Transitional Care Based e-Health Program for Older Muslim Thai Adults with Chronic Obstructive Pulmonary Disease After Hospital Discharge: A Feasibility Study

Abstract

Older adults with chronic obstructive pulmonary disease frequently visit the emergency department due to an acute exacerbation of the disease or symptoms after discharge from hospital. Therefore, providing programs that enable caregivers to recognize and manage alert signs and symptoms in caring for older adults with chronic obstructive pulmonary disease at home is essential. This feasibility study is a part of emergency health management in transitional care program to reduce emergency department visits in older adults with dyspnea, and aimed to develop and test the Transitional Care Based e-Health Program. The program was tested using one group pre-test and post-test design with 50 family caregivers of older adults living with chronic obstructive pulmonary disease. Data was collected from November 2021 to May 2022. The ability to manage dyspnea symptoms among family caregivers and patient emergency department visits was assessed 30 days after hospital discharge. Data were analyzed using the Wilcoxon Signed Rank Test to compare the pre- and post-score differences. After implementation, it was found that the program was feasible and could improve the ability to manage dyspnea. Only three of 50 cases had emergency department visits within 30 days after discharge, accounting for 6% compared to the earlier report of 27.18%. The findings provide potential transitional care based on an e-health program to enhance the ability of dyspnea symptom management among family caregivers. Nurses can use this program in practice. However, further study is needed with randomized controlled trials before it can be widely used nationally.