Questionário de problemas familiares: desenvolvimento da versão portuguesa de um instrumento de avaliação de sobrecarga familiar

Miguel Xavier^1,2, Manuel Gonçalves Pereira¹, Bernardo Barahona Corrêa², & José Miguel Caldas de Almeida^1,3

¹Clínica Universitária de Psiquiatria e Saúde Mental da Faculdade de Ciências Médicasda Universidade Nova de Lisboa – Portugal

²Hospital de S.Francisco Xavier – Portugal

³Coordenador do "Mental Health Program – Division of Health Promotion and Protection"Pan American Health Organization (PAHO), Washington DC – U.S.A.

 

RESUMO: Com a reformulação dos modelos de prestação de cuidados em psiquiatria e saúde mental, tem-se verificado um aumento do número de doentes com perturbações mentais graves a viver com a família, cujos membros passam a estar assim potencialmente sujeitos a uma sobrecarga psicológica significativa. Dado o papel central dos familiares na prestação de cuidados informais, é de extrema relevância avaliar de forma padronizada as suas dificuldades, nomeadamente quanto à necessidade de intervenções de tipo psicoeducacional. Nos últimos anos têm sido elaborados vários instrumentos especificamente para a avaliação da sobrecarga familiar: neste trabalho, os autores descrevem o desenvolvimento da versão portuguesa do "Family Problem Questionnaire-FPQ". Após tradução e retroversão, foi feita a administração do FPQ a uma amostra de conveniência de 160 familiares de indivíduos com diagnóstico de esquizofrenia: numa análise preliminar, os resultados demonstraram boa aceitação e propriedades psicométricas satisfatórias. Este instrumento parece, pois, conter boas potencialidades de aplicação em actividades de investigação e monitorização de qualidade de cuidados prestados nos serviços de saúde mental, nomeadamente em intervenções psicoeducacionais.

Palavras chave: Avaliação de cuidados em saúde mental, Esquizofrenia, Qualidade de cuidados, Sobrecarga familiar

 

Family problem questionnaire: development of the portuguese version of a family burden evaluation tool

ABSTRACT: Probably due to the shift from institutional care to community care, the research has shown that informal carers (eg, family members) of patients with severe and long-term mental illness may experience an important psychological and emotional burden. Given that the family members are becoming such valuable resources as carers, it is crucial to assess their difficulties and needs, namely for the proposal of a psycho-educational intervention. In order to achieve this goal, several instrument focused on family burden assessment have been developed in the last years: in this paper, the authors report the development of the portuguese version of the "Family Problem Questionnaire-FPQ". After the back-translation procedures, a sample of 160 informal caregivers of patients with schizophrenia was evaluated using the FPQ: on a preliminar analysis, the results showed good acceptance and satisfactory psychometric properties. Thus, the FPQ seems to be potentially useful in a wide range of research and practical settings, including clinical and quality of care assessments, as well on the monitoring of psychoeducational interventions.

Key words: Family burden, Mental health care evaluation, Quality of care, Schizophrenia

 

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

 

REFERÊNCIAS

Altman, D., Gore, S., Gardner, M., & Pocock, S. (1983). Statistical guidelines for contributors to medical journals. British Medical Journal, 286, 1489-1493.

        [ Links ]

Basch, C. (1987). Focus group interview: an underutilized research technique for improving theory and practice in health education. Health Education Quarterly, 14, 411-448.

Brown, G., & Birley, J. (1972). Influence of family life on the course of schizophrenic disorder: A replication. British Journal of Psychiatry, 121, 241-258.

Caldas de Almeida, J., & Xavier, M. (1995). Avaliação e Garantia de Qualidade dos Serviços de Saúde Mental. Acta Médica Portuguesa, 8, 119-131

Caldas de Almeida, J., & Xavier, M. (1996). Evaluation of Comprehensive Care to Schizophrenic Patients in Portugal. In WAPR (Ed.), Abstract Book (p. 161). Roterdão.

Caldas de Almeida, J., & Xavier, M. (1997). Perspectivas actuais do tratamento da esquizofrenia na comunidade. Acta Médica Portuguesa, 12, 885-862.

Cumming, J., & Cumming, E. (1965). On the stigma of mental illness. Community Mental Health Journal, 1, 135-143.

Fadden, G., Bebbington, P., & Kuipers, L. (1987). Caring and its burdens. A study of the spouses of depressed patients. British Journal of Psychiatry, 151, 660-667.

Gonçalves Pereira, M. (1996). Repercussões da Doença Mental na Família – Um estudo de familiares de doentes psicóticos. Dissertação de Mestrado apresentada à Faculdade de Ciências Médicas da UNL. Lisboa.

Grad, J., & Sainsbury, P. (1968). The effects that patients have on their families in a community care and control psychiatric service. British Journal of Psychiatry, 14, 265-278.

Hoenig, J., & Hamilton, M. (1966). The schizophrenic patient in the community and his effect on the household. International Journal of Social Psychiatry, 12, 165-176.

Jackson, H., Smith, N., & Mcgowy, P. (1990). Relationship between expressed emotion and family burden in psychotic disorders: An exploratory study. Acta Psychiatrica Scandinavica, 82 (3), 243-249.

Kovess, V., Caldas de Almeida, J., Salize, H., et al. (1996). Evaluation of Comprehensive Care to Schizophrenic Patients: Methodology of the multicentric study. In WAPR (Ed.), Abstract Book (p. 161). Roterdão.

Leff, J. (1997). The downside of reprovision. In J. Leff (Ed.), Care in the Community: Illusion or reality? (pp. 167-175). Chichester: Wiley.

Magliano, L., Fadden, G., Caldas de Almeida, J., Held, T., Guarneri, M., Marasco, C., Tosini, P., & Maj, M. (1998a). Burden on the families of patients with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 33, 404-412.

Magliano, L., Fadden, G., Xavier, M., Held, T., Guarneri, M., Marasco, C., Tosini, P., & Maj, M. (1998b). Social and clinical factors influencing the choice of coping strategies in relatives of patients with schizophrenia: Results of the BIOMED I study. Social Psychiatry and Psychiatric Epidemiology, 33, 413-419.

Magliano L, Fadden, G., Xavier, M., Guarneri, M., Malangone, C., Marasco, C., & Maj, M. (2000). Family burden and coping strategies in schizophrenia: 1-year follow-up data from the Biomed I study. Social Psychiatry and Psychiatric Epidemiology, 35, 109-115.

Mari, J., & Streiner, D. (1994). An overview of family interventions and relapse on schizophrenia: Meta-analysis of research findings. Psychological Medicine, 24, 565-578.

Morosini, P., Roncone, R., Veltro, F., Palomba, U., & Casacchia, M. (1991). Routine Assessment tool in psychiatry: A case of questionnaire of family attitudes and burden. Italian Journal of Psichiatry and Behavioral Sciences, 1, 95-101.b

Mueser, K., Bond, G., & Drake, R. (1998). Models of community care for severe mental ilness: A review of research on case management. Schizophrenia Bulletin, 24 (1), 37-74.

Scazufca, M., & Kuipers L. (1996). Links between Expressed Emotions and Burden of Care in relatives of patients with schizophrenia. British Journal of Psychiatry, 168, 580-587.

Schene; A., Tessler, R., & Gamache, G. (1996). Caregiving in severe mental illness: Conceptualization and measurement. In H. Knudsen & G. Thornicroft (Eds.), Mental Health Service Evaluation. Cambridge: Cambridge University Press.

Streiner, D., & Norman, G. (1995). Scaling responses. In D. Streiner & G. Norman (Eds.), Health Measurement Scales – A practical guide to their development and use (pp. 28-53). Oxford: Oxford Medical Publications.

Treudley, M. (1946). Mental illness and family routines. Mental Hygiene, 15, 407-418.

Veltro, F., Magliano, L., Morosini, P., & Maj, M. (1994). Burden on key relatives of patients with schizophrenia vs neurotic disorders: A pilot study. Social Psychiatry and Psychiatric Epidemiology, 29(2), 66-70.

Winjgaarden, B., Schene, A., Koeter, M., et al. (2000). Caregiving in Schizophrenia: Development, internal consistency and reliability of the IEQ – European Version. Epsilon Study 4. British Journal of Psychiatry, 177 (supp. 39), 21-27.

Xavier, M. (1999). Avaliação de Qualidade de Serviços de Psiquiatria e Saúde Mental.

Dissertação de Doutoramento, apresentada à Universidade Nova de Lisboa. Lisboa: Faculdade de Ciências Médicas.