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Development of a complex intervention for early integration of palliative home care into standard care for end-stage COPD patients
- Source :
- PLOS ONE, PLoS ONE, Vol 13, Iss 9, p e0203326 (2018)
- Publication Year :
- 2018
- Publisher :
- Public Library of Science, 2018.
-
Abstract
- Background : Research suggests that palliative home care should be integrated early into standard care for end-stage COPD patients. Patients also express the wish to be cared for and to die at home. However, a practice model for early integration of palliative home care (PHC) into standard care for end-stage COPD has not been fully developed. Aim : To develop an intervention for early integration of PHC into standard care for end-stage COPD patients. Methods : We conducted a Phase 0-I study according to the Medical Research Council Framework for the development of complex interventions. Phase 0 aimed to identify the inclusion criteria and key components of the intervention by way of an explorative literature search of interventions, expert consultations, and seven focus groups with general practitioners and community nurses on perceived barriers to and facilitators of early integrated PHC for COPD. In Phase 1, the intervention, its inclusion criteria and its components were developed and further refined by an expert panel and two expert opinions. Results : Phase 0 resulted in identification of inclusion criteria and components from existing interventions, and barriers to and facilitators of early integration of PHC for end-stage COPD. Based on these findings, a nurse-led intervention was developed in Phase I consisting of training for PHC nurses in symptom recognition and physical therapy exercises for end-stage COPD, regular visits by PHC nurses at the patients' homes, two information leaflets on selfmanagement, a semi-structured protocol and follow-up plan to record the outcomes of the home visits, and integration of care by enabling collaboration and communication between home and hospital-based professional caregivers. Conclusion : This Phase 0-I trial succeeded in developing a complex intervention for early integration of PHC for end-stage COPD. The use of three methods in Phase 0 gave reliable data on which to base inclusion criteria and components of the intervention. The preliminary effectiveness, feasibility and acceptability of the intervention will be subsequently tested in a Phase II study.
- Subjects :
- Evidence-based nursing
Palliative care
Psychological intervention
lcsh:Medicine
OBSTRUCTIVE PULMONARY-DISEASE
law.invention
Pulmonary Disease, Chronic Obstructive
INITIATION
03 medical and health sciences
LUNG-CANCER
0302 clinical medicine
Belgium
Nursing
Randomized controlled trial
law
Intervention (counseling)
SUPPORT
Medicine and Health Sciences
Humans
Medicine
BREATHLESSNESS
030212 general & internal medicine
lcsh:Science
Evidence-Based Medicine
Multidisciplinary
Agricultural and Biological Sciences(all)
Delivery of Health Care, Integrated
business.industry
Biochemistry, Genetics and Molecular Biology(all)
lcsh:R
Palliative Care
OF-LIFE
Evidence-Based Nursing
Evidence-based medicine
Models, Theoretical
RANDOMIZED CONTROLLED-TRIAL
GENERAL-PRACTITIONERS
Home Care Services
Focus group
Clinical trial
030228 respiratory system
lcsh:Q
HEALTH
business
COSTS
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Database :
- OpenAIRE
- Journal :
- PLOS ONE, PLoS ONE, Vol 13, Iss 9, p e0203326 (2018)
- Accession number :
- edsair.doi.dedup.....51b5c4919fbae3394a2cbc9ca92a3b7a