Background
This spring (2010) the multicenter RCT called ”The Virtual Hospital” will be launched at Frederiksberg University Hospital and Herlev University Hospital. The main objective of the study is to investigate the feasibility and safety of a telemedicine based treatment regimen in COPD patients, compared to conventional hospital treatment.

In order to transfer the patient from the hospital to the telemedicine based homecare treatment regimen, the patient must be able to perform tests and treatments and also contribute to identification of problems and changes in the physical condition. However, so far it has not been investigated whether patients using telehomecare have or acquire the necessary skills to cope with the problems entailed by COPD, in interaction with healthcare professionals and relatives.

Objective
The primary aim of this study is to explore how telemedicine influences COPD patients´ coping of their physical and psychosocial problems. Furthermore the study aims at identifying factors which can develop and enhance the quality of care during the virtual admission. Methods The study is based on self-efficacy theory developed by Albert Bandura (Bandura 1997). Studies in other populations suggest that patients with high self-efficacy beliefs are better at coping with their problems, compared to patients with low self-efficacy believes. The study will apply both quantitative and qualitative methods, and consists of two parts;

1. A quantitative study which aims at describing what characterizes COPD patients´ self-efficacy after virtual admission compared to hospital admission. Self-efficacy will be measured using “The COPD self-efficacy scale”, developed by Wigal et al (Chest 1991). In addition, analyses will be conducted to explore the association between self-efficacy, readmission and the use of bed days during the six month follow-up period.
2. A qualitative study, which aims at describing how COPD patients cope with their physical and psychosocial difficulties, in interaction with healthcare professionals and relatives, during and after virtual admission, compared to their experiences from earlier hospital admissions. Furthermore the study will focus on advantages and disadvantages of virtual admission, experienced by the patients, in order to identify factors enhancing the patients´ coping skills. The qualitative study will be performed using in-depth interviews and will be analyzed using Grounded Theory.

Implications
The influence of telemedicine on COPD patients´ self-efficacy has not been previously explored. Hence, the results of the study can have national as well as international implications for the professional, human and economic prioritisation and development of telemedicine based care and treatment of COPD.