title: Family-based psychosocial support and education as part of pulmonary rehabilitation in COPD: a randomized controlled trial.
abstract: 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.
  
  
  BACKGROUND
  ClinicalTrials.gov; No.: NCT02048306; URL: www.clinicaltrials.gov.
authors.affiliation: School of Health Sciences (ESSUA), Unidade de Investigação e Formação sobre Adultos e Idosos (UNIFAI), Porto, Portugal. Electronic address: amarques@ua.pt.
authors.forename: Alda
authors.initials: A
authors.lastname: Marques
authors.affiliation: School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Jácome
authors.affiliation: School of Health Sciences (ESSUA), Department of Health Sciences (SACS), University of Aveiro, Aveiro, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Cruz
authors.affiliation: School of Health Sciences (ESSUA), Department of Health Sciences (SACS), University of Aveiro, Aveiro, Portugal.
authors.forename: Raquel
authors.initials: R
authors.lastname: Gabriel
authors.affiliation: Graduate Department of Rehabilitation Science, Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
authors.affiliation: School of Health Sciences (ESSUA), Unidade de Investigação e Formação sobre Adultos e Idosos (UNIFAI), Porto, Portugal.
authors.forename: Daniela
authors.initials: D
authors.lastname: Figueiredo
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000328:Adult; D000368:Aged; D017079:Exercise Tolerance / Q000502:physiology; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D016037:Single-Blind Method; D012944:Social Support