title: Day-to-day living with severe chronic obstructive pulmonary disease: towards a family-based approach to the illness impacts.
abstract: OBJECTIVE
  This study explores the perspectives of both patients and family members regarding the impact of chronic obstructive pulmonary disease (COPD) in their family life.
  
  
  METHODS
  An exploratory qualitative study was conducted with patients and their family members in the chronic phase of COPD. Individual interviews were performed to explore participants' perspectives and submitted to thematic analysis.
  
  
  RESULTS
  Six major themes emerged from patients' perspective: (1) impact of COPD symptoms on personal and family daily life; (2) (over)protective family support; (3) difficulties in couple communication; (4) sense of identity loss; (5) fear of COPD progression; and (6) coping resources. Five main themes emerged from the family members' perspective: (1) restrictions in family's social life; (2) emotional distress related to COPD exacerbations; (3) tension in couple relationship; (4) financial strain of COPD; and (5) coping resources.
  
  
  CONCLUSIONS
  The overall findings illustrate the complex interaction between the experience of living with COPD and communication patterns, emotional states, social support and social roles within the family. The results highlight the need to develop family-based interventions to facilitate a functional adjustment to COPD. However, these interventions in COPD remain undeveloped and empirical evidence is needed.
authors.affiliation: a School of Health Sciences, University of Aveiro (ESSUA) , Aveiro , Portugal.
authors.forename: Raquel
authors.initials: R
authors.lastname: Gabriel
authors.forename: Daniela
authors.initials: D
authors.lastname: Figueiredo
authors.forename: Cristina
authors.initials: C
authors.lastname: Jácome
authors.forename: Joana
authors.initials: J
authors.lastname: Cruz
authors.forename: Alda
authors.initials: A
authors.lastname: Marques
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003142:Communication; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology* / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000523:psychology*; D036301:Qualitative Research; D012720:Severity of Illness Index; D012944:Social Support; D013315:Stress, Psychological
keywords: chronic obstructive pulmonary disease; family; family-based interventions; family-systems illness model; impact