"Patch them up and send them home": perceptions of nurses and physiotherapists in their role with end-stage COPD

Jackie Malone, Katherine Froggatt, Nancy Preston

Research output: Contribution to journalMeeting Abstract

Abstract

Background:People with severe Chronic Obstructive Pulmonary Disease (COPD) have a high symptom burden and experience repeated hospital admissions as their disease progresses. End of life is typically difficult to predict, and although palliative care initiatives are developing within COPD, active treatment often continues up to death. There is a lack of literature in the field concerning the impact this has on staff delivering care, and their role in decision-making within this patient group.Aims: To explore the role of staff in caring and treatment decision-making for those with acute severe COPD and the multi-disciplinary team relationships influencing care.Methods:This exploratory, qualitative study consisted of 4 interviews and 1 focus group with nurses and physiotherapists who care for patients with severe COPD in the acute hospital setting. A grounded theory approach to analysis was aided by the software NVivo.Results:Advocacy and support to patients and families were cited as important aspects of their role, but effectiveness is hampered by pressure on beds and the general approach of “patch them up and send them home”. Advocacy was described in terms of information-giving and communication, and staff opinions were consulted in some treatment decisions, but that this depended on the hierarchy of the medical team: “…it comes down to which consultant is in charge that day”. Levels of decision-making involvement and advocacy were related to knowing the patient and professional experience, but were significantly limited by time and other pressures.Conclusions:Participants described frustration regarding the lack of palliative care decision-making in end-stage COPD, but nurses and physiotherapists are developing their roles in advocacy for this patient group. A second phase of data collection is investigating the nature of advocacy in this group further.
Original languageEnglish
Article numberNo. 23
Pages (from-to)S26
Number of pages1
JournalPalliative Medicine
Volume30
Issue number4
Early online date6 Mar 2016
Publication statusPublished - 1 Apr 2016
EventThe 11th Palliative Care Congress - The Scottish Exhibition & Conference Centre (SECC), Glasgow, United Kingdom
Duration: 9 Mar 201611 Mar 2016
Conference number: 11
https://pccongress.org.uk/wp-content/uploads/2017/07/2016-PCC-Programme.pdf

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Community Health Nurses
Physical Therapists
Chronic Obstructive Pulmonary Disease
Decision Making
Palliative Care
Nurses
Patient Advocacy
Pressure
Frustration
Consultants
Focus Groups
Patient Care
Therapeutics
Software
Communication
Interviews

Cite this

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abstract = "Background:People with severe Chronic Obstructive Pulmonary Disease (COPD) have a high symptom burden and experience repeated hospital admissions as their disease progresses. End of life is typically difficult to predict, and although palliative care initiatives are developing within COPD, active treatment often continues up to death. There is a lack of literature in the field concerning the impact this has on staff delivering care, and their role in decision-making within this patient group.Aims: To explore the role of staff in caring and treatment decision-making for those with acute severe COPD and the multi-disciplinary team relationships influencing care.Methods:This exploratory, qualitative study consisted of 4 interviews and 1 focus group with nurses and physiotherapists who care for patients with severe COPD in the acute hospital setting. A grounded theory approach to analysis was aided by the software NVivo.Results:Advocacy and support to patients and families were cited as important aspects of their role, but effectiveness is hampered by pressure on beds and the general approach of “patch them up and send them home”. Advocacy was described in terms of information-giving and communication, and staff opinions were consulted in some treatment decisions, but that this depended on the hierarchy of the medical team: “…it comes down to which consultant is in charge that day”. Levels of decision-making involvement and advocacy were related to knowing the patient and professional experience, but were significantly limited by time and other pressures.Conclusions:Participants described frustration regarding the lack of palliative care decision-making in end-stage COPD, but nurses and physiotherapists are developing their roles in advocacy for this patient group. A second phase of data collection is investigating the nature of advocacy in this group further.",
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"Patch them up and send them home" : perceptions of nurses and physiotherapists in their role with end-stage COPD. / Malone, Jackie; Froggatt, Katherine; Preston, Nancy.

In: Palliative Medicine, Vol. 30, No. 4, No. 23, 01.04.2016, p. S26.

Research output: Contribution to journalMeeting Abstract

TY - JOUR

T1 - "Patch them up and send them home"

T2 - perceptions of nurses and physiotherapists in their role with end-stage COPD

AU - Malone, Jackie

AU - Froggatt, Katherine

AU - Preston, Nancy

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Background:People with severe Chronic Obstructive Pulmonary Disease (COPD) have a high symptom burden and experience repeated hospital admissions as their disease progresses. End of life is typically difficult to predict, and although palliative care initiatives are developing within COPD, active treatment often continues up to death. There is a lack of literature in the field concerning the impact this has on staff delivering care, and their role in decision-making within this patient group.Aims: To explore the role of staff in caring and treatment decision-making for those with acute severe COPD and the multi-disciplinary team relationships influencing care.Methods:This exploratory, qualitative study consisted of 4 interviews and 1 focus group with nurses and physiotherapists who care for patients with severe COPD in the acute hospital setting. A grounded theory approach to analysis was aided by the software NVivo.Results:Advocacy and support to patients and families were cited as important aspects of their role, but effectiveness is hampered by pressure on beds and the general approach of “patch them up and send them home”. Advocacy was described in terms of information-giving and communication, and staff opinions were consulted in some treatment decisions, but that this depended on the hierarchy of the medical team: “…it comes down to which consultant is in charge that day”. Levels of decision-making involvement and advocacy were related to knowing the patient and professional experience, but were significantly limited by time and other pressures.Conclusions:Participants described frustration regarding the lack of palliative care decision-making in end-stage COPD, but nurses and physiotherapists are developing their roles in advocacy for this patient group. A second phase of data collection is investigating the nature of advocacy in this group further.

AB - Background:People with severe Chronic Obstructive Pulmonary Disease (COPD) have a high symptom burden and experience repeated hospital admissions as their disease progresses. End of life is typically difficult to predict, and although palliative care initiatives are developing within COPD, active treatment often continues up to death. There is a lack of literature in the field concerning the impact this has on staff delivering care, and their role in decision-making within this patient group.Aims: To explore the role of staff in caring and treatment decision-making for those with acute severe COPD and the multi-disciplinary team relationships influencing care.Methods:This exploratory, qualitative study consisted of 4 interviews and 1 focus group with nurses and physiotherapists who care for patients with severe COPD in the acute hospital setting. A grounded theory approach to analysis was aided by the software NVivo.Results:Advocacy and support to patients and families were cited as important aspects of their role, but effectiveness is hampered by pressure on beds and the general approach of “patch them up and send them home”. Advocacy was described in terms of information-giving and communication, and staff opinions were consulted in some treatment decisions, but that this depended on the hierarchy of the medical team: “…it comes down to which consultant is in charge that day”. Levels of decision-making involvement and advocacy were related to knowing the patient and professional experience, but were significantly limited by time and other pressures.Conclusions:Participants described frustration regarding the lack of palliative care decision-making in end-stage COPD, but nurses and physiotherapists are developing their roles in advocacy for this patient group. A second phase of data collection is investigating the nature of advocacy in this group further.

KW - end-stage COPD

KW - palliative care

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UR - https://journals.sagepub.com/doi/full/10.1177/0269216316631462#_i134

M3 - Meeting Abstract

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SP - S26

JO - Palliative Medicine

JF - Palliative Medicine

SN - 0269-2163

IS - 4

M1 - No. 23

ER -