Resumo

RODRIGUEZ-OROZCO, Alain R. et al. Organizational and functional profile of the nuclear psychosomatic family with one asthmatic son. Salud Ment [online]. 2008, vol.31, n.1, pp.63-68. ISSN 0185-3325.

Introduction Asthma is a current problem worldwide. By one hand the prevalence of the disease has been increasing in México during the last decades; on the other hand there is a considerable number of patients in whose the disease can not be controlled. The analysis of familiar function is a convenient weapon to approach in a more integrated manner such problem. In this systematic focus, the family becomes the protagonist in the symptoms of the indicated patient. It is within the family where the study proposes to find characteristics that instigate the development of the psychosomatic disease. The psychosomatic family basically suffers problems with boundaries. As with most family problems, the psychosomatic illness pertains to this dynamic group of families where the family roles are intermixed. The desire for a unified family creates a difficult home environment for individual spaces. This difficulty interpreted by Minuchin (1990) as the absence of psychological distance and defined it as the moment where one, or various family members begin to function as a family subsystem to which they do not pertain. According to Onnis (1990), there are four main characteristics of the psychosomatic family: Agglutination This refers to the reciprocal over-involvement of the family members. Each member is prone to intrusive actions, thoughts, feelings and communication with the other members. Reciprocal over-protection The members of the family demonstrate a high grade of diligence and reciprocal interest, encouraging and supplying answers that are of a protective type. As a result, the illness of the patient has a protective function towards the family. Rigidity This is the principal characteristic of the psychosomatic family. The family is resistant to change, and show itself as a unified and harmonious one, where the only problem is the illness of the patient. Outside relationships are scarce and the family remains stuck in the attempt to maintain it's own homeostasis. Avoidance of conflict There is a very low capacity for tolerating conflicts by the family and applies all possible methods to avoid it, which in the end the family only manages to hide the problem. In such a pattern, the patient plays a central and vital role by interfering every time the tension between the parents raises to a threat and the appearance of a symptom blocks the conflict by attracting the attention of the family members towards him/herself. The present study was done to characterize the organizational and functional profile of the nuclear family with one asthmatic child. Methods This is a descriptive semi-quantitative, non-experimental study to understand the family behavior and function of twenty nuclear families with one asthmatic child. The family function was evaluated in nine different areas with Emma Espejel Acco's the Scale of Family Function. This instrument was chosen because they could attain the desired objective and they were standardized for the Mexican population with a sensibility of 0.91 to discriminate between dysfunctional and functional families. Emma Espejel Acco's Scale of Family Function include the following areas: support, affect, disruptive conduct, communication, resources, authority, supervision, negative affect and control and final evaluation of each areas were reported in four categories: functional, fairly functional, poor functional and dysfunctional, attending Espejel Acco's recommendations. The study population was taken from a pool containing 102 psychosomatics families, whose participated in a previous study to characterize clinical patterns of asthma in children, also their relation with social and environmental factors leaded by Rodríguez-Orozco at the University of San Nicolás de Hidalgo, Morelia, México. Those nuclear families with an asthmatic children, within the ages six and twelve years, were included. There were only twenty families that fit the nuclear typology also, requirements for the study and those twenty were the ones included in this study; 95% was considered statistically significant and Pearson's Correlation was applied to study the relations between explored areas of the Scale of Family Function. The written consent was previously received for participant families and this study was run during 2005 at the University of San Nicolás de Hidalgo, Morelia, México. Results The 80% of the families were poorly functional in the area of affect. The communication was poorly functional in 60% of the families, in the area of resources 50 % of the families were fairly functional. Attending authority (75%), supervision(95%) and control (50%) of the families were fairly functional. 70 % of the families were fairly functional in support, and 65% were fairly functional when disruptive conducts were analized. In the area of negative affect almost 50% of the families were fairly functional. Within the obtained results, there was a positive correlation with a significance P <0.05 between the following areas authority and disruptive conduct r= .545 between the areas of authority and communication r=.518, and between disruptive conduct and resources r=.524 Discussion The principal characteristics found in the studied nuclear psychosomatic families with one son with asthma were agglutination, overprotection, rigidity and avoidance of conflict according to the four main characteristics referred in psychosomatic families. The familiar dinamics was really complex, even when all areas of the familiar function are compromised there is a predominance of poor efficacy to demonstrate affect and to communicate their feelings; it is associated with persistence of negative feelings which can not be treat adecuately due to a limited number of resources to solve conflicts. There was a positive correlation between authority and communication; authority and disruptive conduct and disruptive conduct and resources. This means that when authority resides in a parental subsystem, feelings are good expressed within the family; the emerging situations such as addictions and innapropiate social behaviour are well-discussed, despite of the major part of this innapropiate conducts remain unsolved because the family can not recognize the instruments to solve this problems. Conclusions The nuclear psychosomatics families with an asthmatic son, are rigid ones, and all areas of familiar functioning according. Espejel's Scale are affected, in agreement to other authors rigidity, as the crucial characteristics accompanied of avoidance of conflict, reciprocal-overprotection and agglutination. All evaluated areas of family function were affected in nuclear psychosomatic families with an asthmatic son. That is the way to stop the psychosomatic system. The psychological assistance is necessary to integrate to the medical treatment.

Palavras-chave : Psychosomatic family; family function; nuclear family; asthma; children.

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