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 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 Maintenance of non-pharmacological strategies 6 months after patients with chronic obstructive pulmonary disease (COPD) attend a breathlessness service: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e050149
Author(s):  
Tim Luckett ◽  
Mary Roberts ◽  
Vinita Swami ◽  
Tracy Smith ◽  
Jin-Gun Cho ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Psychological Intervention ◽  
Management Strategies ◽  
Self Management ◽  
Integrative Approach ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chaos Narrative ◽  
Severe Copd

ObjectivesThis study aimed to explore the degree to which non-pharmacological strategies for chronic breathlessness are sustained 6 months after completing a breathlessness service in patients with chronic obstructive pulmonary disease (COPD), and patient perceptions regarding the need for ongoing support.DesignA qualitative approach was taken using semistructured telephone interviews. Thematic analysis used an integrative approach.SettingThe Westmead Breathlessness Service (WBS) trains patients with COPD to self-manage chronic breathlessness over an 8-week programme with multidisciplinary input and home visits.ParticipantsPatients with moderate to very severe COPD who had completed the WBS programme 6 months earlier.ResultsThirty-two participants were interviewed. One or more breathlessness self-management strategies were sustained by most participants, including breathing techniques (n=22; 69%), the hand-held fan (n=17; 53%), planning/pacing and exercise (n=14 for each; 44%) and strategic use of a four-wheeled walker (n=8; 25%). However, almost a third of participants appeared to be struggling psychologically, including some who had refused psychological intervention. A ‘chaos narrative’ appeared to be prevalent, and many participants had poor recall of the programme.ConclusionsSelf-management strategies taught by breathlessness services to patients with moderate to very severe COPD have potential to be sustained 6 months later. However, psychological coping may be more challenging to maintain. Research is needed on ways to improve resilience to set-backs and uptake of psychological interventions, as well as to understand and address the implications of poor recall for self-management.Trial registration numberACTRN12617000499381

Exploring patients’ and health professionals’ perspectives on health literacy needs in the context of chronic obstructive pulmonary disease

2021 ◽  
pp. 174239532199944
Author(s):  
Christine R. Borge ◽  
Marie H. Larsen ◽  
Richard H. Osborne ◽  
Eivind Engebretsen ◽  
Marit H. Andersen ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Literacy ◽  
Pulmonary Disease ◽  
Self Management ◽  
Chronic Obstructive ◽  
Health Organizations ◽  
Obstructive Pulmonary Disease ◽  
Inductive Thematic Analysis ◽  
Insufficient Knowledge

Objective Persons with chronic obstructive pulmonary disease (COPD) require complex follow-up by healthcare professionals (HCPs) and may experience several health literacy (HL) needs. This study aimed to explore such needs in people with COPD and the HCPs who care for them. Methods From October 2016 to August 2017 a qualitative study with four focus groups (FG) were performed in people with COPD (n = 14) and three in multidisciplinary HCPs (n = 21). An inductive thematic analysis was used to investigate HL needs. Results Four HL needs emerged: 1) strengthening the feeling of security; 2) combating the burden of insufficient knowledge on COPD and lack of informational flow; 3) supporting motivation for endurance and self-management; and 4) strengthening dignity. Discussion This study highlights a gap between people with COPD who express important HL needs and HCPs’ capabilities to care for these needs. For HCPs to increase HL in such cases, HCPs need to improve their own HL. It is essential to find solutions on how to improve HL in HCPs who care for people with COPD and to increase the availability of interventions that increase HL in COPD. Education programs, health organizations, and governments should be aware of HL needs in such situations.

scholarly journals How health literacy and patient activation play their own unique role in self-management of chronic obstructive pulmonary disease (COPD)?

2018 ◽  
Vol 16 ◽  
pp. 147997311881641 ◽  
Author(s):  
Uday Narayan Yadav ◽  
Hassan Hosseinzadeh ◽  
Jane Lloyd ◽  
Mark Fort Harris
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Literacy ◽  
Pulmonary Disease ◽  
Patient Activation ◽  
Self Management ◽  
Current Evidence ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Unique Role ◽  
Management Interventions

Current evidence indicates that although they are correlated, health literacy (HL) and patient activation (PA) are distinct. This article describes how HL, PA and their determinants intersect and diverge and how these concepts might inform the development of self-management interventions. The concepts of HL and PA contribute to self-management interventions in different ways. HL includes the skills and confidence required for self-management while PA focuses more on motivation and ability to take action. In this light, communication of concepts on HL and PA needs to be more widely understood by academics, researchers and policy experts as each of them plays a unique role in promoting self-management for long-term conditions such as chronic obstructive pulmonary disease.

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