Authors (including presenting author) :
Choi WY(1), Tang KH(1), Chow TY(1), Tse CY(1), Tso HY(1), Cheung HM(1), Lam CM(1), Cheung TY(1)
Affiliation :
(1)Occupational Therapy Department, Tuen Mun Hospital
Introduction :
Chronic COPD patients with poor cardio-pulmonary functions would encounter high difficulties to perform demanding ADL/IADL in community living. Seldom would they aware about their skills and effectiveness in coping with the dyspnea upon performing such tasks. Dyspnea self-management program with use of new technology and behavior change techniques were introduced in a rehabilitation ward in TMH. Intervention included biofeedback when applying coping behaviors skills, environmental restructuring and goal setting.
Objectives :
To evaluate the effectiveness and potential of the self-management program in dyspnea management of Chronic COPD patients.
Methodology :
Chronic COPD patients who are living at home were selected in a rehabilitation ward by a convenient sampling method. Program content included:
-Set achievable goals with patients (by Dyspnea Domain of Chinese version of the Chronic Respiratory Questionnaire)
-Assessment on breathing technique, pacing and coping behaviors in ADL & IADL tasks
-Re-breathing training: Visual feedback with real-time video recording through computer aids i.e. tablet and blue-tooth oximeter
-Self-pacing training: Compare the symptoms of dyspnea by pre- & post- Rate of Perceived Dyspnea & Exertion (RPD & RPE) with new coping behaviors in the same ADL/IADL tasks based on the performance tracing training system
Result & Outcome :
- 30 male patients were recruited (7/2019 to 10/2021)
- In average, patients participated for 1.9 sessions (15 patients could complete 2 sessions or above)
- 46.7% of patients reported less perceived dyspnea after applying coping behaviors
- 54.3%of patients still maintained their Activity of Daily Living functions and coped with dyspnea in their daily living in community without hospital admission within 3 months upon discharged.
Self-management program enhances the patients’ self-awareness of own health condition and living well with chronic disease. They gained benefit from applying coping strategies despite dyspnea symptoms with COPD. This program elicits patients’ motivation to apply various coping behaviors in daily living through re-breathing training during rehabilitation training. Sustaining effective coping behaviors with continuity from hospital to community care is crucial. Consequently, patients would integrate that into their goaled and meaningful activities. Therefore, further implementation of the enhanced program into collaborating community care services e.g. NGO, District Health Centre would be future direction.
