The impact of virtual admission on self-efficacy in patients with chronic obstructive pulmonary disease - a randomised clinical trial

• Published in: Journal of clinical nursing 2014-11, Vol.23 (21-22), p.3124-3137
• Main Authors: Emme, Christina, Mortensen, Erik L, Rydahl-Hansen, Susan, Østergaard, Birte, Svarre Jakobsen, Anna, Schou, Lone, Phanareth, Klaus
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Chronic obstructive pulmonary disease; Clinical trials; Discharge; Female; Humans; Male; Middle Aged; Nursing; Patient Admission; Patient admissions; Pulmonary Disease, Chronic Obstructive - nursing; Pulmonary Disease, Chronic Obstructive - psychology; randomised clinical trial; Self Efficacy; Telemedicine; virtual admission
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.12553

Aims and objectives To investigate how virtual admission during acute exacerbation influences self‐efficacy in patients with chronic obstructive pulmonary disease, compared with conventional hospital admission. Background Telemedicine solutions have been highlighted as a possible way to increase self‐efficacy in patients with chronic diseases, such as chronic obstructive pulmonary disease. However, little is known about how telemedicine‐based virtual admission as a replacement of hospital admission during acute exacerbation affects chronic obstructive pulmonary disease patients' self‐efficacy. Design This study was a nonblinded, randomised clinical multicentre trial. The study was a substudy to The Virtual Hospital, investigating the feasibility and safety of telemedicine‐based treatment at home for patients with acute exacerbation of chronic obstructive pulmonary disease. Methods Participants were consecutively randomised to virtual admission or conventional hospital admission. Data from 50 patients were analysed. Self‐efficacy was assessed at baseline, three days after discharge, and also six weeks and three months after discharge, using the Danish version of ‘The chronic obstructive pulmonary disease self‐efficacy scale'. Results Intergroup comparison showed no significant differences between the two groups at baseline, three days after discharge, six weeks after discharge or three months after discharge. Furthermore, intragroup comparison did not reveal significant differences in the chronic obstructive pulmonary disease self‐efficacy scale mean sum score within the two groups. Conclusions The results of the study suggest that there is no difference between self‐efficacy in chronic obstructive pulmonary disease patients undergoing virtual admission, compared with conventional hospital admission. However, the anticipated sample size could not be reached, which prompts caution regarding interpretation of the findings. Relevance to clinical practice This study provides new insight into how virtual admission affects chronic obstructive pulmonary disease patients' self‐efficacy. Clinicians should consider the timing, duration and the content in the design of telemedical interventions directed at improving chronic obstructive pulmonary disease patients' self‐efficacy, as telemedicine solutions alone may not be sufficient to enhance self‐efficacy.