Profiling family resilience in chronic obstructive pulmonary disease: a network analysis approach to identifying intervention targets.

AIM: This study aimed to explore the status of and the factors influencing family resilience among patients with chronic obstructive pulmonary disease (COPD) and caregivers and to construct a related structural model and system of influencing factors for family resilience based on network analysis methods. Furthermore, the study aimed to identify the core variables in the network, explore the interaction mechanisms and pathways of different variables, and provide an intervention basis and direction for the improvement of resilience in COPD families.

DESIGN

The study employed a cross-sectional survey design.

METHODS

A total of 221 COPD patient-caregiver dyads were recruited using convenience sampling from April 2023 to November 2024 at two hospitals in Tianjin, China. SPSS 26.0 was used to perform descriptive statistics, univariate analysis, correlation analysis, and multivariate analysis. R 4.2.1 was used to construct the network of family resilience dimensions, the item network, and the network models of family resilience and its influencing factors among COPD patients and caregivers.

RESULTS

Family communication and problem-solving exhibited the highest centrality in the family resilience network, showing the strongest correlation with caregivers' ability to maintain a positive outlook. In addition, significant patient-caregiver correlations were identified in the dimensions of family communication and problem-solving. In the item network of family communication and problem-solving among COPD patients and caregivers, the node FCPS19 (We discuss problems and feel good about the solutions") exhibited the highest centrality, while the strongest correlation was observed between FCPS19 and FCPS20("We discuss things until we reach a resolution"). A statistically significant difference in the strength of the node FCPS8 ("We can ask for clarification if we do not understand each other") was observed between COPD patients and caregivers. In the network of family resilience and its influencing factors among COPD patients and caregivers, family communication and problem-solving exhibited the highest centrality. The strongest correlation was observed between the family concern of caregivers and the family communication and problem-solving of patients. A statistically significant difference in the strength of family communication and problem-solving was observed between spousal caregivers and offspring caregivers.

CONCLUSION

Interventions focused on improving family communication and problem-solving methods can enhance family resilience among patients and caregivers, especially offspring caregivers. Both patients and caregivers prefer to discuss problems with family members to find satisfactory solutions. Compared to patients, caregivers require more explanations from family members when they do not understand something. Nurses should encourage other family members to care more for caregivers, monitor changes in family communication and problem-solving between patients and caregivers, and explore their potential connections.