Short summary

Patients with severe COPD struggle with their breathing, which often results in hospital admission. For the patients and their caregivers this is extremely stressful and insecure. Healthcare professionals lack information on how to support. The project aims to identify exactly what happens for the patients and their caregivers when they are discharged from the hospital. Patients will be wearing technological devices to monitor their physiological arousal, reactions and surroundings at home.

Rationale

For the vulnerable and fragile group of patients with advanced chronic obstructive pulmonary disease (COPD) and their caregivers, the severe exacerbations and frequent transitions between hospital and home-based care are extremely stressful and insecure. Healthcare providers lack information on how to manage their complex, interrelated physical and psychological symptoms.

The overall aim of the COPD-EXIT project is to explore the psychophysiological processes that emerge upon hospital discharge after a severe COPD-exacerbation and explore biopsychosocial factors associated with readmission.

The specific objectives are: 1) To use technological devices to monitor and photo-document, in situ and second-by-second, which types of activities, surroundings and states that trigger physiological arousal for patients with COPD up-on hospital discharge after a COPD-exacerbation. 2) To examine how objective measurement of physiological factors is associated with patient- and care-giver-reported measures of psychological distress, exacerbation triggers, activities of daily living and physical symptoms. 3) To follow patients over time with the purpose of identifying which objectively measured and self-reported factors is associated with readmission at 7, 30 and 365 days after hospital discharge. 4) To explore the subjective experience of the transition from hospital to own home after a COPD-exacerbation from the perspective of patients and caregivers.

Description of the cohort

Patients will be recruited from the inpatient department and the Accident & Emergency (A&E) department at Lillebaelt Hospital in Vejle. Patients are eligible if they are diagnosed with COPD and is currently admitted to Vejle Hospital with a COPD exacerbation. Caregivers living with the included patients will also be invited to take part in the study.

Data and biological material

Monitoring wristband: physiological arousal data (e.g., heart rate, respiratory rate) Wearable cameras: pictures of everyday situations Questionnaire data: sociodemographic factors, breathlessness, anxiety and depression symptoms, activities of daily living, exacerbation triggers, interoception, caregiver burden.

Collaborating researchers and departments

Department of Psychology, Aarhus University

• Sinué Salgado

Research Unit for General Practice, University of Southern Denmark

• Jesper Lykkegaard

VIA University College

• Dorthe Sørensen
• Tina Helle