[Chronic heart failure as a crisis event of the family]. / La malattia cardiaca cronica come evento critico familiare.

ABSTRACT

The family greatly influences any of its members and significantly contributes to the patient rehabilitation. A limited and superficial interest from the family as well as an overprotective and anxiogenic behavior may lead to chronicization, relapse or even to progression of the disease. The close relationship between the patient and the physician is an illusion, since family members deeply affect this interaction. They may first influence the cardiologist's choice and later, through comments or actions, treatment expectations, diagnosis and therapy by sustaining or, on the contrary, minimizing the patient-physician interaction. A therapeutic triangle, which includes the family, the patient and the physician, develops from the beginning; thus the physician needs to be aware of it to use these interactions in the best interest of the patient himself. In this context clinical psychologists play a pivotal role first in identifying dysfunctional relations within the family and then in supporting the family to overcome crisis events.