Authors (including presenting author) :
Carrie TANG(1), CHOI WY(1), CHAN SP(1), TSE CY(1), CHOW TY(1), CHEUNG HM(1), LAM CM(1), CHEUNG TY(1)
Affiliation :
(1) Occupational Therapy Department, Tuen Mun Hospital
Introduction :
Chronic obstructive pulmonary disease (COPD) is a progressive chronic disease leading to over 13,000 episodes of inpatient discharges and deaths in Hong Kong in 2021 (Hospital Authority, 2021). Advanced technology is proven to be effective in COPD management from in-hospital care, early discharge to ongoing self-management of stable COPD at home (Ding et al., 2019). In Occupational Therapy Department in TMH, wearable technology is applied for self-monitoring of patients to perform Extended Hour Rehabilitation (EHR) which is training besides training time or even public holiday.
Objectives :
To enhance EHR training for COPD patients with the use of wearable technology beyond training session or even public holiday
Methodology :
Pulmonary rehabilitation is a comprehensive intervention including education, self-management program and exercise training. Education includes awareness of symptoms in ADL/ Instrumental ADL, dyspnea management and energy conservation. COPD patients in a rehabilitation ward of TMH are recruited with convenient sampling. The training involves two components – (1) ADL or functional training and (2) breathing retraining. Before EHR, therapists will interview patients and select activity with highest level of shortness of breath. During the training, patients put on wearable technology (i.e. fingertip Bluetooth pulse oximeter). Cardiorespiratory parameters measured by the oximeter (e.g. SpO2 level and heart rate) act as objective feedback to patients. Patients are required to record data from the oximeter, rate of perceived dyspnea (RPD) and exertion (PPE), and dosage of oxygen therapy on the activity log-sheet before and after training. Patients’ performance can be monitored through communication with ward nurse and via EHR record sheet. Therapists would also review the performance with patients in the next OT session. Cardiorespiratory parameters obtained from the activity log-sheet can provide additional information on the incorporation of the newly learnt skills in the self-management program into daily activities, and also the need and dosage of home oxygen therapy in related ADL tasks. Therapist would upgrade or downgrade the activities if needed. Dyspnea management skills will be reinforced in OT session if indicated.
Result & Outcome :
There are total 11 cases recruited from August 2021 to October 2022. Each session of EHR includes 15 minutes of ADL/functional training and 15 minutes of breathing retraining. In average, patients can perform 3 sessions a day. All patients reported decreased in RPD and RPE at the end of the session. Therefore, wearable technology not only provide additional training opportunities to patients but also increase the self-efficacy and enhance generalization of dyspnea management into daily life.
