Profiling the physiological and psychological effectiveness of singlet oxygen in the management of Chronic Obstructive Pulmonary Disease (COPD)

COPD is a progressive respiratory disease and is currently the third leading cause of death worldwide. Primary COPD symptoms include breathlessness, cough, and sputum production; these symptoms are linked to a host of secondary physical issues, such as poor sleep quality and fatigue and psychological issues, such as anxiety and depression. These issues have a broad and negative impact on people's quality of life. This thesis aims to understand further the day-to-day effects of COPD symptomology, exploring the experiences of how COPD affects the quality of life and the insight from COPD participants regarding medication(s), in addition to the efficacy of current strategies and interventions and whether there is scope for a non-pharmacological intervention that could potentially fill this void. The overall aim is to increase the knowledge and awareness of the physiological and psychological determinants that affect the quality of life of COPD patients. A variety of different types of data and data collection methods, which includes using Qualtrics online survey, online Microsoft Team interviews, PhotoVoice and receiving photographs using an application called Signal and planning to conduct a double-blinded NHS randomised controlled trial (RCT) in collaboration with external stakeholders.

The main findings are that COPD participants' physiological and psychological symptoms increase in severity as the respiratory condition progresses, which is consistent with previous research literature. However, despite significant differences such as for breathlessness, sleep quality and health-related quality of life, the results that were not expected and were the opposite of the proposed hypotheses were the non-significant results such as for self-compassion, readiness to use a new intervention, as well as confidence to try a new intervention. The results highlight that self-compassion remained moderate across the different COPD severities (medium, high and very high), and the readiness and confidence to try a new intervention were very high across the COPD severities. Also, medication side effects and changing medications. However, despite this, COPD participants have shown readiness and confidence to try new interventions that improve the management of their condition. An abundance of different interventions and strategies that are non-pharmacological based are already being used to help manage COPD symptoms, showing additional support that participants are willing to try anything to improve their quality of life. This thesis highlights the importance of using new qualitative methodologies such as PhotoVoice and the significant insight and vulnerabilities it captures from participants, as well as using patient and public representatives across the research processes.

The thesis also presents a double-blind RCT protocol, co-designed with the patient and public representatives, to collect empirical data on the efficacy and safety of a singlet oxygen energy device (SoeMac) as an adjunct therapy to prescribed medications. This protocol has been developed extensively and is ready to be implemented. To ensure effectiveness, further research should investigate the role of self-compassion and self-conscious emotions such as guilt, self-criticism, shame-based avoidance, and embarrassment for each level of COPD severity (including low COPD severity), COPD participants from ethnic minority backgrounds and younger COPD onset. Concerted attempts driven by physiological and psychological research that underpin clinical interventions are required to ensure that the needs and wants of patients are addressed and that treatments and benefits to patients are accepted and accessible.