title: Family dynamics in families of severe COPD patients.
abstract: OBJECTIVE
  The purpose of this study was to describe family dynamics in families with severe chronic obstructive pulmonary disease (COPD) on the basis of Barnhill's framework for healthy family systems. The sample consisted of 35 severe COPD patients and 30 family members at Tampere University Hospital, Finland or in the neighbouring regions.
  
  
  BACKGROUND
  Chronic obstructive pulmonary disease is a public health problem worldwide. It is a slowly progressive airway disease, producing a decline in lung function which is not fully reversible.
  
  
  METHODS
  The sample included the families of patients without oxygen therapy and the families of patients who had long-term oxygen therapy (LTOT). The data were collected using the Family Dynamics Measure 2 (FDM2) and the Family Dynamics Questionnaire (FDQ).
  
  
  METHODS
  A quantitative research method was employed in the study. Frequency and percentage distributions, as well as cross-tabulations, were used to describe the data. Mean values and standard deviations were calculated for the sum variables of six dimensions of the FDM2.
  
  
  RESULTS
  In the dimensions of individuation, mutuality and flexibility, dynamics in the families of patients with LTOT was significantly better than of the patients without oxygen therapy. Especially in the dimension of mutuality, the families of LTOT patients functioned very well, while in the dimensions of communication and roles, family dynamics in these families was notably worse, although still good.
  
  
  CONCLUSIONS
  Poor self-identity--enmeshment, isolation from others and lack of flexibility to varying conditions--in families with severe COPD can weaken the ability of the families to manage in everyday life.
  
  
  CONCLUSIONS
  Families need family nursing to adapt to alterations occurring when a family member has severe COPD. Nurses can give support and help for these families for their roles of patient and caregiver, as well as opportunities to speak with someone about their situation.
authors.affiliation: Department of Nursing Science, University of Tampere, Etelä-Pohjanmaa Hospital District, Tampere, Finland. merja.kanervisto@uta.fi
authors.forename: Merja
authors.initials: M
authors.lastname: Kanervisto
authors.forename: Eija
authors.initials: E
authors.lastname: Paavilainen
authors.forename: Johanna
authors.initials: J
authors.lastname: Heikkilä
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001294:Attitude to Health; D017281:Cost of Illness; D005190:Family / Q000523:psychology*; D022143:Family Nursing / Q000458:organization & administration / Q000523:psychology; D005195:Family Relations; D005260:Female; D005387:Finland; D006301:Health Services Needs and Demand; D006699:Home Care Services; D006801:Humans; D008134:Long-Term Care / Q000523:psychology; D008297:Male; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D010102:Oxygen Inhalation Therapy / Q000523:psychology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000517:prevention & control / Q000523:psychology*; D012649:Self Concept; D012720:Severity of Illness Index; D012934:Social Isolation; D012944:Social Support; D011795:Surveys and Questionnaires