Family Genogram in General Medicine: A Soft Technology that can be Strong. An Update

Abstract

What is traditionally called individual, family and community care are elements of the same reality and cannot be separated. The genogram is an instrument or tool of the biopsychosocial model that gives information about the patient, their family and context, and that implies a prognostic value and useful information for the consultation. The biomedical family history means collecting problems of genetic transmission, but from the biopsychosocial point of view it can go much further: the elaboration of the genogram produces a therapeutic link with the family, implying a qualitative change in the relationship; the genogram gives rise hypotheses -in circular terms-about patients' risks for family related illnesses or stressors, such as diabetes, hypertension, coronary heart disease, substance abuse, and depression; It allows developing a provisional explanation about how the family system is organized around a problem; genogram shows events of family life, transitions and turning points, that mean opportunistic prevention and treatment moments. "Complex" genograms present families with psychosocial problems that can be expressed like biomedical problems. The genogram can be used as a screening system in all patients, at their first glance, regardless of the problem that motivates their consultation, to identify biological or psychosocial problems that would manifest themselves later. It is advisable to make "feasible" genograms avoiding excessive information that paralyzes understanding and intervention. The genograms are a fixed photograph of the family at a certain moment, and the concept of "chronogram" should be incorporated (evolution of the same genogram after the time).

Characteristics and Vaccine Booster Effectiveness in Covid-19 Infections Using 15 Days Post-Booster Period as Baseline during the Omicron Wave in A General Medicine office in Toledo (Spain)

“…-Age and sex -Chronic diseases (defined as "any alteration or deviation from normal that has one or more of the following characteristics: is permanent, leaves residual impairment, is caused by a non-reversible pathological alteration, requires special training of the patient for rehabilitation, and / or can be expected to require a long period of control, observation or treatment" [27], classified according to the International Statistical Classification of Diseases and Health-Related Problems, CD-10 Version: 2019 [28] -Social-occupancy class (according to the Registrar General's classification of occupations and social status code) [29][30] -If they were Health Care Workers -Problems in the family context (complex families) based on the genogram and in the experience of the GP for their continuity of care and knowledge of the family (genogram is a schematic model of the structure and processes of a family, which included the family structure, life cycle and family relational patterns. It was understood that "complex" genograms present families with psychosocial problems) [31][32][33][34] -Ethnic minority…”

Evolution of the Characteristics of Covid-19 Index Cases From the Year 2000 (Not Vaccinated) To 2021 (Vaccinated) Within the Families, in Toledo (Spain): The Importance of Psycho-Social Factors

“…Age, Sex, symptoms, severity of the disease, chronic diseases, classified according to the International Statistical Classification of Diseases and Health-Related Problems, CD-10 Version: 2019, social-occupancy class, problems in the family context and low income household based on the genogram and in the experience of the GP for their continuity of care and knowledge of the family, number of family members, and ethnic minority [30][31][32][33][34].…”

General Doctor's Consultation Work Begins before Entering the Patient and does not End when Patient Comes Out

“…It is advisable to make "feasible" genograms avoiding excessive information that paralyzes understanding and intervention. The genograms are a fixed photograph of the family at a certain moment, and the concept of "chrono-genogram" should be incorporated (evolution of the same genogram over time) [23].…”