DEVELOPMENT AND EVALUATION OF A SELFMANAGEMENT PROGRAMME AS IT CHANGED FROM FACE-TO-FACE TO ONLINE

ABSTRACT

Background St Gemma's Hospice offered an onsite breathlessness group for two years. In late 2019 the content was reviewed, and in January 2020 a reviewed programme was piloted (P1) incorporating self-management strategies for patients experiencing breathlessness, fatigue and anxiety. COVID-19 restrictions led to the move to a video version, (P2) patients watching at home supported with telephone follow up. Aim To provide a comprehensive new programme, enabling education sessions to continue for patients whilst unable to attend in person. This allowed us to explore use of video as an education resource and consider if there were long term benefits for retaining this model of education delivery. Methods Developed the project by pre-programme literature search, previous model evaluation, gap analysis, and model planning. To move the project online scripted and visual resources were developed, recorded sessions on Zoom, uploading to a secure video platform accessed by password. Pre- and post- course patient VAS scores of management of symptoms, feedback from patients and staff, comparison patient numbers for onsite and online sessions and analysis of cost effectiveness. Results P1 = 15 patients Jan 2020 - March 2020. P2 = 72 patients August 2020 and March 2021. Manage symptoms on a VAS of 1-10, 1 = not managing;10 = well managing Breathlessness, mean improvement -1.4 Fatigue, mean improvement - 0.55 Anxiety, mean improvement - 2.4 Positive feedback;ongoing accessibility to toolkit resources, patient self-efficacy Cost;Onsite per patient = £116.31 versus Online Program = £76.30 Conclusions Mean values for pre- and post- evaluations indicate improvement of patients' ability to self-manage except for fatigue which was inconclusive. Consideration is required of patients' suitability, symptoms/technical ability. Offering virtual education sessions widened access for patients who struggled to attend on site due to transport, mobility or high volume oxygen. Video education is as effective as face-to-face.