Family and chronic illness

Abstract

Suvremena medicinska praksa suočena je s porastom broja oboljelih od kroničnih bolesti. Kronična bolest utječe na ustaljenu dinamiku obitelji. Obiteljska dinamika podrazumijeva tip i model obitelji, značenja, vjerovanja i rituale, fazu životnog ciklusa u kojoj se obitelj nalazi u trenutku suočavanja s kroničnom bolešću te osnovne aspekte funkcioniranja koji uključuju kohezivnost, prilagodljivost, komunikaciju i organizaciju obitelji. Kronični bolesnici, kao i članovi njihove obitelji, dotadašnji način života moraju prilagoditi zahtjevima bolesti, uključujući i psihološku prilagodbu. Kod članova obitelji suočenih s bolešću jednog svojeg člana u početku dominira negacija, slijedi depresivna faza i žalovanje te polako nastupa prihvaćanje, čime se dotadašnji odnosi zamjenjuju odnosima druge kvalitete. Funkcionalna obitelj je fleksibilna i u stanju je prilagoditi svoju dinamiku kako bi pronašla mjesta za bolest uz istovremeni rad na ciljevima, rutini i ritualima koje je imala i prije pojave bolesti. U proces liječenja kronične bolesti neophodno je aktivno uključiti članove obitelji. Studije su pokazale da liječenje kroničnih bolesti orijentirano obitelji predstavlja unaprjeđenje u liječenju u odnosu na tradicionalno liječenje orijentirano na bolest ili pojedinačnog bolesnika, kako po pitanju rezultata liječenja i ishoda bolesti tako i u odnosu na ekonomske kriterije.Modern medical practice is faced with increasing number of people with chronic diseases. Chronic illness affects standard family dynamics. Reaction of the family faced with a chronic illness of their member depends on the unique balance of family members and relations between them. Family dynamics refers to the type and model of the family, meanings, beliefs and rituals, life cycle stage in which the family is at the time of dealing with chronic disease as well as basic aspects of functioning including cohesiveness, adaptability, communication and organization of the family. Chronic patient, and his family members, have to adapt their former way of life to the demands of illness, including psychological adjustment. In a family which is faced with the disease of one of its members initially dominates negation, the next phase is depression and mourning, then they slowly accept the situation and it replaces the former relations with new quality relations. Functional family is flexible and is able to adapt their dynamics to find space for a disease with simultaneous work on the goals, routines and rituals that it had before the incidence of the disease. In the process of chronic diseases treatment, it’s necessary to actively involve family members. Studies showed that family-oriented treatment of chronic diseases is an improvement in treatment over traditional treatment of a disease-oriented or individual- oriented treatement, both regarding the results of treatment and outcome of disease and in relation to economic criteria