Experiences With In-Person and Virtual Health Care Services for People With Chronic Obstructive Pulmonary Disease: Qualitative Study
Bibliographic record
Abstract
BACKGROUND: The World Health Organization and the European Commission predict increased use of health technologies in the future care for patients in Europe. Studies have shown that services based on telehealth, which includes components of education, as well as rehabilitation initiatives can support the self-management of individuals living with COPD. This raises an interest in how virtual and in-person interactions and roles can best be organized in a way that suits people living with COPD in relation to their treatment and rehabilitation. OBJECTIVE: This study aims to investigate how individuals living with COPD experience different combinations of virtual and in-person care, to help us better understand what aspects are valued and how to best combine elements of these services in future care. METHODS: Two rounds of semistructured interviews were conducted with 13 and 4 informants, respectively. The individuals were all recruited in relation to a research project led by the telehealth initiative Epital Health. The first round of interviews included 11 informants, as 2 dropped out. Of these, 7 received the telemedicine service provided by Epital Health, 3 participated in a 12-week COPD program provided by their respective municipality, and 1 did not receive any supplementary service besides the usual care. In the second round, which included 4 informants, all had at one point received the telemedicine service and participated in a municipality-based rehabilitation program. A content analysis of the interviews was performed based on deductive coding with 4 categories, namely, (1) Self-management, (2) Health-related support, (3) Digital context, and (4) Well-being. RESULTS: Medical and emotional support from health care professionals is a key aspect of care for individuals with COPD. Acute treatment with at-home medicine, monitoring one's own condition through technology, and having easy access and close contact with health care professionals familiar to them can promote self-management and well-being, as well as provide a feeling of security. Having regular meetings with a network of peers and health care professionals provides education, support, and tools to cope with the condition and improve own health. Furthermore, group-based activity motivates and increases the activity level of the individuals. Continued offers of services are desired as many experience a decrease in achieved benefits after the service ends. More emphasis is placed on the importance of the therapeutic and medical elements of care compared with factors such as technology. The identified barriers related to optimal utilization of the virtual service were related to differentiation in levels of contact depending on disease severity and skills related to the practical use of equipment. CONCLUSIONS: A combination of virtual and in-person services providing lasting medical and social support is suggested for the future. This should build upon the preferences and needs of individuals living with COPD and support relationships to caregivers and peers.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.010 | 0.008 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.007 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".