Abstract:

Introduction:
According to WHO, 65 million individuals globally have moderate to severe COPD. People with chronic obstructive pulmonary disease (COPD) are offered rehabilitation programs after being diagnosed. The program help people manage their own condition and build good behaviors including quitting smoking, increase exercise, and improve eating habits to avoid being underweight or obese. Rehabilitation programs focus on a specific medical condition and may advise on ex. taking medicine correct. The needs, values, and preferences of people with COPD, are not considered in the medical and educational approaches. Traditional scholastic learning-based rehabilitation programs do not serve all needs of people with COPD. A practical approach could help people with low education and health literacy, thus we must find new innovative ways to educate them. Furthermore, digital health solutions are making people more active partners and bringing health care closer to people, with high expectations to the people. Social learning theories and communities allow us to include people with COPD, provide digital health services, and improve COPD awareness. Based on situated learning, community of practice, and learning architecture, we created a framework where peoples' needs, values, and preferences are met and where health professionals and people with long-term health conditions work together in best practice to improve health care.

We present a meta-synthesis, based on previous studies, on how to provide new digital health care and include people with COPD, by using the theory of Etienne Wengers Learning Architecture, Community of practice and situated learning.

Method:
This meta-synthesis is built on previous results based on an ethnographic method, where we located the needs, values and preferences of people with COPD who participated in a 24/7 digital health care system. Earlier results included three main categories; health, value creations and resources was important for people with COPD. Inspired by Etienne Wenger, we used the concept of Learning Architecture, consisting of four dualities 1) Reification and participation, 2) Designed and emergent, 3) Local and global, 4) Identification and negotiability, as an framework for the meta-synthesis. Where the findings from the previous studies are incorporated into the theory of Learning Architecture.

Results:
We created a digital health educations framework based on the theory of Learning Architecture for people with COPD. The framework's consist of four dualities matching the theory of Learning Architecture but are tailored to the digital health care system. Furthermore, the framework consist of six learning cases; citizens values, measurements, hobbies, health professionals, social network and technology, which is material to in light health care professionals to understand the needs, values and preferences of people with COPD included in the digital health care system.

Conclusion:
This project rethink education of people with COPD by integrating it into a digital health care service setting and community. It is proposed to shift patient education from scholastic rehabilitation programs to situated orientated learning, where COPD patients can learn in terms of their needs, values, and preferences. The design considers how to use Etienne Wenger's learning architecture to health care and how to create a digital health community for COPD patients. The next step is to implement and test the framework into the health care system.

Keywords:

Patient education, COPD, digital health, Situated learning, community of practice, learning architecture, health literacy, chronic conditions.