Comparing the effects of smartphone-based and face-to-face pulmonary rehabilitation education on caregiver burden and quality of life among the family caregivers of patients with chronic obstructive pulmonary disease: a randomized controlled field trial

Abstract

Background Functional limitation among patients with chronic obstructive pulmonary disorder (COPD) and their dependence on their family caregivers (FCs) can significantly increase caregiver burden (CB) and reduce the quality of life (QOL) among FCs. Education of pulmonary rehabilitation (PR) to FCs is a strategy with potential positive effects on CB. This study was conducted to compare the effects of smartphone-based and face-to-face (FTF) PR education on CB and QOL among the FCs of patients with COPD. Methods This randomized controlled field trial was conducted in 2021–2022. Participants were purposefully selected from the PR unit of Khorshid comprehensive respiratory care clinic in Isfahan, Iran, and randomly allocated to a control and an intervention group. Participants in the control group received PR education in twelve 30–60-min FTF sessions held twice weekly in six consecutive weeks. Their counterparts in the intervention group received PR education for 6 weeks through an android application. The Zarit Burden Interview and the 12-item Short Form Health Survey (SF-12) were used for data collection before and immediately after the study intervention. The SPSS software (v. 24.0) was used to analyze the data through the independent-sample t, paired-sample t, chi-square, and Fisher’s exact tests. Results The means of participants’ age was 47.7 ± 13.8 years in the control group and 44.1 ± 14.8 years in the intervention group. Most participants in these groups were female (82.9% vs. 71.4%). The pretest mean scores of CB and QOL were respectively 50.77 ± 10.64 and 27.82 ± 3.9 in the control group and 49.77 ± 7.65 and 26.71 ± 3.5 in the intervention group with no significant between-group difference (P > 0.05). At the posttest, these values were respectively 51.57 ± 7.32 and 27.74 ± 3.28 in the control group and 37.31 ± 6.95 and 34.37 ± 2.8 in the intervention group, and between-group differences were significant (P < 0.05). The mean scores of CB and QOL did not significantly change in the control group (P > 0.05), but respectively decreased and increased significantly in the intervention group (P < 0.05). Conclusions Smartphone-based PR education is effective in significantly decreasing CB and improving QOL among the FCs of patients with COPD. Trial registration Iranian Registry of Clinical Trials IRCT20161203031200N3

The Effects of Digital Health Interventions for Pulmonary Rehabilitation in People with COPD: A Systematic Review of Randomized Controlled Trials

“…Two trials used Web-based applications [ 15 , 16 ], five trials used video conferencing [ 17 , 18 , 19 , 20 , 21 ], one trial used online sessions [ 22 ], and five trials used smart phone applications [ 23 , 24 , 25 , 26 , 27 ]. The digital technology used in the pulmonary rehabilitation programmes in these trials focused on different types of exercise (endurance, strengthening, aerobic, breathing, flexibility, stretching, and resistance).…”

“…The digital technology used in the pulmonary rehabilitation programmes in these trials focused on different types of exercise (endurance, strengthening, aerobic, breathing, flexibility, stretching, and resistance). Five trials used an exercise programme combined with an education session [ 16 , 17 , 20 , 25 , 26 ]. The study characteristics are summarized in Table 2 .…”

“…The PEDro scores of the included trials ranged from 6 to 9, indicating good to excellent quality trials ( Table 3 ). One trial scored 6 because of the bias in blinding of all subjects and random allocation to groups [ 17 ], eight trials scored 7 because of bias in blinding of all subjects and allocation concealed [ 15 , 16 , 19 , 21 , 22 , 23 , 25 , 26 ], three trials scored 8 because of bias in blinding of all subjects [ 18 , 24 , 27 ], and one trial scored 9 because of bias in blinding of therapists and assessors [ 20 ]. The risk of bias using the CROB2 tool showed that 11 trials were at a low risk of bias (across all domains) [ 15 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ] and two trials were at “some concern” of risk of bias (some concerns in two domains) [ 16 , 17 ].…”

“…While two studies showed that the tele-PR improved exercise capacity more than regular PR [ 15 , 19 ], four studies did not find a significant difference in improvement between the two groups [ 17 , 20 , 22 , 24 ]. In terms of QOL, two studies showed an enhanced improvement in tele-PR compared to regular PR [ 19 , 26 ], while one study showed no differences [ 17 ]. Furthermore, two studies revealed enhanced improvements in COPD signs and symptoms [ 19 , 20 ], and another two studies showed that the difference in improvement was not significant [ 15 , 24 ].…”

Effectiveness of a supportive care program via a smartphone application on the quality of life and care burden among family caregivers of patients with major depressive disorder: a randomized controlled trial

“…In Otero’s (2020) study, conducting an intervention with a brief psychological approach through a smartphone application was effective in reducing caregivers’ depression symptoms [ 34 ]. Other studies in this regard have also benefited from this type of support intervention to improve the quality of life and reduce the burden of care for other diseases [ 35 , 36 ]. Nevertheless, most of the evidence related to interventions based on mobile phone applications has focused on chronic physical diseases, and less has addressed the caregivers of patients with mental disease.…”