In clinical practice, it is not rare to encounter situations in which parents and families are asked to leave the child alone with the health care team in rooms full of devices throughout the performance of procedures, which at times may give rise not only to conflicts but, more importantly, emotional sequelae in children or adolescents. We conducted a narrative review of the literature by searching the digital library of the public health care system of Andalusia for articles concerning the experiences of health care professionals and families with the accompaniment of paediatric patients during health care procedures. We restricted the search to studies published in Spanish or English and conducted in humans. The review evinced the need to humanise care in order to improve care quality. The need to accompany minors is supported by the evidence from works that have analysed the factors involved in the persistence of these behaviours and attitudes in both professionals and parents. We consider it necessary to develop institutional policies and appoint mediators to compile the statements of different national and international societies, taking into account legal aspects but, above all, the pertinent values from a health care ethics perspective, and in pursuit of the best interests of the child.

OBJECTIVE: Family members play a major role in the assessment and final result of the treatments of patients. The goal of the present study was to evaluate how much the perception of patients\' family members could be trusted regarding the vertigo and imbalance which they experienced.
METHODS: A cross-sectional study was conducted on 110 patients and their family members who were referred to the Central Vestibular Clinic in Mashhad from April 2018 to September 2019. Family members were categorized as spouses, children, and other relatives of patients. Patients and their family members separately completed the Dizziness Handicap Inventory (DHI) by the paper and pencil method. DHI has a high reliability, validity, and internal consistency.
RESULTS: Mean DHI scores of patients and their family members were 45.35±20.24 and 42.01±22.83, respectively. The correlation between DHI scores of patients and family members, except children, were significant (p<.05).
CONCLUSIONS: A relatively weak to moderate relationship between the perception of patients and their family members, except children, was found. They were more aware of the physical aspects of vertigo and imbalance than the emotional ones.

OBJECTIVE: Family members play a major role in the assessment and final result of the treatments of patients. The goal of the present study was to evaluate how much the perception of patients\' family members could be trusted regarding the vertigo and imbalance which they experienced.
METHODS: A cross-sectional study was conducted on 110 patients and their family members who were referred to the Central Vestibular Clinic in Mashhad from April 2018 to September 2019. Family members were categorized as spouses, children, and other relatives of patients. Patients and their family members separately completed the Dizziness Handicap Inventory (DHI) by the paper and pencil method. DHI has a high reliability, validity, and internal consistency.
RESULTS: Mean DHI scores of patients and their family members were 45.35±20.24 and 42.01±22.83, respectively. The correlation between DHI scores of patients and family members, except children, were significant (p<.05).
CONCLUSIONS: A relatively weak to moderate relationship between the perception of patients and their family members, except children, was found. They were more aware of the physical aspects of vertigo and imbalance than the emotional ones.

OBJECTIVE: Information is one of the most important needs of families of critical patients. Healthcare professionals also identify the great value of communication with families to reduce their anxiety and stress. Despite this, families may feel inadequately informed, causing added suffering. The purpose of this study is to provide an understanding of both families\' and healthcare professionals\' perspectives on information giving within intensive care units (ICU).
METHODS: A narrative review was conducted using MEDLINE, CINAHL, PsycINFO databases and the Cochrane Library to identify studies published in either English or Spanish from 2002 to 2018.
RESULTS: 47 studies were included, and five categories were identified: 1)\"the need to know\"; 2)family satisfaction with the information received; 3)impact of information on families\' experiences in the ICU; 4)nurses and physicians\' perceptions of information transmission, and 5)information process in the ICU.
CONCLUSIONS: Providing honest and truthful information to the families of critical patients is essential to reduce family anxiety and increase family control, although this often appears to be inadequately accomplished by staff. Interdisciplinary involvement in information giving may be beneficial for both families and ICU professionals. This review brings new understanding about the process of information to families of ICU patients and it can be used to improve the quality and humanization of care in the ICUs.

Carers of patients with borderline personality disorder (BPD) experience high levels of distress. Several studies have been carried out on interventions designed to decrease their burden. However, the evidence from these studies has not been summarized. The objective of this work is to explore the clinical utility of interventions developed for family members of patients with BPD. A systematic review was conducted following the PRISMA guidelines (registration number CRD42018107318), including psychological interventions focused on relatives of patients with BPD. The following databases were used: PsycINFO, PubMed, EBSCOhost, and Web of Science. Two independent researchers reviewed the studies to determine whether the eligibility criteria were met. A total of 2,303 abstracts were identified. After duplicates had been removed, 1,746 studies were screened. Finally, 433 full-text articles were reviewed, yielding 11 studies that satisfied the inclusion criteria. Results show that these interventions with different clinical formats and settings are effective. The quality of the included studies varies, and the empirical support for these programs is still preliminary. The results help to establish a general framework for interventions specifically developed for family members of patients with BPD, but additional efforts should be made to improve the methodological quality of this field of research and more solidly determine the utility of these interventions. Given the paucity of data so far, this information may open up new lines of research to improve the effectiveness of future programs for carers of patients with BPD and help to reduce their burden.
Los familiares de pacientes con trastorno límite de la personalidad (TLP) experimentan elevados niveles de estrés. Se han llevado a cabo varios estudios sobre intervenciones diseñadas para disminuir su carga. Sin embargo, los datos obtenidos de estos estudios no se han expuesto. El objetivo de este trabajo es explorar la utilidad clínica de las intervenciones desarrolladas para los familiares de los pacientes con TLP. Se realizó una revisión sistemática siguiendo las directrices de PRISMA (número de registro CRD42018107318), que incluyó intervenciones psicológicas centradas en los familiares de los pacientes con TLP. Se utilizaron las siguientes bases de datos: PsycINFO, PubMed, EBSCOhost, y Web of Science. Dos investigadores independientes revisaron los estudios para determinar si se cumplían los criterios de elegibilidad. Se identificaron un total de 2303 resúmenes. Después de extraer los duplicados, se evaluaron 1746 estudios. Finalmente, se revisaron 433 artículos de texto completo, lo que dio lugar a 11 estudios que cumplían los criterios de inclusión. Los resultados demuestran que estas intervenciones con diferentes formatos y orientaciones clínicas son eficaces. La calidad de los estudios incluidos varía, y el apoyo empírico para estos programas es todavía preliminar. Los resultados contribuyen a establecer un marco general para las intervenciones desarrolladas específicamente para los familiares de los pacientes con TLP, pero se deberían realizar esfuerzos adicionales para mejorar la calidad metodológica de este campo de investigación y determinar con mayor solidez la utilidad de estas intervenciones. Dada la escasez de datos hasta el momento, esta información puede abrir nuevas líneas de investigación para mejorar la eficacia de los futuros programas para los cuidadores de los pacientes con TLP y ayudar a reducir su carga.
家庭社会经济地位经常与儿童的早期发展相关联。将 SES 视为聚合变量存在许多问题，因为 SES 的不同组成部分可能通过不同的机制与子结果相关。本研究的目的是调查父母参与家庭学习活动和儿童参与课外活动（EAs）发挥的作用是否是促使了SES的单个组成部分和儿童入学准备相关联起来。为开展本研究特在中国广东省共招募了588个学龄前儿童家庭。在三个时间点分别对儿童的接受性词汇、汉语阅读和早期数学技能进行了评估，孩子们的社交技能由家长来评定。家长们报告他们和孩子一起参与在家的学习活动，以及他们的孩子参与课外活动（EAs）的情况。结果表明家庭SES的所有三个组成部分都与儿童入学准备的多个方面有关，但途径不同。父母收入情况只是通过课外活动参与情况与儿童入学准备程度相关，父母教育程度和职业地位通过父母参与和儿童课外活动参与两方面与入学准备程度相关联。研究结果表明，单独地考虑SES组成部分可以增进对不同途径的细微差别的理解， 这些途径都能将SES和儿童入学准备程度相关联起来。中国政府可以为低SES家庭提供侧重认知刺激这个方面的家长教育项目，以促进儿童的入学前的准备。此外，政府需要确保儿童获得平等的机会参与到课外活动EAs，这样可以防止来自不同社会经济背景的儿童之间的发展差距越来越大。.

OBJECTIVE: To determine the satisfaction of relatives of deceased patients with the care received in a palliative care unit (PCU) and compare it with cases in which a team with specific psychological care were not involved.
METHODS: An anonymous survey (n=202) was administered to the relatives (response rate, 42.1%), which evaluated 9 issues related to the process of dying and the overall assessment of the care.
RESULTS: The overall satisfaction was high (mean score of 9.22); the score for the full team was 9.40, while that of the team without the psychologist was 8.40 (P=.005). The items that scored highest were \"team availability\", \"information received\" and \"assistance for facing the disease\", followed by \"pain control\", \"peaceful death\", \"assistance for patient-family communication\", \"grief support\" and \"quality of life\".
CONCLUSIONS: Based on the relatives\' assessment, the hospital PCU teams help increase the quality of care at the end of life.

Severe Traumatic brain injury (sTBI) often instigates widespread long-lasting disability and is accompanied by extensive rehabilitation. Unsurprisingly, sTBI also holds malignant consequences for patients\' close relatives. The burden caused by the injury and its severity explains some of the ramifications for the relatives. Additionally, some findings demonstrate that patients with sTBI and their relatives develop posttraumatic stress (PTS) symptoms. However, although the link between PTS symptoms and physical and mental health is well-documented in literature, the effect of PTS symptoms on relatives of patients with sTBI has barely been examined. This study examines the influence of PTS symptoms of patients with sTBI and their relatives on the physical and mental health and functioning of the relatives. Patients who sustained a severe sTBI (Abbreviated Injury Scale of the head region > 3) and close relatives were included in a multi-center, prospective cohort study (TRAST-MI). One-hundred patients and their relatives were assessed at 2, 6, and 12 months post injury. Outcome variables included health-related quality of life (SF-12) as well as emotional, cognitive, interpersonal, and total functioning (PCRS). Relatives\' physical health was predicted by relatives\' PTS symptoms (Slope=-1.76; p = .043), and mental health was predicted by both patients\' (Slope=-2.77; p = .034) and relatives\' (Slope=-6.59; p < .001) PTS symptoms. Functioning level was only predicted by patients\' PTS symptoms (Slope=-.25; p< .001). The findings emphasize that TBI should be considered a comprehensive traumatic experience reaching further than mere physical damage to the brain and its direct consequences, affecting the injured individual and close relatives.
El traumatismo craneoencefálico grave (TCEG) generalmente provoca una discapacidad duradera generalizada y está acompañado por una larga rehabilitación. Como es de esperarse, el TCEG también tiene consecuencias nocivas para los familiares cercanos de los pacientes. El agobio causado por la lesión y su gravedad explica algunas de las repercuciones en los familiares. Además, algunos resultados demuestran que los pacientes con TCEG y sus familiares desarrollan síntomas de estrés postraumático (EPT). Sin embargo, aunque la asociación entre los síntomas de EPT y la salud física y mental está bien documentada en la bibliografía, el efecto de los síntomas de EPT en los familiares de los pacientes con TCEG casi no se ha analizado. Este estudio analiza la influencia de los síntomas de EPT de los pacientes con TCEG y sus familiares en la salud física y mental y en el funcionamiento de los familiares. Se incluyó a pacientes que sufrieron un TCEG (escala abreviada de lesiones de la región craneana > 3) y a familiares cercanos en un estudio de cohorte prospectivo realizado en varios centros (TRAST-MI). Se evaluó a cien pacientes y a sus familiares a los dos, a los seis y a los doce meses después de la lesión. Entre los criterios de valoración se encontraron la calidad de vida relacionada con la salud (SF-12) así como el funcionamiento emocional, cognitivo, interpersonal y total (PCRS). La salud física de los familiares se predijo mediante los síntomas de EPT de los familiares (Pendiente = -1.76; p = .043), y la salud mental se predijo mediante los síntomas de EPT de los pacientes (Pendiente = -2.77; p = .034) y los familiares (Pendiente = -6.59; p < .001). El nivel de funcionamiento solo se predijo mediante los síntomas de EPT de los pacientes (Pendiente = -.25; p < .001). Los resultados enfatizan que el TCE debe considerarse una experiencia traumática amplia que va más allá del mero daño físico al cerebro y sus consecuencias directas, y que afecta a la persona lesionada y a sus familiares cercanos.
重度创伤性脑伤(sTBI)造成广泛的长期性残,伴随大量的康复治疗。 sTBI对病人的亲近的家属有伤害的结果,这一点并不惊奇。脑伤引起的负担和严重性解释了有疾病衍生出的对近亲的影响。另外,有些研究结论证明有sTBI的病人和他们的亲人都出现了PTS创伤后压力症候。但是尽管PTS症状和身体心理健康之间的关系在文献里面有很多记录,PTS症状在sTBI病人的亲戚中的情况尚未有研究。本研究旨在考察有sTBI的病人 和他们的亲戚中的PTS症状,考察他们身体和心理健康及亲属的正常功能方面的状况。这是一项多中心的前瞻性队列研究,对重度sTBI (小型头部区域的伤害程度>3)患者和他们的亲近家属进行考察。100多个病人本人和家属在病人受伤后的2,6,12个月都进行了评估检查。结果变量包括健康相关的生活质量(SF-12)以及情绪、认知、人际交往和整个功能(PCRS)。 家属的身体健康状况可以由家属的PTS症状 ((Slope斜率 =-1.76; p值=.043)来预测,心理健康则可以由病人(Slope = -2.77; p = .034)和亲属的(Slope = -6.59; p < .001) PTS症状来预测。功能水平只能被病人的PTS症状预测 (Slope = -.25; p < .001)。这些研究结果强调TBI 脑部创伤是一个综合性的创伤经历,其影响力远远超过仅仅对脑部肉体方面的创伤和造成的直接后果,还影响到受伤者本人以及其亲近的家属。.

OBJECTIVE: Several studies have shown misconceptions about brain injury in different populations. The aim of this study was to assess the knowledge and perceptions about brain injury of family members of neurosurgical patients in our hospital.
METHODS: The participants (n=81) were relatives of patients admitted to the neurosurgery department between February and August 2016. They voluntarily completed a 19-item true-false format survey about brain injury based on a translation of other questionnaires used in previous studies from other countries (USA, Canada, UK, Ireland and New Zealand). Also, some sociodemographic data were collected (age, sex, education level and the patient\'s pathology). Data analysis was developed through graphical modelling with a regularisation parameter plotted on a network representing the association of the items of the questionnaire from the response pattern of participants.
RESULTS: Data analysis showed two conceptual areas with a high rate of wrong answers: behaviour and management of patients, and expectations about acquired brain injury recovery.
CONCLUSIONS: The results obtained in this study would enable us to objectify misconceptions about acquired brain injury in patients\' relatives attended in the neurosurgery department. This lack of knowledge could be a great obstacle in patients\' recovery process. Therefore, we suggest placing the emphasis on the provision of information on brain injury to patients\' families, especially with regard to its symptoms and course of development.

OBJECTIVE: To study the agreement between the level of satisfaction of patients and their families referred to the care and attention received during admission to the ICU.
METHODS: A prospective, 5-month observational and descriptive study was carried out.
METHODS: ICU of Marqués de Valdecilla University Hospital, Santander (Spain).
METHODS: Adult patients with an ICU stay longer than 24h, who were discharged to the ward during the period of the study, and their relatives.
METHODS: Instrument: FS-ICU 34 for assessing family satisfaction, and an adaptation of the FS-ICU 34 for patients. The Cohen kappa index was calculated to assess agreement between answers.
RESULTS: An analysis was made of the questionnaires from one same family unit, obtaining 148 pairs of surveys (296 questionnaires). The kappa index ranged between 0.278-0.558, which is indicative of mild to moderate agreement.
CONCLUSIONS: The families of patients admitted to the ICU cannot be regarded as good proxies, at least for competent patients. In such cases, we must refer to these patients in order to obtain first hand information on their feelings, perceptions and experiences during admission to the ICU. Only when patients are unable to actively participate in the care process should their relatives be consulted.

OBJECTIVE: To determine the level of satisfaction of family members with the care and decision making process, and to know the level of satisfaction of patients discharged from ICU.
METHODS: A prospective, observational and descriptive study with a duration of 5 months was carried out.
METHODS: The ICU of Marqués de Valdecilla University Hospital, Santander (Spain).
METHODS: Family members of adult patients admitted to the ICU and patients discharged to the ward.
METHODS:
METHODS: Family Satisfaction Intensive Care Survey (FS-ICU 34) of family members of patients discharged to the ward. We adapted the FS-ICU 34 in relation to care for application to the patients.
RESULTS: A total of 385 questionnaires were obtained: 192 from families of survivors and 162 from patients, and 31 from relatives of non-survivors. The majority of relatives were satisfied with overall care and overall decision making (survivors: 83.46 ± 11.83 and 79.42 ± 13.58, respectively; non-survivors: 80.41 ± 17.27 and 79.61 ± 16.93, respectively). Patients were very satisfied with the care received (84.71 ± 12.85).
CONCLUSIONS: The level of satisfaction of the relatives of patients admitted to the ICU is high, in the same way as the degree of patient satisfaction. Still, there are several points that should be improved, such as the waiting room environment and the atmosphere of the ICU in terms of noise, privacy and lighting. In relation to the decision making process, there are also some aspects that may be improved, such as the provision of hope regarding recovery of the critically ill relative.