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Family-based psychosocial support and education as part of pulmonary rehabilitation in COPD: a randomized controlled trial |
Marques A, Jacome C, Cruz J, Gabriel R, Brooks D, Figueiredo D |
Chest 2015 Mar;147(3):662-672 |
clinical trial |
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
BACKGROUND: Involving family as part of the patient's rehabilitation plan of care might enhance the management of chronic obstructive pulmonary disease (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 PR (control). 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 = 0.048) and family members (p = 0.004) 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 = 0.026) and in psychological distress (p = 0.033) compared to 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 < 0.001). CONCLUSIONS: This research supports family-based PR programs to enhance coping and psychosocial adjustment to illness of the family system. CLINICAL TRIALS REGISTRATION NUMBER: NCT02048306.
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