Family Intervention For Patients Research Articles

Effect of family intervention on relapse rate of Chinese patients with alcohol-dependent.

This study explored the impact of a family intervention on the relapse rate of Chinese patients with alcohol dependence. A total of 151 male patients with alcohol dependence who were discharged from the Substance Dependence Department of the Wenzhou Seventh People's Hospital from January to December 2020 were selected. They were divided into the control (n = 73) and experimental (n = 78) groups. Patients in both groups received routine alcohol cessation treatment. Moreover, patients in the experimental group were followed up by a professional psychiatrist to carry out individual family intervention. The Family Function Rating Scale (FAD), a Self-made general information questionnaire, and the Chinese version of the Family Intimacy and Adaptability Scale (FACESI-CV) were performed. Re-drinking rate and readmission rate were assessed. Family intervention could reduce relapse rate (31, 39.74%) and rehospitalization (27, 34.62%) compared with the control group. After family training, FAD factor scores were improved in the experiment group in comparison with the control group. Family training improved communication (18.2 ± 3.7), role (20.8 ± 2.5), emotional response (10.8 ± 1.8), emotional involvement (13.7 ± 1.2), behavioral control (19.8 ± 1.2), and overall functionality (23.5 ± 2.1) in the experiment group in comparison with the control group. After family training, intimacy (70.5 ± 8.7) and adaptability (64.1 ± 6.9) in the experiment group was higher than in the control group. After family intervention, Michigan Alcohol Dependence Scale (MAST) (9.21 ± 0.68) and Short-Form 36 (SF-36) (80.32 ± 4.47) in the experiment group were higher than the control group. Family intervention for families of patients with alcohol dependence can improve their family function, increase their family intimacy and adaptability, and reduce the rate of relapse.

Clinical Pearls

During the pandemic, extracorporeal membrane oxygenation (ECMO) was instituted for patients with COVID-19 hypoxemia refractory to mechanical ventilation support. Although some patients had favorable outcomes, many who survived hospitalization were left with significant functional disability. Palliative care consultation with family members of ECMO patients has been studied, but the focus has primarily been on end-of-life care and not on overall care expectations.Siddiqui and colleagues implemented an early, scripted palliative care intervention for families of patients with COVID-19 receiving ECMO. After interviewing families, most within 24 to 72 hours of ECMO initiation, they identified these themes: Social isolation and related grief of not being at the patient’s bedsideHelping patients’ children adjust to a new normalCoping with multiple family members suffering from COVID-19Importance of faith and spiritualityNeed for hope and gratitudeFutility of prolonged ECMO therapyPalliative care has expanded to care for patients at all stages of chronic illness. The study findings support early family engagement and assistance for those dealing with COVID-19 and similar illnesses.See Article, pp 166-174Workplace stress can contribute to negative consequences for both staff and patients. Caring for critically ill patients adds additional stressors for intensive care nurses, which were further exacerbated by the COVID-19 pandemic. Although some interventions exist for nurse support, none focus on nurses taking time out to meet their own needs.Smith and colleagues assessed nurses’ perceptions of their stress and the usability of a Lavender Lounge—a quiet room with items and activities available to help them destress. They found The very factors that lead to burnout were the ones perceived as barriers to use of the Lavender Lounge. The authors suggest an approach that includes organizational change that supports reduced staff workload.See Article, pp 198-204Thirst is a complex symptom that affects between 49% and 98% of adult patients. Unrelieved thirst can become a distressing experience that overshadows other ailments. Although nurses can alleviate the distress caused by thirst, there are no standard protocols for accurate assessment and evaluation.Ciftci and colleagues developed and tested the Thirst Discomfort Scale to standardize measurement of thirst in adult patients. They found Although further study with other types of patients is warranted, the Thirst Discomfort Scale can be used to assess and evaluate the symptom of thirst in adult patients.See Article, pp 176-183Pressure injury (PI) prevention and treatment guidelines have historically been geared toward adult patients and adapted by pediatric providers. However, children with congenital heart disease (CHD) have unique factors that increase their susceptibility to PIs.To prevent PIs, Shields and colleagues explored the specific risk factors of the care and management of PIs in pediatric patients with CHD. They found This study adds to the limited literature on key risk factors for pediatric patients with CHD developing PIs. Clinicians providing care for these patients should use this knowledge to decrease the incidence of PIs.See Article, pp 216-220

Internet-Based Information Sharing With Families of Patients With Stroke in a Rehabilitation Hospital During the COVID-19 Pandemic: Case-Control Study.

BackgroundThe spread of COVID-19 has affected stroke rehabilitation. Given that inpatient visits are restricted in most institutions, alternative ways of providing information to family members are imperative. Informing families about patients’ rehabilitation progress via the web may help involve families in the rehabilitation process, enhance patients’ motivation to continue rehabilitation, and contribute overall to patients’ improvement in activities of daily living (ADL).ObjectiveWe aimed to investigate the feasibility of the Internet-Based Rehabilitation Information Sharing (IRIS) intervention for families of patients with stroke at a rehabilitation hospital and examine the effect of IRIS on patients’ ADL improvement.MethodsIn this case-control study, participants were inpatients at a rehabilitation hospital between March 2020 and April 2021. The intervention group (information and communication technology [ICT] group) included patients and families who requested IRIS, which consisted of a progress report on patients’ rehabilitation using text, photos, and videos. Those who did not receive internet-based information were included in the non-ICT group. The control group, matched with the ICT group based on a 1:1 propensity score, was selected from the non-ICT group. The covariates for calculating the propensity score were patients’ age, sex, and motor and cognitive scores on the Functional Independence Measure at admission. The main outcome was the degree of ADL improvement during hospitalization. Multiple regression analysis (forced entry method) was performed to confirm the impact of ICT use on ADL improvement. The independent variables were the presence of intervention, length of hospital stay, and number of days from onset to hospitalization.ResultsIn total, 16 groups of patients and families participated in the IRIS. The mean age of patients was 78.6 (SD 7.2) and 78.6 (SD 8.2) years in the ICT and control groups, respectively. The median total Functional Independence Measure difference was 28.5 (IQR 20.3-53.0) and 11.0 (IQR 2.8-30.0) in the ICT and control groups, respectively, and the ICT group showed significant improvement in ADL function (P=.02). In the multiple regression analysis of the ICT and control groups, the unstandardized regression coefficient was 11.97 (95% CI 0.09-23.84) for ICT use. These results indicate that ICT use was independently and significantly associated with improvement in ADL.ConclusionsThis study examined the effect of IRIS on family members to improve ADL in patients with stroke who are hospitalized. The results showed that IRIS promotes the improvement of patients’ ADL regardless of age, sex, motor and cognitive functions at admission, and the length of hospital stay.

Cognitive Therapy and Family Intervention for Patients with Dementia and Psychosis.

The population of older adults is increasing rapidly due to global population aging in the background of increasing life expectancy and reducing mortality rate. This phenomenon is projected to be more rapid in developing countries like India in the next few decades. The increase in the population of older adults is also associated with increasing prevalence of chronic noncommunicable diseases including dementia. Dementia is a condition characterized by progressive cognitive decline with significant impairment in the ability to do functional activities independently. Dementia has multiple causes that contribute to the existence of several subtypes with varying clinical presentation and outcome. Alzheimer's disease (AD) is the most common subtype of dementia (50%–60%). Vascular dementia (VD), diffuse lewy body dementia (DLBD), frontotemporal dementia (FTD), and mixed dementia are some of the other important types of dementia. The recent revision of classification – Diagnostic Statistical Manual-V refers dementia as major neurocognitive disorder. Dementia is emerging as a major public health priority due to increasing prevalence, increased risk for mortality, high level of disability, caregiver burden, and cost burden. The current estimates of global prevalence of dementia are nearly 47 million with nearly 4.6 million patients with dementia in India. The incidence rate of dementia is also alarming with one new case estimated to occur every 3 seconds. The global prevalence of dementia is estimated to increase to 131 million in the year 2050. The global economic cost for care of persons with dementia is estimated to increase from 818 billion USD to 2 Trillion USD by the year 2050. Behavioral and psychological symptoms such as delusions, hallucinations, depression, and agitation are common in persons with dementia. They contribute to significant distress in patients as well as caregivers. They are also an important reason for institutionalization. The major concern in the care of persons with dementia is the lack of effective disease modifying drugs and modest efficacy of currently available symptomatic drug treatments. Considering the low awareness about dementia in India, there is huge treatment gap for even the diagnosis and pharmacological treatment of persons with dementia. The important focus of treatment in dementia is the improvement of the quality of life and well-being of patients as well as the caregivers. Psychosocial interventions such as cognitive therapy and family interventions have been evaluated in persons with dementia and their caregivers. However, there are important challenges in improving the access for psychosocial interventions for persons with dementia. This clinical guideline will discuss about the potential role for these psychosocial interventions in the management of persons with dementia particularly in Indian context.

SAFIR© : An Early Intervention for Supporting Families of Patients With Acquired Brain Injuries

SAFIR© : An Early Intervention for Supporting Families of Patients With Acquired Brain Injuries

An informative nursing intervention for families of patients admitted to the intensive care unit regarding the satisfaction of their needs: The INFOUCI study

AimTo evaluate whether an informative intervention by nursing professionals through Short Message Service (SMS) improved patients’ family members’ satisfaction with the intensive care experience. Methods/designThis was an exploratory, two-armed, randomised, non-pharmacological, prospective study. The intervention consisted of providing information to the contact persons of patients admitted to the ICU of the University Hospital La Princesa (Madrid, Spain) through SMS based on the patient’s nursing assessment. Nursing diagnoses established by NANDA and based on the Virginia Henderson model were used as a reference. The main result was the satisfaction levels of the contacts of patients admitted to the intensive care unit, which was evaluated with the Critical Care Family Needs Inventory. ResultsThe total score on the Critical Care Family Needs Inventory was significantly better in the intervention group (16.6 ± 3.3 vs. 19.1 ± 4.7; p = 0.012) compared with the control group. All participants included in the intervention considered it useful to some degree. Even when the contact person received negative information, there was no demand for information outside established hours, which was included as a possible adverse effect of the intervention. ConclusionSupport in the form of additional nursing information implied an increase in the satisfaction of the needs perceived by the contact persons of patients admitted to the intensive care unit, together with a better perception of the quality of intensive care unit care and a reassuring and beneficial effect.

Psychoeducational family intervention for people with eating disorders: Rationale and development

IntroductionFamily members of patients with EDs report high levels of burden, psychological distress and the need to receive information on the disease of their ill relative. There is the need to provide family members and patients with psychoeducational family intervention in order to satisfy their care needs.ObjectiveTo develop a new psychoeducational approach for patients with Eating Disorders (EDs) and their relatives according to the Falloon model.Aims(1) To develop a family psychoeducational intervention for patients with EDs. (2) To implement the experimental intervention in the clinical routine care. (3) To evaluate efficacy of the approach in terms of reduction of family burden and improvement of relatives’ coping strategies.ResultsThe Department of Psychiatry of the University of Naples SUN has developed a new psychoeducational family intervention for patients with EDs and their family members. The intervention consists of 6 sessions, scheduled weekly. The sessions deal with several topics such as information on EDs (e.g., causes, symptoms, clinical characteristics), communication skills (e.g., how to express an unpleasant feeling) and problem solving skills. The intervention is led by trained mental health professionals, such as psychiatrists, psychologists or rehabilitation technicians.DiscussionThis is the first example of psychoeducational intervention for families of patients with EDs developing according to the Falloon approach.ConclusionsFamily intervention represents an essential tool to provide to patients with EDs and their family members in order to promote a global recovery.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The effectiveness of information-sharing interventions to reduce anxiety in families waiting for surgical patients undergoing an elective surgical procedure: a systematic review

Background Whilst waiting for patients undergoing surgery, a lack of information regarding the patient’s status and the outcome of surgery, can contribute to the anxiety experienced by family members. Effective strategies for providing information to families are therefore required. Objectives To synthesize the best available evidence in relation to the most effective information-sharing interventions to reduce anxiety for families waiting for patients undergoing an elective surgical procedure. Inclusion criteria Types of participants All studies of family members over 18 years of age waiting for patients undergoing an elective surgical procedure were included, including those waiting for both adult and pediatric patients. Types of intervention All information-sharing interventions for families of patients undergoing an elective surgical procedure were eligible for inclusion in the review. Types of studies All randomized controlled trials (RCTs) quasi-experimental studies, case-controlled and descriptive studies, comparing one information-sharing intervention to another or to usual care were eligible for inclusion in the review. Types of outcomes Primary outcome: The level of anxiety amongst family members or close relatives whilst waiting for patients undergoing surgery, as measured by a validated instrument such as the S-Anxiety portion of the State-Trait Anxiety Inventory (STAI). Secondary outcomes: Family satisfaction and other measurements that may be considered indicators of stress and anxiety, such as mean arterial pressure (MAP) and heart rate. Search strategy A comprehensive search, restricted to English language only, was undertaken of the following databases from 1990 to May 2013: Medline, CINAHL, EMBASE, ProQuest, Web of Science, PsycINFO, Scopus, Dissertation and Theses PQDT (via ProQuest), Current Contents, CENTRAL, Google Scholar, OpenGrey, Clinical Trials, Science.gov, Current Controlled Trials and National Institute for Clinical Studies (NHMRC). Methodological quality Two independent reviewers critically appraised retrieved papers for methodological quality using the standardized critical appraisal instruments for randomized controlled trials and descriptive studies from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instruments (JBI-MAStARI). Data extraction Two independent reviewers extracted data from included papers using a customized data extraction form. Data synthesis Statistical pooling was not possible, mainly due to issues with data reporting in two of the studies, therefore the results are presented in narrative form. Results Three studies with a total of 357 participants were included in the review. In-person reporting to family members was found to be effective in comparison with usual care in which no reports were provided. Telephone reporting was also found to be effective at reducing anxiety, in comparison with usual care, although not as effective as in-person reporting. The use of paging devices to keep family members informed were found to increase, rather than decrease anxiety. Conclusions Due to the lack of high quality research in this area, the strength of the conclusions are limited. It appears that in-person and telephone reporting to family members decreases anxiety, however the use of paging devices increases anxiety.

The effectiveness of information sharing interventions as a means to reduce anxiety in families waiting for surgical patients undergoing an elective surgical procedure: a systematic review protocol

Review question/objective What are the most effective information sharing strategies used to reduce anxiety in families of patients undergoing elective surgery? This review seeks to synthesize the best available evidence in relation to the most effective information-sharing intervention to reduce anxiety for families waiting for patients undergoing an elective surgical procedure. The specific objectives are to review the effectiveness of evidence of interventions designed to reduce the anxiety of families waiting whilst their loved one undergoes a surgical intervention. A variety of interventions exist and include surgical nurse liaison services, intraoperative reporting either by face-to-face or telephone delivery, informational cards, visual information screens, and intraoperative paging devices for families. Inclusion criteria Types of participants All studies of family members over 18 years of age waiting for patients undergoing an elective surgical procedure will be included, including those waiting for both adult and paediatric patients. Studies of families waiting for other patient populations, eg emergency surgery, chemotherapy or intensive care patients will be excluded. Types of intervention(s)/phenomena of interest All information-sharing Interventions for families of patients undergoing an elective surgical procedure will be included, including but not limited to: surgical nurse liaison services, in-person intraoperative reporting, visual information screens, paging devices, informational cards and telephone delivery of intraoperative progress reports. Interventions that take place during the intraoperative phase of care only will be included in the review. Preadmission information sharing interventions will be excluded. Types of outcomes The outcomes of interest include: Primary outcome: the level of anxiety amongst family members or close relatives whilst waiting for patients undergoing surgery, as measured by a validated instrument (such as the S-Anxiety portion of the State-Trait Anxiety Inventory).4 Secondary outcomes: family satisfaction and other measurements that may be considered indicators of stress and anxiety, such as mean arterial pressure (MAP) and heart rate.

The effectiveness of information-sharing interventions as a means to reduce anxiety in families waiting for surgical patients undergoing an elective surgical procedure: a systematic review protocol

Review question/objective What are the most effective information sharing strategies used to reduce anxiety in families of patients undergoing elective surgery? This review seeks to synthesize the best available evidence in relation to the most effective information-sharing intervention to reduce anxiety for families waiting for patients undergoing an elective surgical procedure. The specific objectives are to review the effectiveness of evidence of interventions designed to reduce the anxiety of families waiting whilst their loved one undergoes a surgical intervention. A variety of interventions exist and include surgical nurse liaison services, intraoperative reporting either by face-to-face or telephone delivery, informational cards, visual information screens, and intraoperative paging devices for families. Inclusion criteria Types of participants All studies of family members over 18 years of age waiting for patients undergoing an elective surgical procedure will be included, including those waiting for both adult and paediatric patients. Studies of families waiting for other patient populations, eg emergency surgery, chemotherapy or intensive care patients will be excluded. Types of intervention(s)/phenomena of interest All information-sharing Interventions for families of patients undergoing an elective surgical procedure will be included, including but not limited to: surgical nurse liaison services, in-person intraoperative reporting, visual information screens, paging devices, informational cards and telephone delivery of intraoperative progress reports. Interventions that take place during the intraoperative phase of care only will be included in the review. Preadmission information sharing interventions will be excluded. Types of outcomes The outcomes of interest include: Primary outcome: the level of anxiety amongst family members or close relatives whilst waiting for patients undergoing surgery, as measured by a validated instrument (such as the S-Anxiety portion of the State-Trait Anxiety Inventory).4 Secondary outcomes: family satisfaction and other measurements that may be considered indicators of stress and anxiety, such as mean arterial pressure (MAP) and heart rate.

Adjunctive Couple and Family Intervention for Patients With Anxiety Disorders

Family-focused therapy for anxiety disorders (FFT-AD), a flexible couple/family treatment provided in conjunction with cognitive-behavioral therapy (CBT) for anxiety disorders, is described. The treatment is based upon research showing that anxious patients are more likely to drop out of or fare poorly in CBT when they live with a family member who is hostile toward or emotionally over-involved with the patient, accommodates excessively to the patient's anxiety, or is perceived by the patient to be destructively critical. An adaptation of FFT for bipolar disorder, the treatment is intended for patients with anxiety disorders, regardless of their specific disorder type. FFT-AD is illustrated with two cases.

P01-227-Implementing family psychoeducational intervention in bipolar i disorder: a randomized controlled trial

IntroductionBipolar disorder is associated with high personal and social burden, impaired social functioning and high levels of disability. The psychoeducational family intervention, found to be effective in the treatment of schizophrenia, may be particularly useful for patients with bipolar disorder and their relatives.Aims & methodsThis study, funded by the Italian Ministry of Health, coordinated by the Department of Psychiatry of the University of Naples SUN and carried out in 11 randomly selected mental health centres, included the following phases1) development of informative materials;2) training of 2 mental health workers per center;3) random selection of 16 families of patients with bipolar disorder for each center: 8 being randomly allocated to the experimental group and 8 to the control group.Results62 families have been recruited. Mental health workers reported several advantages in conducting the intervention, in particular in the relationship with patients and families. Significant improvements have been reported in professional skills and relationships with colleagues. The advantages tend to increase over time. The main reported difficulties are lack of time to run the intervention, identification of appropriate families, excessive workload and the need to integrate this intervention with other work commitments.ConclusionsIt is possible to provide psychoeducational family intervention for patients with bipolar I disorder and their families, after a relatively short period of training. In order to facilitate the dissemination of this intervention in routine conditions, a better planning of the activities of the mental health centers may be useful.

P.2.e.002 Psychoeducational intervention in families of patients with bipolar disorder

P.2.e.002 Psychoeducational intervention in families of patients with bipolar disorder

Educational intervention for the relatives of schizophrenia patients in Finland

Two methods of providing an educational intervention for families of patients with schizophrenia in Finland were compared. The aims of the intervention were to improve relatives' level of knowledge about the illness, and change the level of expressed emotion (EE), objective burden and psychological distress. Sixty-nine persons participated in the oral presentation groups comprising eight sessions and 128 persons participated in the video education comprising six sessions. The education led to significant knowledge gains and to an increase in the psychological well-being of the participants, but there were no significant changes in objective burden or EE status after intervention. Furthermore, there was only one difference between the two methods of information delivery. The participants in the video groups felt more often that the lessons were useful to them than did the participants in the oral presentation groups. The evidence suggests that brief educational intervention can yield significant benefits in meeting the needs of family members. Better designed, randomized studies investigating the efficacy of brief educational interventions are needed.

Developing Effective Services for Patients with Personality Disorders

This review focused on empirical research that addressed the effectiveness of service models for the care of patients with personality disorders. Services discussed included those delivering acute care, such as crisis and emergency services and acute psychiatric hospitalization; continuing care, such as outpatient services, day hospital treatment, and assertive community treatment programs; and other community programming, such as integrated treatment for comorbid substance abuse and psychoeducational interventions for families of patients with personality disorders. The review focused on studies that included patients with personality disorders, and it measured outcomes relevant to patients with personality disorders. Evidence from randomized controlled trials was highlighted. Few systematic studies of acute services were available. Community programming can decrease the risk of suicide attempts and reliance on inpatient admissions. Services must develop methods of ensuring compliance with treatment. Assertive community treatment for Axis II patients should be developed, implemented, and tested. Comprehensive programming for patients with personality disorders must include integrated treatment for substance abuse and family psychoeducational programs. Promising new models of care for patients with personality disorders are ready for testing and wider application.

Inpatient Family Intervention: A Randomized Clinical Trial

Although family intervention is practiced in most psychiatric hospitals, to our knowledge, no adequately controlled studies of its efficacy exist. This study was designed to answer, in part, the question of the relative efficacy of hospitalization with family intervention as compared with hospitalization without family intervention for patients (1) with major psychiatric disorders, (2) in need of hospital treatment, and (3) for whom both treatments are judged clinically feasible. This article compares treatment results at the time of hospital discharge for 169 patients randomly assigned to the inpatient Family Intervention or comparison conditions. Inpatient Family Intervention had greater efficacy than the comparison treatment, mostly attributable to its effect on female patients, especially those patients (and their families) with affective disorder.