Palliative care for people with COPD: A neglected area in the primary sector

Background: Patients with COPD receive less palliative care in the primary sector than patients with other diseases with comparable symptoms and prognoses. Aims: To examine health professionals9 reflections, experiences and considerations on palliative care for people with COPD in primary healthcare. Methods: In 2014, 66 health professionals (nurses, assistants and helpers) participated in a 120-minute group interview. Ten group interviews with 3-8 participants were completed. Professionals were invited from eleven homecare districts in Denmark and the interviews were analyzed descriptively. During the interviews five major questions were discussed: what is palliation and who needs palliative care; what are the challenges in working with COPD sufferers; how do you identify palliative care needs; do you initiate discussions with patientsabout the future; and are you able to respond to patient9s palliative care needs? Results: Health professionals expressedvague definitions of palliative careservices to patients suffering from COPD; revealed urgent need for knowledge; and thought it was difficult to find the right time for serious conversations about future life concerns related to COPD. The participants considered good relations and clear agreements to be important for the patients9 confidence but felt unable to help and support the patients during crisis of breathlessness and anxiety. Conclusion: Palliative care for people with COPD in primary health care isa neglected area. Primary health professionals are eager to learn about COPD and how to manage palliation, relieve symptom and communicate.