The complexity of palliative care in persons living with severe COPD

The complexity of palliative care in persons living with severe COPD.
Author Smorawski, Gitte Andsager, University College South Denmark, Denmark
Co-author(s) Husted, Marianne Reventlov, University College South Denmark, Denmark
Noe, Bodil Bjørnshave, University College South Denmark, Denmark (Presenting Author)
Background
Palliative care is effective but underused to persons living with severe COPD. We aimed to gain knowledge about health professionals-, relatives- and individuals experiences and reflections on challenges and successes in the palliative care. We wanted to concretize proposals for a future palliative care effort to persons living with severe COPD.
Method
Ten qualitative semi-structured individual interviews were conducted with persons living with severe COPD and their relatives. Furthermore, three focus group interviews with health professionals with experience in COPD and palliative care were conducted. Inductive content analysis was used.
Results
Palliation to persons living with COPD has some special conditions. Due to repeated exacerbations and dyspnoea everyday life is unpredictable and feels unsafe. It is important that palliation imply the professional’s attention and their sensitive approach to help the individuals tame and sustain their feeling of self-respect and dignity related to anxiety. An in-depth knowledge about the individual’s life-situation and personal history is an essential part of “COPD palliation” in order to address hope/ hopelessness and blame related to the disease. However, this need in sparsely met. We find that an improved relationship between the individuals, their relatives, and the professionals and between professionals across disciplines and sectors is needed to improve palliation.
Conclusion
This study provides an insight to COPD palliation and points to some organizational challenges that should be addressed to meet the palliative care needs. Advanced care planning is proposed as an initiative to improve palliative care to persons living with severe COPD.