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Original Research: COPD |

Family-Based Psychosocial Support and Education as Part of Pulmonary Rehabilitation in COPDFamily-Based Pulmonary Rehabilitation in COPD: A Randomized Controlled Trial

Alda Marques, PhD, PT; Cristina Jácome, MSc; Joana Cruz, MSc; Raquel Gabriel, MSc; Dina Brooks, PhD; Daniela Figueiredo, PhD
Author and Funding Information

From the School of Health Sciences (ESSUA) (Drs Marques and Figueiredo and Mss Jácome, Cruz, and Gabriel) and the Department of Health Sciences (SACS) (Mss Cruz and Gabriel), University of Aveiro, Aveiro, Portugal; the Unidade de Investigação e Formação sobre Adultos e Idosos (UNIFAI) (Drs Marques and Figueiredo), Porto, Portugal; and the Graduate Department of Rehabilitation Science (Dr Brooks), Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.

CORRESPONDENCE TO: Alda Marques, PhD, PT, School of Health Sciences, University of Aveiro (ESSUA), Agras do Crasto-Campus Universitário de Santiago, Edifício 30, 3810-193 Aveiro, Portugal; e-mail: amarques@ua.pt


This work was presented in abstract form at the European Respiratory Society International Congress, September 6-10, 2014, Munich, Germany, and received the 1st Grant for Best Abstracts in Rehabilitation and Chronic Care.

FUNDING/SUPPORT: This work was supported by Portuguese National Funds through FCT-Foundation for Science and Technology [Grant RIPD/CIF/109502/2009].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(3):662-672. doi:10.1378/chest.14-1488
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BACKGROUND:  Involving family as part of the patient’s rehabilitation plan of care might enhance the management of COPD. The primary aim of this study was to investigate the impact of a family-based pulmonary rehabilitation (PR) program on patients and family members’ coping strategies to manage COPD.

METHODS:  Family dyads (patient and family member) were randomly assigned to family-based (experimental) or conventional (control) PR. Patients from both groups underwent exercise training three times a week and psychosocial support and education once a week, during 12 weeks. Family members of the family-based PR attended the psychosocial support and education sessions together with patients. In the conventional PR, family members did not participate. Family coping and psychosocial adjustment to illness were assessed in patients and family members of both groups. Patients’ exercise tolerance, functional balance, muscle strength, and health-related quality of life were also measured. All measures were collected pre/post-program.

RESULTS:  Forty-two dyads participated (patients: FEV1, 70.4% ± 22.1% predicted). Patients (P = .048) and family members (P = .004) in the family-based PR had significantly greater improvements in family coping than the control group. Family members of the family-based PR had significantly greater changes in sexual relationships (P = .026) and in psychologic distress (P = .033) compared with the control group. Patients from both groups experienced significant improvements in exercise tolerance, functional balance, knee extensors strength, and health-related quality of life after intervention (P < .001).

CONCLUSIONS:  This research supports family-based PR programs to enhance coping and psychosocial adjustment to illness of the family system.

TRIAL REGISTRY:  ClinicalTrials.gov; No.: NCT02048306; URL: www.clinicaltrials.gov

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