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Published: 07 Jun, 2021

Strategies for self-management crucial for COPD patients

PROFILE “Awareness of how much can be done to improve the well-being of a person with COPD can increase. Healthcare staff have good knowledge of how to care for people with diabetes and cancer but report a lack in competence and resources concerning people with COPD – this is despite there being more people with COPD than diabetes in Sweden.”

Text: Inger Nilsson

This according to Karin Wadell, Professor at the Department of Community Medicine and Rehabilitation at Umeå University, with a joint employment at Medicincentrum at the University Hospital of Umeå. She is a physiotherapist specialised in respiration and is also active in research, teaching and clinical work.

She wishes to develop strategies for self-management for people with chronic obstructive pulmonary disease, COPD, who are treated in specialist care, primary care and municipal home nursing care.

“To stop the development of this disease, quitting to smoke is the most vital action. Improving life with the disease is achieved by increased levels of physical activity and ability,” says Karin Wadell.

People with COPD often blame themselves

Several strategies for physical exercise have been studied at Umeå University. Pool training with or without oxygen, and resistance training, to mention a few.

“People with COPD often blame themselves, which can lead to them seeking help at a late stage. But COPD can also be caused by other factors than smoking, and nothing is improved by delaying to seek medical help or find out how to live with your disease. If you live far away from specialist care, you may hesitate to travel. In a study, researchers found that only a small portion of people with COPD get help with lung rehabilitation although it has proven positive effects.”

An eHealth tool – KOLwebben

This is where eHealth comes into the picture. Karin Wadell’s research group has developed and evaluated an eHealth tool – KOLwebben – in collaboration with other departments at Umeå University. KOLwebben contains information based on the Swedish National Board of Health and Welfare’s treatment guidelines and provides advice for both people with COPD and healthcare staff.

Previously, patients were supposed to rest when they became out of breath

KOLwebben focuses particularly on physical activity, which is something that people with COPD often struggle with. The sense of being out of breath can lead to people avoiding physical activity, but if you learn the right technique for breathing during the activity, the activity can be carried out with less discomfort.

“Previously, patients were supposed to rest when they became out of breath, but if each individual finds their technique and their pace, they can be active and exercise more efficiently. And it doesn’t matter WHAT form of exercise, the importance is THAT you exercise.”

This year, the running of KOLwebben will be taken over by the Swedish Heart-Lung Foundation.

My COPD-app

“We are currently developing ‘Min KOL’ (My COPD), which is a new eHealth tool for people with stable COPD. It is being developed on 1177.se. The app ‘Min KOL’ provides an opportunity for a more customised treatment programme.

“We were supposed to conduct a study on ‘Min KOL’ this spring, but we had to postpone that project due to the pandemic. Instead, we are hoping to launch the study after the summer. Everything takes longer now. I have other work tasks and the pandemic makes patient contact more difficult.”

Research on lung rehabilitation can somewhat contribute to finding treatment for COVID-19 – a disease that often affects the lungs.

“It helps to have good expertise in lung medicine given the fact that breathing technique is so important and that you can be affected by productive cough that causes mucus – but COVID is so much more,” emphasises Karin Wadell.

She has worked with following up COVID-19 in a national team and in the National Board of Health and Welfare’s work of providing knowledge support, and is currently chairperson of the regional team at Region Västerbotten. Karin Wadell also participates in a regional team for the treatment of asthma and COPD.

Set up a graduate school

Karin Wadell participates, together with colleagues from the department and Region Västerbotten, in an EU project aimed to set up a graduate school (the Health Cascade) focusing on strategies to develop co-creative health-promoting methods in both healthcare and other parts of society. This autumn, a doctoral student will be hired for the project too.

Karin Wadell is also course coordinator of a new course on rehabilitation of cardiac and respiratory disease at the Physiotherapy Programme, which is in the process of revising its programme syllabus.

“What propels me is to enable people with respiratory disease to get the treatment that has best effect and the healthcare they have the right to. Anything that facilitates for healthcare staff and helps the self-management of people with respiratory diseases provides increased security, a better lifestyle and makes patients more independent.”

About Karin Wadell

Name: Karin Wadell
Family: Large family, but the closest family are a husband, two children and a cat
Comes from: Stockholm
Lives: Umeå
Motivates me at work: Contributing to providing access to evidence-based and effective care for people with pulmonary disease
Inspires me: Solution-oriented people
Best relaxation: Spending time in nature and with family and friends as well as horse riding