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Respir Care. 2016 Aug;61(8):1081-9. doi: 10.4187/respcare.04624. Epub 2016 Jul 5.

Exploring the Benefits to Caregivers of a Family-Oriented Pulmonary Rehabilitation Program.

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School of Health Sciences, University of Aveiro, Aveiro, Portugal, and Center for Health Technology and Services Research (CINTESIS.UA), Portugal.
Lab 3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal, and Institute for Research in Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.
Lab 3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.



COPD is a highly incapacitating disease, particularly among older people, implying significant burden for family caregivers. Involving caregivers in comprehensive pulmonary rehabilitation programs might benefit their functional coping to care demands; however, there is no objective evidence to sustain such assumption. This study is a secondary analysis aiming to analyze the effects of a family-based pulmonary rehabilitation program on close family caregivers of older subjects with COPD.


This is a mixed-method study. Family caregivers were randomly assigned to family-based (experimental) or conventional (control) pulmonary rehabilitation. Caregivers from the family-based pulmonary rehabilitation (n = 20; 80.0% female; age 63.1 ± 9.5 y) attended the psychoeducational component together with their relatives. In the conventional pulmonary rehabilitation, caregivers did not participate (n = 19; 68.4% female; age 53.6 ± 11.3 y). Self-rated instruments (Family Crisis Oriented Personal Scales, Depression Anxiety and Stress Scales, and Carers' Assessment of Difficulties Index) and focus group interviews were used to assess the intervention.


Caregivers from the family-based pulmonary rehabilitation had significantly greater improvements in overall family coping (P = .01), reframing (P = .01), seeking spiritual support (P = .01), and mobilizing to acquire help (P = .02). No significant differences were found for emotional state. Significant improvements in overall burden (P = .01), reactions to caregiving (P = .01), physical demands of caring (P = .044), and poor family support (P = .038) were observed, although there were no significant between-group differences. Qualitative data sustained the benefits of involving family caregivers in pulmonary rehabilitation.


The findings provide valuable evidence to recommend the inclusion of COPD family caregivers in comprehensive pulmonary rehabilitation. Family-oriented pulmonary rehabilitation maximizes caregivers' adaptive coping and potentially prevents negative psychological outcomes; however, further research is needed.


COPD; burden; coping; emotional state; family caregiving

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