Mindful-Breath for People With COPD

The feasibility of interventions will be evaluated in terms of rates of recruitment, retention, and adherence. Reasons for these rates will be recorded.

Instances of adverse events (information regarding physical and psychological problems will be kept)

Satisfaction with intervention will be measured by a questionnaire rating on four key domains: usefulness of treatment, opinion of the therapist, perceived improvement and likelihood to recommend the treatment to others

Time spent on moderate-vigorous PA in the past week (min) measured by a smartwatch. The data will be considered valid if the participants wear the smartwatch for ≥10 hours/days for ≥5 days in the past week of assessment time-point

Self-reported PA in the past week will be measured by the validated 9-item International Physical Activity Questionnaire Short-form (IPAQ-SF)(Chinese), which records four intensity PA levels: 1) vigorous-intensity activity such as aerobics, 2) moderate-intensity activity such as leisure cycling, 3) walking, and 4) sitting.

Pulmonary function will be evaluated using portable spirometry. The assessment includes measuring forced expiratory volume in 1s (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), and oxygen saturation (SaO2). The highest value for FEV1, FVC, and EFV1/FVC (Tiffeneau-Pinelli index) from three reproducible efforts will be recorded.

Perceived stress will be measured by the validated 10-item Perceived Stress Scale (PSS)(Chinese)(Cronbach's α: 0.78-0.91). The event frequency of each item in the last month will be rated using a five-point Likert scale. Higher scores indicate higher perceived stress levels.

Spiritual well-being measured by the validated Chinese Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12-Item Scale (FACIT-Sp-12), which assess three constructs: belief, meaning and sense of peace on a 4-point Likert scale. High scores indicate high levels of spiritual well-being.

Symptom burden and HRQOL will be measured by the validated disease-specific 50-item St. George's Respiratory Questionnaire (SGRQ)(Chinese), which assesses three domains: frequency and severity of respiratory symptoms, effects of breathlessness on mobility and PA, and psychosocial impact of the disease. Scores are weighted such that every domain score and the total score range from 0-100. Higher scores indicate a poorer HRQOL. The minimally clinically important response to treatment is defined as an improvement of 4% on the separate domains and the total score.

Impact of COPD on daily life will be measured by the COPD Assessment Test (CAT). This patient-completed questionnaire evaluates the overall effect of COPD-specifically symptoms such as cough, sputum, dyspnea, and chest tightness-on health status. CAT scores range from 0 to 40, with higher scores indicating a more severe impact of COPD on a patient's life. A five-unit difference in scores distinguishes stable patients from those experiencing exacerbations.

Breathlessness will be measured by the modified Medical Research Council (mMRC) Dyspnoea scale. The mMRC scale is a self-assessment tool used to measure the level of impairment caused by breathlessness during daily activities, rated on a scale from 0 (no breathlessness except on strenuous exercise) to 4 (too breathless to leave the house, or breathless when dressing or undressing).

Cardiopulmonary functions will be assessed through the 6-minute walk test, where distance walked, oxygen saturation (SpO2), and heart rate will be measured.

Exacerbation in the follow-up period will be recorded to better to understand the frequency and severity of COPD exacerbations, contributing to a comprehensive understanding of disease management and progression.