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以家庭为基础的心理社会支持与教育作为慢性阻塞性肺疾病肺康复的一部分:一项随机对照试验

Family-based psychosocial support and education as part of pulmonary rehabilitation in COPD: a randomized controlled trial.

作者信息

Marques Alda, Jácome Cristina, Cruz Joana, Gabriel Raquel, Brooks Dina, Figueiredo Daniela

机构信息

School of Health Sciences (ESSUA), Unidade de Investigação e Formação sobre Adultos e Idosos (UNIFAI), Porto, Portugal.

School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal.

出版信息

Chest. 2015 Mar;147(3):662-672. doi: 10.1378/chest.14-1488.

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.

TRIAL REGISTRY

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

摘要

背景

让家庭参与患者的康复护理计划可能会改善慢性阻塞性肺疾病(COPD)的管理。本研究的主要目的是调查基于家庭的肺康复(PR)计划对患者及其家庭成员应对COPD策略的影响。

方法

将家庭二元组(患者和家庭成员)随机分配到基于家庭的(实验组)或传统的(对照组)PR。两组患者均接受每周三次的运动训练以及每周一次的心理社会支持和教育,为期12周。基于家庭的PR组的家庭成员与患者一起参加心理社会支持和教育课程。在传统PR组中,家庭成员不参与。评估两组患者及其家庭成员的家庭应对方式和对疾病的心理社会适应情况。还测量了患者的运动耐量、功能平衡、肌肉力量以及与健康相关的生活质量。所有测量指标均在项目前后收集。

结果

42个二元组参与研究(患者:第1秒用力呼气容积[FEV1]为预测值的70.4%±22.1%)。与对照组相比,基于家庭的PR组中的患者(P = 0.048)和家庭成员(P = 0.004)在家庭应对方面有显著更大的改善。与对照组相比,基于家庭的PR组的家庭成员在性关系(P = 0.026)和心理困扰(P = 0.033)方面有显著更大的变化。干预后,两组患者在运动耐量、功能平衡、膝关节伸肌力量以及与健康相关的生活质量方面均有显著改善(P < 0.001)。

结论

本研究支持基于家庭的PR计划,以增强家庭系统对疾病的应对能力和心理社会适应能力。

试验注册

ClinicalTrials.gov;编号:NCT02048306;网址:www.clinicaltrials.gov。

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