Nurse‐led integration of palliative care for chronic obstructive pulmonary disease: An integrative literature review

Abstract

Aims and objectives To uncover what is known about nurse‐led models or interventions that have integrated palliative care into the care of patients with chronic obstructive pulmonary disease. Background Chronic obstructive pulmonary disease is a highly symptomatic, incurable disease characterised by chronic symptoms that without appropriate palliation can lead to unnecessary suffering for patients and their caregivers. While palliative care practices can relieve suffering and improve quality of life, most palliative models of care remain cancer‐focused. New models, including nurse‐led care that integrates palliative care for patients with chronic obstructive pulmonary disease, could address patient suffering and therefore need to be explored. Method A mixed‐studies integrative review was undertaken. Seven databases were searched for articles published between 2008–2018. The PRISMA framework was applied to the search, and six studies met the review eligibility criteria. Content analysis of the articles was undertaken, and data were compared, looking for different nurse‐led models and outcomes related to palliative care in chronic obstructive pulmonary disease. Results Nurse‐led, integrated palliative care models for patients with chronic obstructive pulmonary disease are rare and just four of the six articles found in this review had published results. Advance care planning was found to be the most common focus for nurse‐led interventions in chronic obstructive pulmonary disease, and in all cases, results demonstrated an improvement in end‐of‐life discussions and completion of advance care directives. Of the reviewed articles, none used a qualitative framework to explore nurse‐led models that integrated palliative care in chronic obstructive pulmonary disease. Conclusion While nurse‐led advance care planning was one type of palliative care practice associated with positive patient outcomes, there is a need for deeper exploration of nurse‐led models that holistically address the bio‐psycho‐social‐spiritual needs of patients with chronic obstructive pulmonary disease, and their caregivers. Relevance to clinical practice Integrating nurse‐led supportive care clinics into chronic obstructive pulmonary disease services could be a way forward to address the unmet bio‐psycho‐social‐spiritual needs of patients with chronic obstructive pulmonary disease, and their caregivers.

Facilitators and barriers to the delivery of palliative care to patients with Parkinson’s disease: a qualitative study of the perceptions and experiences of stakeholders using the socio-ecological model

“…Considering the direct and frequent contact between nurses and patients, nurses may be the best people to communicate the patient’s needs. Most previous studies [ 47 , 48 ] have shown that nurse-led PC services effectively improve patient and carer life quality, indicating the condition to fully utilize their roles to reduce healthcare costs and promote PC for PD patients.…”

Nurse-Led Interventions in Chronic Obstructive Pulmonary Disease Patients: A Systematic Review and Meta-Analysis

“…Last but not least, evidence of the benefits of smoking cessation in COPD has been demonstrated, including decreased disease progression, and reduced symptoms and mortality [ 6 ]. Nurse interventions focused on reducing smoking have been covered in two studies [ 11 , 49 ] but only in Jolly et al [ 11 ], the number of smokers decreased after 12 months.…”

“…Nursing management of COPD patients achieves better outcomes in the day-to-day management of the disease, improving the patient’s knowledge of disease management [ 4 , 5 ]. Indeed, home visits and remote management with telemedicine at discharge time by hospital nurses and in primary care should be considered, not only for COPD patients but also for their families [ 6 ].…”

Palliative Care Nursing in Australia and the Role of the Registered Nurse in Palliative Care

“…This PCA emphasises the need for easy access to holistic patient-centred and family-centred multidisciplinary palliative care [ 4 ]. Nurse-led end-of-life (EOL) care planning, including advanced care planning, is increasingly acknowledged as a palliative care approach associated with improved patient outcomes, especially in ways that are holistically patient-centred and family-centred [ 5 ].…”