Éducation thérapeutique de familles de patients schizophrènes : le modèle de l’Hôtel-Dieu de France au Liban

Abstract

IntroductionSchizophrenia is a chronic illness that causes considerable functional disability. The care of a schizophrenic patient is a heavy burden which impacts negatively the patient's family. It alters the quality of life of the caregiver and creates a distress and dissatisfaction with respect to his/her role due to several factors. This negative effect on the patient's support system can also indirectly affect the prognosis of the patient's disease through the increase of relapse rate, therefore entering a vicious cycle. The therapeutic education of families of patients suffering of schizophrenia has revealed to be an efficient and positive intervention on many levels. An efficient psychoeducation program can improve the knowledge of the family members, decrease the burden of the disease and reduce the patient's relapse rate. ObjectivesGiven the frequent solicitation of the psychiatric team by the caregivers, a psychoeducation program for the family members of schizophrenic patients was implemented at the psychiatric department of Hôtel-Dieu de France, a University Hospital in Lebanon, aiming to help these families in acquiring a realistic vision of the disease, thus enabling them to actively collaborate in psychiatric care, and to tackle and discuss the common daily encountered problems in the management of such patients, finally suggesting ways to deal with these problems. DescriptionSelected family members of three schizophrenic patients attended the psychoeducation program after obtaining the consent of the patients. The intervention consisted of ten sessions, of one hour and a half each, at the pace of one session per week and it was led by a multidisciplinary team: a psychiatrist, a psychologist, a nursing manager and an occupational therapist. The psychoeducation program consisted of the presentation of the disease and of related important information, of debriefing sessions and of experience-sharing sessions between the three families. An assessment of knowledge related to schizophrenia was made before and after the implementation of the program. ContributionThe psychoeducation program enabled the families to acquire new and useful knowledge about the disease, helped in relieving their distress and in dealing with negative emotions caused by the presence of the disease in a family member. Since the family constitutes a central hub in the patient's life in Lebanese society, such therapeutic education of families of patients with schizophrenia is found to be essential in the management of the disease. Many psychoeducational approaches have been described in the literature. They differ from one another by the program's content and/or duration and the composition of the attending group. In our case, we implemented a relatively short program to a multiple-family group without the participation of the patients. ConclusionThe implementation of a psychoeducation program to the families of patients suffering of schizophrenia is important because the family members continually face particularly difficult circumstances. Such programs have several positive effects on both family members and patient. However, their long-term effects should be further evaluated and the duration of the program should be adapted accordingly. Such interventions may also be of benefit when implemented to families of patients with chronic mental disorders other than schizophrenia.