the association between perception of family functioning and mode of medical treatment in Mexicans between 40 and 65 years whose suffer from chronic kidney disease. MATERIAL AND METHODS: Participants 37 patients, 22 men, 40 to 65 years of age with chronic renal disease secondary to diabetes mellitus. Patients were assigned to three groups, diet, diet + dialysis and diet + hemodialysis, they responded to four self-administered questionnaires, a demographic questionnaire and three questionnaires to assess family functioning, the Apgar family test, the family functioning perception test, and the scale of Garcia et al. RESULTS: There was no relationship between perception of family functioning of patients with chronic kidney disease secondary to diabetes mellitus and type of medical treatment. CONCLUSIONS: The perception of family functioning was not associated with the type of medical treatment of adults with chronic renal failure secondary to diabetes mellitus. The use of various instruments to explore family functioning is important to identify areas to address the psychotherapeutic management of the family. Key words: Family functioning, Diabetes mellitus type 2, Chronic renal disease, Middle adulthood.

No asociación entre percepción del funcionamiento familiar y modalidad de tratamiento de la enfermedad renal crónica secundaria a diabetes mellitus / No association between perception of family functioning and treatment modality for chronic renal disease secondary to diabetes mellitus

Introducción: Este trabajo se hizo con el objetivo de estudiar si existe relación entre percepción del funcionamiento familiar y modalidad de tratamiento médico en mexicanos entre 40 y 65 años con enfermedad renal crónica. Material y métodos: Participaron 37 pacientes, 22hombres, entre 40 y 65 años de edad con enfermedad renal crónica secundaria a Diabetes Mellitus. Los pacientes fueron asignados a tres grupos, uno dieta, otro dieta + diálisis y otro dieta + hemodiálisis, estos respondieron a cuatro cuestionarios autoaplicados, uno sociodemográfico y otros tres para estimar funcionamiento familiar, el apgar familiar, la prueba de percepción del funcionamiento familiar FF-SIL y la escala de funcionamiento familiar de García y colaboradores. Resultados: No hubo relación entre percepción del funcionamiento familiar de pacientes con enfermedad renal crónica secundaria a Diabetes mellitus y modalidad de tratamiento médico. Conclusiones: La percepción del funcionamiento familiar no estuvo asociada con el tipo de tratamiento médico de adultos con insuficiencia renal crónica secundaria a Diabetes Mellitus. El uso de varios instrumentos para explorar funcionamiento familiar permite identificar áreas a las que dirigir prioritariamente el manejo psicoterapeútico de estas familias (AU)

Introduction: This work was undertaken with the aim of studying the association between perception of family functioning and mode of medical treatment in Mexicans between 40 and 65 years whose suffer from chronic kidney disease. Material and methods: Participants 37 patients, 22 men, 40 to 65 years of age with chronic renal disease secondary to diabetes mellitus. Patients were assigned to three groups, diet, diet + dialysis and diet + hemodialysis, they responded to four self-administered questionnaires, a demographic questionnaire and three questionnaires to assess family functioning, the Apgar family test, the family functioning perception test, and the scale of Garcia et al. Results: There was no relationship between perception of family functioning of patients with chronic kidney disease secondary to diabetes mellitus and type of medical treatment. Conclusions: The perception of family functioning was not associated with the type of medical treatment of adults with chronic renal failure secondary to diabetes mellitus. The use of various instruments to explore family functioning is important to identify areas to address the psychotherapeutic management of the family (AU)