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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences (2001)
Institute of Medicine (IOM)

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. "5 Individuals and Families: Models and Interventions." Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences. Washington, DC: The National Academies Press, 2001.

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences

TABLE 5–1 Family Focused Intervention Research on Selected Chronic Diseasesa

Diseases of Childhood and Adolescence

Diseases of Adulthood and the Elderly

Cystic fibrosis1

Breast cancer1

Cancer1

Coronary arterial disease1

Insulin-dependent diabetes2

Hypertension1

Congenital heart disease1

Non-insulin-dependent diabetes0

Sickle-cell anemia1

Alzheimer’s disease and other dementia2

Asthma2

Human immunodeficiency virus0

 

Chronic obstructive pulmonary disease and asthma0

a Superscript numbers refer to amount of correlational and intervention research found in literature: 2=considerable, 1=some, 0=little or none.

Interventions for Children and Adolescents with Chronic Disease

An organizational framework of family-focused interventions is helpful for comparing outcomes across several diseases. Three categories are used here and defined in Table 5–2: psychoeducational interventions to provide information about the disease and methods for its management by multiple family members, modified psychoeducational interventions to strengthen and improve family relationship quality and functioning, and family therapy. These are described below with illustrative examples.

Psychoeducational Interventions

This is the most common type of family-focused intervention. It aims to increase family members’ understanding of the disease and its management and to improve their capacity for management of the disease, including early recognition of the stress-induced changes occasioned by managing disease in the family setting and more effective adaptations that involve asking for help, reconfiguring expectations, reappropriating roles, and so on. Education and behavioral methods predominate. Parents and siblings of ill children are common targets for psychoeducational inter-

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