Abstract
Background:: Despite significant needs, patients with chronic obstructive pulmonary disease (COPD) make limited use of palliative care, in part because the current models of palliative care do not address their key concerns. Objective:: Our aim was to develop a tailored model of palliative care for patients with COPD and their family caregivers. Method:: Based on information gathered within a program of studies (qualitative research exploring experiences, a cohort study examining service use), an expert advisory committee evaluated and integrated data, developed responses, formulated principles to inform care, and made recommendations for practice. The informing studies were conducted in two Australian states: Victoria and South Australia. Results:: A series of principles underpinning the model were developed, including that it must be: (1) focused on patient and caregiver; (2) equitable, enabling access to components of palliative care for a group with significant needs; (3) accessible; and (4) less resource-intensive than expansion of usual palliative care service delivery. The recommended conceptual model was to have the following features: (a) entry to palliative care occurs routinely triggered by clinical transitions in care; (b) care is embedded in routine ambulatory respiratory care, ensuring that it is regarded as “usual” care by patients and clinicians alike; (c) the tasks include screening for physical and psychological symptoms, social and community support, provision of information, and discussions around goals and preferences for care; and (d) transition to usual palliative care services is facilitated as the patient nears death. Significance of results:: Our proposed innovative and conceptual model for provision of palliative care requires future formal testing using rigorous mixed-methods approaches to determine if theoretical propositions translate into effectiveness, feasibility, and benefits (including economic benefits). There is reason to consider adaptation of the model for the palliative care of patients with other nonmalignant conditions.
| Original language | English |
|---|---|
| Pages (from-to) | 452-460 |
| Number of pages | 9 |
| Journal | Palliative and Supportive Care |
| Volume | 16 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Aug 2018 |
Keywords
- Chronic obstructive pulmonary disease
- Integrated care
- Models of care
- Palliative care
Cite this
}
A conceptual model : Redesigning how we provide palliative care for patients with chronic obstructive pulmonary disease. / Philip, Jennifer; Crawford, Gregory; Brand, Caroline; Gold, Michelle; Miller, Belinda; Hudson, Peter; Smallwood, Natasha; Lau, Rosalind; Sundararajan, Vijaya.
In: Palliative and Supportive Care, Vol. 16, No. 4, 08.2018, p. 452-460.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - A conceptual model
T2 - Redesigning how we provide palliative care for patients with chronic obstructive pulmonary disease
AU - Philip, Jennifer
AU - Crawford, Gregory
AU - Brand, Caroline
AU - Gold, Michelle
AU - Miller, Belinda
AU - Hudson, Peter
AU - Smallwood, Natasha
AU - Lau, Rosalind
AU - Sundararajan, Vijaya
PY - 2018/8
Y1 - 2018/8
N2 - Background:: Despite significant needs, patients with chronic obstructive pulmonary disease (COPD) make limited use of palliative care, in part because the current models of palliative care do not address their key concerns. Objective:: Our aim was to develop a tailored model of palliative care for patients with COPD and their family caregivers. Method:: Based on information gathered within a program of studies (qualitative research exploring experiences, a cohort study examining service use), an expert advisory committee evaluated and integrated data, developed responses, formulated principles to inform care, and made recommendations for practice. The informing studies were conducted in two Australian states: Victoria and South Australia. Results:: A series of principles underpinning the model were developed, including that it must be: (1) focused on patient and caregiver; (2) equitable, enabling access to components of palliative care for a group with significant needs; (3) accessible; and (4) less resource-intensive than expansion of usual palliative care service delivery. The recommended conceptual model was to have the following features: (a) entry to palliative care occurs routinely triggered by clinical transitions in care; (b) care is embedded in routine ambulatory respiratory care, ensuring that it is regarded as “usual” care by patients and clinicians alike; (c) the tasks include screening for physical and psychological symptoms, social and community support, provision of information, and discussions around goals and preferences for care; and (d) transition to usual palliative care services is facilitated as the patient nears death. Significance of results:: Our proposed innovative and conceptual model for provision of palliative care requires future formal testing using rigorous mixed-methods approaches to determine if theoretical propositions translate into effectiveness, feasibility, and benefits (including economic benefits). There is reason to consider adaptation of the model for the palliative care of patients with other nonmalignant conditions.
AB - Background:: Despite significant needs, patients with chronic obstructive pulmonary disease (COPD) make limited use of palliative care, in part because the current models of palliative care do not address their key concerns. Objective:: Our aim was to develop a tailored model of palliative care for patients with COPD and their family caregivers. Method:: Based on information gathered within a program of studies (qualitative research exploring experiences, a cohort study examining service use), an expert advisory committee evaluated and integrated data, developed responses, formulated principles to inform care, and made recommendations for practice. The informing studies were conducted in two Australian states: Victoria and South Australia. Results:: A series of principles underpinning the model were developed, including that it must be: (1) focused on patient and caregiver; (2) equitable, enabling access to components of palliative care for a group with significant needs; (3) accessible; and (4) less resource-intensive than expansion of usual palliative care service delivery. The recommended conceptual model was to have the following features: (a) entry to palliative care occurs routinely triggered by clinical transitions in care; (b) care is embedded in routine ambulatory respiratory care, ensuring that it is regarded as “usual” care by patients and clinicians alike; (c) the tasks include screening for physical and psychological symptoms, social and community support, provision of information, and discussions around goals and preferences for care; and (d) transition to usual palliative care services is facilitated as the patient nears death. Significance of results:: Our proposed innovative and conceptual model for provision of palliative care requires future formal testing using rigorous mixed-methods approaches to determine if theoretical propositions translate into effectiveness, feasibility, and benefits (including economic benefits). There is reason to consider adaptation of the model for the palliative care of patients with other nonmalignant conditions.
KW - Chronic obstructive pulmonary disease
KW - Integrated care
KW - Models of care
KW - Palliative care
UR - http://www.scopus.com/inward/record.url?scp=85020074571&partnerID=8YFLogxK
U2 - 10.1017/S147895151700044X
DO - 10.1017/S147895151700044X
M3 - Article
VL - 16
SP - 452
EP - 460
JO - Palliative and Supportive Care
JF - Palliative and Supportive Care
SN - 1478-9515
IS - 4
ER -