Barriers to palliative care in people with chronic obstructive pulmonary disease in home care: A qualitative study of the perspective of professional caregivers

Publication: Research - peer-reviewJournal article

DOI

  • Camilla Askov Mousing
  • Helle Timm
  • Kirsten Lomborg
  • Marit Kirkevold

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AIMS AND OBJECTIVES: To examine the experiences with palliative care in people with chronic obstructive pulmonary disease among professional caregivers in a Danish home care setting.

BACKGROUND: Many patients with advanced chronic obstructive pulmonary disease (COPD) depend on professional caregivers in the primary sector to provide assistance and care. However, COPD patients receive no or only very little palliative care compared to patients with cancer although they may have many burdensome symptoms.

DESIGN: Qualitative explorative study.

METHODS: In 2013-2014, ten professional caregivers from three districts in a Danish municipality were followed during home visits to patients with chronic obstructive pulmonary disease and individual interviews about palliative care were subsequently conducted. In 2014, 66 professional caregivers, representing eleven home care districts, participated in ten group discussions about palliative care needs in this group of patients. Data was analysed using qualitative descriptive analysis.

RESULTS: The study revealed a non-awareness of palliative care for patients with chronic obstructive pulmonary disease among the professional caregivers who expressed vague understanding of palliative care and lack of knowledge about the disease. Organisational barriers, such as lack of time and continuity in patient care and lack of opportunity to discuss palliative care and lack of peer learning were experienced as challenging in the provision of palliative care. Non-awareness and organisational barriers led to difficulties in identifying PC needs and reluctance to initiate conversations about PC.

CONCLUSION: The findings indicate a need for education, training and reflection among professional caregivers in home care. Also, organisational changes may be needed to reduce the barriers to palliative care. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalJournal of Clinical Nursing
ISSN0962-1067
DOIs
StateE-pub ahead of print - 19 Jul 2017

    Keywords

  • Journal Article