Altamash Shaikh
Saifee Hospital, Mumbai, Maharashtra, India.
Indian J Endocrinol Metab. 2013 Oct;17(Suppl 1):S292-4. doi: 10.4103/2230-8210.119619.
Another major force not letting us succeed in the treatment of diabetes remains right inside the patients home, their family members. Hence, it is important to know the perception of the close family members about this simple and strong tool in diabetes, 'insulin'. The drug is nearing its century, it has not fully being accepted gracefully even in todays electronic savvy society. So, we need to strongly discover the reason for its non-acceptance, while trials are out inventing new drugs. One vital thing that can change this attitude is increasing the understanding of this drug, insulin in depth to close people around the patient, the 'family'. Underestimating family's perception about disease and treatment for diabetes is detrimental to both diseased and the doctor. This consists of a biopsychosocial model; biological, psychological and social factors. Family forms the most important part of it. The strategies in family therapy include psychodynamic, structural, strategic, and cognitive-behavioral component. Diabetes has and will continue to rise, so will be the treatment options. From the clinicians side its to fix fasting first but from patients its fix family first. Family therapy demonstrates the importance of insulin initiation and maintenance in insulin naive patients, and continuation for others. The specific needs of such patients and their impact on family life are met with family therapy. Who needs family therapy? Benefits of family therapy and a case based approach is covered.
另一个阻碍我们成功治疗糖尿病的主要因素就在患者家中,即他们的家庭成员。因此,了解糖尿病患者的亲密家庭成员对糖尿病治疗中这个简单而有力的工具——“胰岛素”的看法非常重要。胰岛素问世已近百年,即使在当今这个精通电子技术的社会,它也尚未被完全欣然接受。所以,在不断试验研发新药的同时,我们需要深入探究其未被接受的原因。能改变这种态度的一个关键因素是,向患者身边的亲近之人,也就是“家人”,深入普及对胰岛素这种药物的认识。低估家人对糖尿病疾病及治疗的认知,对患者和医生都不利。这涉及到一个生物心理社会模型,包括生物、心理和社会因素。家庭是其中最重要的部分。家庭治疗的策略包括心理动力、结构、策略和认知行为等方面。糖尿病已经并将持续增加,治疗选择也会随之增多。从临床医生的角度来看,首先要解决空腹血糖问题,但从患者的角度来说,首先要解决家庭问题。家庭治疗证明了在初治胰岛素患者中启动和维持胰岛素治疗的重要性,以及对其他患者持续治疗的重要性。家庭治疗满足了这类患者的特殊需求及其对家庭生活的影响。谁需要家庭治疗?文中涵盖了家庭治疗的益处及基于案例的方法。