1. We declare no conflicts of interest!
University Healthcare Research Centre
Experiences of using a mobile phone application to motivate physical activity in persons with COPD: a mixed method study
Ann-Britt Zakrisson, district nurse, PhD.
University Healthcare Research Centre, Faculty of Health and Medicine,
Örebro University, Sweden.
Co-writers
Terese Anerös, district nurse, MSc, PhD-student, University Healthcare Research Centre, Faculty of Health and Medicine, Örebro University, Sweden.
Gabriella Eliason BMA, University lecturer, PhD. School of Medical Sciences, Örebro University, Sweden
Anette Forsberg, RPT, ass. professor1. University Healthcare Research Centre, Faculty of Health and Medicine, Örebro University, Sweden.
We declare no conflicts of interest!

2. Background Breathlessness and fatigue decrease physical activity
University Healthcare Research Centre
Background
Breathlessness and fatigue decrease physical activity
Social isolation and fear of deterioration (Wortz et al., 2012)
Dyspnoea is experienced fearful
A feeling of no oxygen when breathing (Bailey 2004)
The level of physical activity is reduced already at GOLD stage II (Troosters et al., 2010, Watz et al., 2009)
Care includes preventing and handling dyspnea (Marciniuk 2011, Katajisto 2012)
Encourage to physical activities (van Gestel 2012)
Technical devices to promote health (Joe 2013)

3. University Healthcare Research Centre
Aim
To describe the experiences of using a saturation meter with a mobile application with alarm to motivate physical activity, explore if this application increases the level of physical activity and describe persons with COPD experiences of reasons to be physical active.

4. Methods Mixed methods design (Sandelowski 2000)
University Healthcare Research Centre
Methods
Mixed methods design (Sandelowski 2000)
COPD at GOLD stadium II and III (n=10)
Intervention: 1 group information – 6 weeks mobile app
Data of physical activity – accelerometer
Qualitative interview study
Analysed with qualitative content analysis

5. Demographics of the participants at baseline (n=10)
University Healthcare Research Centre
Results
Demographics of the participants at baseline (n=10)
n (%)
Mean (SD)
Min - Max
Genus (female)
5 (50)
Smokers
Age
67.1 (3.2)
BMI
26,9 (5.1)
16,8 - 34,1
FEV1
51,3 (15.2)
6MWT
461,8 (127.4)
mMRC
1,57 (0.8)
0 - 3
CCQ *
Total
1.8 (0.9)
Symptom
2.3 (0.8)
Function
1.3 (1.1)
Mental
1.5 (1.4)
*0 points indicate “asymptomatic/ no limitation” to 6 points indicate “extremely symptomatic/totally limited”.

6. University Healthcare Research Centre
Accelerometer data combined with GOLD stadium I-IV and 6-minutes walking-test at base-line and after six weeks (n=7)
Patient Id
GOLD **
Stadium
I -IV
MVPA *a
(minutes)
Mean
MVPA *b
Mean phys act *a
(counts per minute)
Mean phys act *b
6MWT *a *b A5 II 40
*84
244
*401
520
560
A10
III 86
*89
633
599
600
640
A13 8 7
139
141
380
320
A14 21 20
144
157
400
410
A16 26
*56
169
*282
A18 45 25
277
251
420
A20 14 15
148
143
500
* a=one week before intervention, *b=six week after intervention
** Overview of the four GOLD stages: I (mild COPD) > 80%,
II (moderate) 50%-80%, III (severe) 30%-50%, IV (very severe) <30%

7. Technical news - interesting but difficult,
University Healthcare Research Centre
My use of saturation meter connected to a mobile application with alarm meant, after all, most difficulties with the technical devices
Increased security with new knowledge ”Yes, I found that I dared to do a little more. Before that I had been wondering a little what I had in saturation when it felt as heavy. Now I saw that it was not so dangerous. Then I dared to go a little more.”
Technical news - interesting but difficult,
The mobile application - both user-friendly and dodgy
Brought nothing useful.
” I do not understand it. I thought it was pure lucky hit when I found the symbol.”

8. A feeling of hopelessness got limits of physical activities
University Healthcare Research Centre
My relation to physical activity is a sense of resignation when I want to do more than I can
Reasons for physical activities was a sense of feeling good ”Yes I think I'm feeling good and I will keep me moving and be active in all possible ways. I do not want to be sitting here at home. Then I have to help with that”
A feeling of hopelessness got limits of physical activities
Support facilitates physical activity
The disease led to adjustments in daily life
” I just be out of breath and it was really hard (to be in a nordic walking group). It was no fun when I could not cope as I wanted. I walked anyway, but I was always the last one, it was not fun.”

9. Conclusion Much technical problems experienced
University Healthcare Research Centre
Conclusion
Much technical problems experienced
Walked slower, stayed and rest and avoided activities with others
Were very active for only one or two hours per day
They experienced that they were very active