Experiences of people with Chronic Obstructive Pulmonary Disease (COPD) using activity monitors and healthcare practitioners' perspectives of their application within healthcare

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease where symptoms can include breathlessness, coughing and sputum production. Physical activity (PA) can increase life expectancy, reduce hospital admission, and improve quality of life for people with COPD. Activity monitors (e.g., apps and wearables) are becoming increasingly utilised by people with COPD to help increase levels of PA. Previous research has focussed on using activity monitors for monitoring PA, often as an objective research measure. Insight into the experiences of people with COPD using monitoring technology in everyday life could support the development and delivery of effective interventions to increase PA. Furthermore, understanding how healthcare practitioners (HCPs) can support patients with activity monitors and make use of PA data collected at home could increase the effectiveness of remote-delivered interventions and treatment. Therefore, comprised of three studies, this thesis sought to explore the experiences of people with COPD using activity monitors and HCPs’ views and experiences of supporting people with COPD using activity monitors. Study 1, a scoping review, explored the experiences of people with COPD using technology for monitoring PA. Online scientific databases were searched. Twelve studies, published between 1st January 2016 and 16th March 2021, were included and analysed using thematic synthesis. Seven themes were developed which summarised the experiences of people with COPD using activity monitors. This review provides insight into how people with COPD use activity monitors and integrate them into their life. Study 2, an Interpretative Phenomenological Analysis (IPA) study, explored the experiences of people with COPD using activity monitors in everyday life. Seven semi-structured face-to-face or telephone interviews were conducted between August 2018 and June 2020 with people with COPD, who had used activity monitors within the last year. Four themes were developed using IPAdemonstrating the range of experiences of engagement with activity monitors over time. This study provides a detailed insight into how people with COPD use activity monitors at home in everyday life. Activity monitors have the potential to widely benefit people with COPD with increasing PA and self-management of their health condition. Study 3 explored HCPs’ views and experiences of supporting people with COPD who had used activity monitors. Seventeen semi-structured telephone or online interviews were conducted with HCPs, including a nurse, occupational therapist, physician, and physiotherapists, between September 2020 and May 2021. Interviews were analysed using reflexive thematic analysis. Four themes were developed highlighting the challenges and benefits of HCPs supporting patients with using activity monitors and utilising patient collected PA data. This study highlights that HCPs recognise the potential for activity monitors to positively impact patients’ ability to self-manage their COPD. Overall, each study in this thesis deepened our knowledge and understanding of people with COPD using activity monitors and the role of HCPs supporting people with COPD who have used activity monitors. Activity monitors are useful tools to increase PA, motivation and disease self-management. Activity monitors and utilising PA data collected at home can positively impact patients’ health and self-management behaviours. There is potential for activity monitors to be integrated effectively and efficiently into healthcare practices, such as pulmonary rehabilitation, to support COPD treatment. However, further research is needed into the practicalities of employing activity monitors within healthcare settings. The co-creation of evidencebased guidelines is essential for HCPs to reduce barriers and increase HCPs skills and confidence to successfully utilise activity monitors in practice

Date of Award	2023
Original language	English
Awarding Institution	Coventry University
Supervisor	Louise Sewell (Supervisor), Cain Clark (Supervisor), Petra Wark (Supervisor), Carol Percy (Supervisor) & Gillian Ward (Supervisor)