scholarly journals Usefulness and Relevance of an eHealth Tool in Supporting the Self-Management of Chronic Obstructive Pulmonary Disease: Explorative Qualitative Study of a Cocreative Process (Preprint)

2018 ◽  
Author(s):  
Malin Tistad ◽  
Sara Lundell ◽  
Maria Wiklund ◽  
André Nyberg ◽  
Åsa Holmner ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Health Care ◽  
Pulmonary Disease ◽  
Health Care Professionals ◽  
Qualitative Content Analysis ◽  
Management Strategies ◽  
Self Management ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

BACKGROUND New strategies are urgently needed to support self-management for people with chronic obstructive pulmonary disease (COPD) in primary care. The use of electronic health (eHealth) solutions is promising. However, there is a lack of knowledge about how such eHealth tools should be designed in order to be perceived as relevant and useful and meet the needs and expectations of the health professionals as well as people with COPD and their relatives. OBJECTIVE The objective of this study was to explore the aspects of an eHealth tool design and content that make it relevant and useful for supporting COPD-related self-management strategies from the perspective of health care professionals, people with COPD and their relatives, and external researchers. METHODS Data were collected during the development of an eHealth tool. A cocreation process was carried out with participants from two primary care units in northern Sweden and external researchers. Individual interviews were performed with health care professionals (n=13) as well as people with COPD (n=6) and their relatives (n=2), and focus group discussions (n=9) were held with all groups of participants. Data were analyzed using qualitative content analysis. RESULTS The overarching theme, reinforcing existing support structures, reflects participant views that the eHealth tool needs to be directly applicable and create a sense of commitment in users. Moreover, participants felt that the tool needs to fit with existing routines and contexts and preferably should not challenge existing hierarchies between health care professionals and people with COPD. Important content for health care professionals and people with COPD included knowledge about self-management strategies. Videos were regarded as the most effective method for communicating such knowledge. CONCLUSIONS The cocreation in the development process enables participant perspectives and priorities to be built into the eHealth tool. This is assumed to contribute to a tool that is useful and relevant and, therefore, adopted into clinical practice and everyday life. Findings from this study can inform the development of eHealth tools for people with COPD in other contexts, as well as the development of eHealth tools for self-management support of other chronic diseases.

scholarly journals Perspectives that Influence Action Plans for Chronic Obstructive Pulmonary Disease

2006 ◽  
Vol 13 (7) ◽  
pp. 362-368 ◽  
Author(s):  
S Costi ◽  
D Brooks ◽  
RS Goldstein
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Pulmonary Disease ◽  
Health Care Professionals ◽  
Action Plan ◽  
Self Management ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Breathing Exercises ◽  
Difficulty Breathing

BACKGROUND: Prompt treatment of acute exacerbations (AEs) in chronic obstructive pulmonary disease (COPD) improves quality of life and reduces the use of health care resources. Although patient self-management through an individualized action plan (AP) can help with early initiation of therapy, its use is critically dependent on the patient recognizing the features of an exacerbation.OBJECTIVE: To describe COPD patients’ experiences with AEs, as well as health care professionals’ (HCPs’) attitudes toward the provision of an AP as part of self-management education.METHODS: Thirty-two patients with moderate to severe COPD who recently experienced at least one AE, and 22 HCPs with experience in the management of COPD, were interviewed.RESULTS: The most common symptoms and signs associated with an AE were difficulty breathing (84%), fatigue (81%), cold symptoms (59%), changes in sputum colour (53%) or amount (47%), and cough (44%). The main precipitants identified were environmental triggers (47%), infective agents (31%), excessive activities (25%), emotional factors (16%) and changes in medications (9%). Strategies for dyspnea relief included increasing medications (72%), resting (56%), avoiding exposure to environmental triggers (41%) and performing breathing exercises (31%). Patients supported the use of an AP and recommended that it be individualized for symptoms and triggers, and that it should also include strategies for addressing anxiety and depression. HCPs also supported the use of an individualized AP and recommended that it be regularly revisited, depending on the patient’s disease severity.CONCLUSIONS: Patients’ experiences with AEs do not always conform to a standard medical definition. Therefore, an understanding of their experience is of value in the design of an individualized AP. HCPs support the use of an AP that emphasizes self-management of exacerbations as well as general COPD management.

Chronic obstructive pulmonary disease and comorbidities through the eyes of the patient

2012 ◽  
Vol 9 (3) ◽  
pp. 183-191 ◽  
Author(s):  
Pauline Boeckxstaens ◽  
Marina Deregt ◽  
Piet Vandesype ◽  
Sara Willems ◽  
Guy Brusselle ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Health Care ◽  
Pulmonary Disease ◽  
Patient Characteristics ◽  
Self Management ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Primary Care Practices ◽  
End Stage

Patient’s attitudes and illness beliefs have shown to be of great importance in chronic obstructive pulmonary disease (COPD). As former qualitative research has mainly focused on patients with end-stage COPD, who are recruited within hospital or pulmonary rehabilitation settings, and excluding patients with disabling comorbidities, this study specifically aims to explore the perspectives of patients with COPD and comorbidities in primary care. This study was designed as a qualitative, explorative study using open patient interviews. The study was conducted at three primary care practices, East Flanders, Belgium. A total number of seven patients, diagnosed with COPD and given a minimum score of 2 on the Charlson Comorbidity Index were included. In-depth interviews were recorded and transcribed verbatim. Thematic analysis was deductive using NVivo software. Researchers’ triangulation was performed. Participants show high adaptation capabilities and report quite positively about their functional status, with an emphasis on social participation and partnership. Knowledge of the causes and consequences of COPD appears rather limited, and participants predominantly show an external locus of control in relation to the reported factors influencing the disease and strategies for self-management. Patients with COPD with comorbidity integrate their illness and symptoms into their lives. However, a lack of knowledge and education may leave them more anxious and more dependent on health care than necessary. Our results indicate that health care workers should adopt a positive approach toward patient’s functioning and empower and inform their patients. We believe that chronic care for patients with COPD should provide personalized rehabilitation taking into account individual patient characteristics and self-management and coping attitudes. We believe that there is a generic core to be identified, which can tackle both COPD and comorbidities. Further research is mandatory to develop these generic programs focusing on patients with complicated needs. Primary care can provide the setting for exploration.

scholarly journals Experiences and factors affecting usage of an eHealth tool for self-management among people with chronic obstructive pulmonary disease - a qualitative analysis study (Preprint)

2020 ◽  
Author(s):  
Sarah Marklund ◽  
Malin Tistad ◽  
Sara Lundell ◽  
Lina Östrand ◽  
Ann Sörlin ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Literacy ◽  
Pulmonary Disease ◽  
Qualitative Content Analysis ◽  
Management Strategies ◽  
Self Management ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Factors Affecting ◽  
Over Time

BACKGROUND Self-management strategies are regarded as highly prioritized in chronic obstructive pulmonary disease (COPD) treatment guidelines. However, individual and structural barriers lead to a staggering amount of people with COPD that are not offered support for such strategies, and new approaches are urgently needed to circumvent these barriers. A promising way of delivering health services such as support for self-management strategies is the use of eHealth tools. Though, there is a lack of knowledge about the usage of, and factors affecting the use of eHealth tools over time in people with COPD. OBJECTIVE This study aimed, among people with COPD, to explore and describe the experiences of an eHealth tool over time and factors that might affect usage. METHODS The eHealth tool included information on evidence-based self-management treatment for people with COPD, including texts, pictures, videos as well as interactive components such as a step registration function with automatized feedback. In addition to the latter, automated notifications of new content, as well as pedometers were used as triggers to increase usage. After having access to the tool for three months, 16 individuals (12 women) with COPD were individually interviewed. At 12 months access to the tool, seven (five women) of the previous 16 individuals accepted a second individual interview. Data were analyzed using qualitative content analysis. User frequency was considered in the analysis, and participants were divided into users and non-user/seldom-users depending on the number of logins and minutes of usage per month. RESULTS Three main categories; ambiguous impact basic conditions for usage and approaching capability emerged from the analysis, which, together with their subcategories, reflects the participants' experiences of using the eHealth tool. Non-user/seldom-users¬ reported low motivation, a higher need for technical support, a negative view about the disease and self-management and had problematic health literacy. The latter as measured by the communicative and critical health literacy scale. Users felt comfortable with IT-tools, had a positive view on triggers and had sufficient health literacy. Benefits including behavior changes, were mainly expressed after 12 months had passed, and among users. CONCLUSIONS Findings of this study indicate that level of motivation, comfortability with IT-tools as well as the level of health literacy seem to affect usage of an eHealth tool over time. Also, gaining benefits from the eHealth tool seems reserved for the users and specifically after 12 months regarding behavioral changes, thus suggesting that eHealth tools can be a suitable media for supporting COPD-specific self-management skills – however not for everyone or at all times. These novel findings are of importance when designing new eHealth tools as well as when deciding on whether or not an eHealth tool might be appropriate to use if the goal is to support self-management among people with COPD. CLINICALTRIAL ClinicalTrials. gov: NCT02696187 INTERNATIONAL REGISTERED REPORT RR2-doi:10.1136/bmjopen-2017-016851

scholarly journals Perceptions of Home Telemonitoring Use Among Patients With Chronic Obstructive Pulmonary Disease: Qualitative Study

10.2196/16343 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e16343 ◽  
Author(s):  
Sara Lundell ◽  
Mari Modig ◽  
Åsa Holmner ◽  
Karin Wadell
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Pulmonary Disease ◽  
Self Management ◽  
Easy Access ◽  
Chronic Obstructive ◽  
Successful Implementation ◽  
Obstructive Pulmonary Disease ◽  
Major Health Problem ◽  
Home Telemonitoring

Background Chronic obstructive pulmonary disease (COPD) is a major health problem and an economic burden globally. There is growing interest in how electronic health (eHealth) can be used to provide efficient health care. Telemonitoring, where the patient’s health-related data is transmitted to a health care provider, can be used to detect early signs of exacerbations. A successful implementation of telemonitoring systems into clinical practice requires in-depth knowledge of the users’ preferences. Objective The aim of this study was to explore perceptions of the use of a home telemonitoring system among patients with COPD. Methods Semistructured individual interviews were carried out with 8 women and 5 men who were participants in a project aimed at developing and evaluating a telemonitoring system. The web-based telemonitoring system measured pulmonary function, subjective symptoms, and oxygen saturation. Participants were interviewed after having used the system for 2-4 months. Interview transcripts were analyzed with qualitative content analysis. Results The analysis resulted in the theme A transition toward increased control and security and four categories: using with (in)security, affecting technical concern or confidence, providing easy access to health care, and increasing control over the disease. The participants reported various perceptions of using the telemonitoring system. They expressed initial feelings of insecurity, both in terms of operating the system and in terms of their disease. However, the practical management of the telemonitoring system became easier with time; the participants gradually gained confidence and improved their self-management. New technology was perceived as an important complement to existing health care, but the importance of maintaining a human contact in real life or through the telemonitoring system was emphasized. Conclusions This study captured a transition among the participants from being insecure and experiencing technical concerns to acquiring technical confidence and improving disease management. Telemonitoring can be a valuable complement to health care, leading to increased self-knowledge, a sense of security, and improved self-management. Suggestions to improve the further development and implementation of telemonitoring systems include better patient education and the involvement of end users in the technical development process. Additional research is needed, particularly in the design of user-friendly systems, as well as in developing tools to predict which patients are most likely to find the equipment useful, as this may result in increased empowerment, improved quality of life, reduced costs, and a contribution to equity in health.

scholarly journals Use of an eHealth tool for exercise training and online contact in people with severe chronic obstructive pulmonary disease on long-term oxygen treatment: A feasibility study

2020 ◽  
Vol 26 (4) ◽  
pp. 3184-3200
Author(s):  
Pernilla Sönnerfors ◽  
Karin Wadell ◽  
Ing-Mari Dohrn ◽  
André Nyberg ◽  
Michael Runold ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Exercise Training ◽  
Pulmonary Disease ◽  
Health Care Professionals ◽  
Chronic Obstructive ◽  
Full Potential ◽  
Obstructive Pulmonary Disease ◽  
Positive Effects ◽  
Technical Functions

Technology developments and demand for flexibility in health care and in contact with the health care system are two factors leading to increased use of eHealth solutions. The use of eHealth has been shown to have positive effects in people with chronic obstructive pulmonary disease, but the full potential for this group needs to be explored. Therefore, the aim was to evaluate the feasibility of an eHealth tool used for exercise training and online contacts for people with severe chronic obstructive pulmonary disease. The 10-week intervention included an eHealth tool for exercise training in home environment and regular online contacts, as well as weekly e-rounds for health care professionals. Seven of the nine participants completed the study. The eHealth tool was found to be feasible for e-rounds, exercise training and online contacts. Participants could manage the tool and adhere to training; positive effects were shown, and no adverse events occurred. Technical functions need to be improved.

scholarly journals Clinical Decision-Making Tool for Safe and Effective Prescription of Exercise in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Results From an Interdisciplinary Delphi Survey and Focus Groups

2015 ◽  
Vol 95 (10) ◽  
pp. 1387-1396 ◽  
Author(s):  
Pat G. Camp ◽  
W. Darlene Reid ◽  
Frank Chung ◽  
Ashley Kirkham ◽  
Dina Brooks ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Focus Groups ◽  
Pulmonary Disease ◽  
Health Care Professionals ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Chronic Obstructive ◽  
Delphi Panel ◽  
Obstructive Pulmonary Disease

Background Exercise is recommended for people with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), yet there is little information to guide safe and effective mobilization and exercise for these patients. Objectives The purpose of this study was to develop a clinical decision-making tool to guide health care professionals in the assessment, prescription, monitoring, and progression of mobilization and therapeutic exercise for patients with AECOPD. Design and Methods A 3-round interdisciplinary Delphi panel identified and selected items based on a preselected consensus of 80%. These items were summarized in a paper-based tool titled Mobilization in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD-Mob). Focus groups and questionnaires were subsequently used to conduct a sensibility evaluation of the tool. Results Nine researchers, 13 clinicians, and 7 individuals with COPD identified and approved 110 parameters for safe and effective exercise in AECOPD. These parameters were grouped into 5 categories: (1) “What to Assess Prior to Mobilization,” (2) “When to Consider Not Mobilizing or to Discontinue Mobilization,” (3) “What to Monitor During Mobilization for Patient Safety,” (4) “How to Progress Mobilization to Enhance Effectiveness,” and (5) “What to Confirm Prior to Discharge.” The tool was evaluated in 4 focus groups of 18 health care professionals, 90% of whom reported the tool was easy to use, was concise, and would guide a health care professional who is new to the acute care setting and working with patients with AECOPD. Limitations The tool was developed based on published evidence and expert opinion, so the applicability of the items to patients in all settings cannot be guaranteed. The Delphi panel consisted of health care professionals from Canada, so items may not be generalizable to other jurisdictions. Conclusions The AECOPD-Mob provides practical and concise information on safe and effective exercise for the AECOPD population for use by the new graduate or novice acute care practitioner.

scholarly journals Findings of the Chronic Obstructive Pulmonary Disease-Sitting and Exacerbations Trial (COPD-SEAT) in Reducing Sedentary Time Using Wearable and Mobile Technologies With Educational Support: Randomized Controlled Feasibility Trial (Preprint)

2017 ◽  
Author(s):  
Mark W Orme ◽  
Amie E Weedon ◽  
Paula M Saukko ◽  
Dale W Esliger ◽  
Mike D Morgan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Sedentary Behavior ◽  
Pulmonary Disease ◽  
Health Care Professionals ◽  
Sedentary Time ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Randomized Controlled ◽  
Study Researcher

BACKGROUND Targeting sedentary time post exacerbation may be more relevant than targeting structured exercise for individuals with chronic obstructive pulmonary disease. Focusing interventions on sitting less and moving more after an exacerbation may act as a stepping stone to increase uptake to pulmonary rehabilitation. OBJECTIVE The aim of this paper was to conduct a randomized trial examining trial feasibility and the acceptability of an education and self-monitoring intervention using wearable technology to reduce sedentary behavior for individuals with chronic obstructive pulmonary disease admitted to hospital for an acute exacerbation. METHODS Participants were recruited and randomized in hospital into 3 groups, with the intervention lasting 2 weeks post discharge. The Education group received verbal and written information about reducing their time in sedentary behavior, sitting face-to-face with a study researcher. The Education+Feedback group received the same education component along with real-time feedback on their sitting time, stand-ups, and steps at home through a waist-worn inclinometer linked to an app. Patients were shown how to use the technology by the same study researcher. The inclinometer also provided vibration prompts to encourage movement at patient-defined intervals of time. Patients and health care professionals involved in chronic obstructive pulmonary disease exacerbation care were interviewed to investigate trial feasibility and acceptability of trial design and methods. Main quantitative outcomes of trial feasibility were eligibility, uptake, and retention, and for acceptability, were behavioral responses to the vibration prompts. RESULTS In total, 111 patients were approached with 33 patients recruited (11 Control, 10 Education, and 12 Education+Feedback). Retention at 2-week follow-up was 52% (17/33; n=6 for Control, n=3 for Education, and n=8 for Education+Feedback). No study-related adverse events occurred. Collectively, patients responded to 106 out of 325 vibration prompts from the waist-worn inclinometer (32.62%). Within 5 min of the prompt, 41% of responses occurred, with patients standing for a mean 1.4 (SD 0.8) min and walking for 0.4 (SD 0.3) min (21, SD 11, steps). Interviews indicated that being unwell and overwhelmed after an exacerbation was the main reason for not engaging with the intervention. Health care staff considered reducing sedentary behavior potentially attractive for patients but suggested starting the intervention as an inpatient. CONCLUSIONS Although the data support that it was feasible to conduct the trial, modifications are needed to improve participant retention. The intervention was acceptable to most patients and health care professionals. CLINICALTRIAL International Standard Randomized Controlled Trial Number (ISRCTN) 13790881; http://www.isrctn.com/ISRCTN13790881 (Archived by WebCite at http://www.webcitation.org/6xmnRGjFf)

Sign in / Sign up

Export Citation Format

Share Document