Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Mar 2;18(1):24.
doi: 10.1186/s12904-019-0410-0.

Assigned nurses and a professional relationship: a qualitative study of COPD patients' perspective on a new palliative outpatient structure named CAPTAIN

D G Bove  1   2 , M O Jellington  3 , M Lavesen  3 , K Marså  4 , S F Herling  5
Affiliations

Assigned nurses and a professional relationship: a qualitative study of COPD patients' perspective on a new palliative outpatient structure named CAPTAIN

D G Bove et al. BMC Palliat Care. .

Abstract

Background: Little is known of how to organize non-malign palliative care, and existing knowledge show that patients with COPD live with unmet palliative needs and low quality of life. With the intent to improve palliative care for patients with COPD, we changed the structure of our outpatient clinic from routine visits by a pulmonary specialist to a structure where each patient was assigned a nurse, offered annual advance care planning dialogues, and ad hoc pulmonary specialist visits. The aim of this study was to explore COPD patients' experiences with a new and altered palliative organization.

Methods: The design was interpretive description as described by Thorne. We conducted ten semi-structured interviews with patients with severe COPD from January 2017 to December 2017.

Results: Patients described how the professional relationship and the availability of their nurse was considered as the most important and positive change. It made the patients feel safe, in control, and subsequently influenced their ability to self-manage their life and prevent being hospitalized. The patients did not emphasize the advanced care planning dialogues as something special or troublesome.

Conclusion: We showed that it is relevant and meaningful to establish a structure that supports professional relationships between patient, nurse and physician based on patients needs. The new way of structuring the outpatient care was highly appreciated by COPD patients and made them feel safe which brought confidence in self-management abilities.

Keywords: Interpretive description; Non-malign palliative care; Nurse/physician collaboration; Palliative care organization; Qualitative research.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Participants were informed both verbal and in writing about study aim and its voluntary nature and gave written consent prior to the individual interview. Furthermore, the study was approved by the Chief Executives at Nordsjællands Hospitals’ Department of Pulmonary and Infectious Diseases in Denmark. According to The Ethics Committee (www.nvk.dk) in Denmark, the Biomedical Research Ethics Committee System Act does not apply to qualitative studies in general nor the present study. Participants are referred to by pseudonyms.

Consent for publication

Not applicable.

Competing interests

No conflict of interest has been declared by the authors DGB, MOJ, ML and SFH. K.M has received honoraria from Almirall, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Norpharma, Novartis, Intermune, and Roche for presenting at meetings and symposia and honoraria for participation in advisory board for AstraZeneca and Novartis.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Lokke A, Hilberg O, Kjellberg J, Ibsen R, Jennum P. Economic and health consequences of COPD patients and their spouses in Denmark-1998-2010. COPD. 2013;19. - PubMed
    1. Blinderman CD, Homel P, Billings JA, Tennstedt S, Portenoy RK. Symptom distress and quality of life in patients with advanced chronic obstructive pulmonary disease. J Pain Symptom Manag. 2009;38(1):115–123. doi: 10.1016/j.jpainsymman.2008.07.006. - DOI - PubMed
    1. Bausewein C, Booth S, Gysels M, Kuhnbach R, Haberland B, Higginson IJ. Understanding breathlessness: cross-sectional comparison of symptom burden and palliative care needs in chronic obstructive pulmonary disease and cancer. J Palliat Med. 2010;13(9):1109–1118. doi: 10.1089/jpm.2010.0068. - DOI - PubMed
    1. Schroedl CJ, Yount SE, Szmuilowicz E, Hutchison PJ, Rosenberg SR, Kalhan R. A qualitative study of unmet healthcare needs in chronic obstructive pulmonary disease. A potential role for specialist palliative care? Ann Am Thorac Soc. 2014;11(9):1433–1438. doi: 10.1513/AnnalsATS.201404-155BC. - DOI - PMC - PubMed
    1. Jabbarian LJ, Zwakman M, van der Heide A, Kars MC, Janssen DJA, van Delden JJ, et al. Advance care planning for patients with chronic respiratory diseases: a systematic review of preferences and practices. Thorax. 2017;6. - PubMed