La adherencia familiar en el trastorno mental grave

OBJECTIVE: Identify attitudes and behaviors that evidence and characterize family adherence to treatment in patients with severe mental disorder. DESIGN: Qualitative descriptive, from an interpretative social approach. LOCATION: Chia, Colombia, with professionals in the psychiatric and geriatric settings. PARTICIPANTS: Twelve professionals in psychiatry, nursing and psychology, with experience in care of patients with serious mental disorder and their families. METHOD: Intentional sampling. Twelve semi-structured interviews were carried out. The analysis strategy was made from the procedures of constant comparison and open coding of the grounded theory. As validation strategies, triangulation was done between researchers and methods, as interviews and results survey. RESULTS: Two categories of family adherence were defined: family and treatment (treatment cooperation, knowledge about the disease and attention to the disease evolution), and family attitudes towards the patient (patient's care, patient's promotion of autonomy, and affective attachment with the patient). A third category showed aspects that diminished family adherence, such as lack or distortion of information regarding mental disorder, or family and patient endurance attitudes. CONCLUSIONS: Participants agree about the relevance of the construct named «family adherence», which describes the behaviors and attitudes of the family regarding the treatment of patients with severe mental disorder. Family adherence can be seen as active participation behavior, but also as a process of strengthening relationships, which can reduce the burden and suffering on family members, caregivers and patients.