1.9.1 Health professionals' views of palliative care provision for patients with advanced COPD (78)

Allison Spence, Community Hospice Nurse, Community Services, Northern Ireland Hospice, Belfast, United Kingdom Co authors: Mary Waldron, George Kernohan, Felicity Hasson, Barbara Watson, Barbara Cochrane & Dorry McLaughlin

Abstract:

Background:

Chronic Obstructive Pulmonary Disease(COPD) affects 1.5% of the UK population and is the fourth leading cause of death worldwide. Despite this, patients with such conditions receive fragmented care as they near the end of life, and have minimal access to specialist palliative care.

Aim:

To explore the views and perceptions of health and social care professionals of palliative care for patients and their carers living with advanced COPD.

Methods:

A qualitative study, using two focus groups and six interviews, was undertaken with 23 health and social care professsionals representing nursing, medical, allied health professional and social work disciplines. With permission. all data was audio recorded and all transcripts were analysed using content analysis framework.

Results:

Whilst participants were familiar with the concepts of palliative care and did not dispute its place, a number of factors challenged the delivery of this care for patients and their carers with COPD. These included a lack of clarification of professional roles within the multi-disciplinary team, unpredictable illness trajectories, lack of a common understanding of the nature of palliative care and the lack of knowledge and confidence in initiating such discussions.

Discussion:

Despite the acceptance that the palliative care approach is appropriate, findings displayed a poor understanding of health and social care professionals' role in palliative care and a lack of knowledge of how and when to introduce such care. For many, the attitudes that death was a failure, which underpins professional practice, may pose a potent barrier to good palliative care.

Conclusion:

The findings offer an insight into health and social care professionals' understanding of palliative care and suggest that educational interventions to facilitate change are required. Further research into approaches to professional behavioural change is required.

Biography:

Allison Spence, Qualified as a RGN in 1986. Spent 15 years witin an acute hospital setting working in acute medicine,liver and HIV wards. She then moved to the Northern Ireland Hospice as a Hospice at Home Co-ordinator and also worked in its In-Patient Unit. During her time in the hospice, she graduated in June 2006 with a BSc (Hons) in Specialist Practice (Palliative Care Option.) She is now employed as a Community Hospice Nurse.