Identifying and responding to health care professional barriers and facilitators to meeting the needs of patients with advanced COPD and their informal carers

Morag Farquhar, Caroline Moore, Carole A. Gardener, Hanne Holt Butcher, Gail Ewing, Patrick White, Sara Booth, Sophie Howson, Ravi Mahadeva, Peter Burge, Tom Ling, Living with Breathlessness Study Team

Research output: Contribution to conferencePoster

Abstract

Background: Management of advanced chronic obstructive pulmonary disease (COPD) should relieve symptoms, optimise daily functioning and reduce carer burden. Health care professional (HCP) barriers and facilitators to meeting patient and carer needs exist but our understanding of them is limited, and we don’t know stakeholder views of actionable responses to them.

Aim: To identify barriers and facilitators to HCPs’ ability to meet patient and carer needs in advanced COPD, and stakeholder views of actionable responses to them.

Method: HCPs were nominated by a population-based cohort of patients participating in the multiple-perspective mixed-method Living with Breathlessness Study. We purposively sampled 45 HCPs for topic-guided interviews: medical and nursing specialists and generalists from primary and secondary care. Verbatim transcripts analysed with framework approach. National stakeholder workshop (October 2015) will review actionable responses.

Results: Barriers and facilitators to meeting needs exist at operational, professional and patient levels, varying by professional group and setting. Barriers included: the drive of organisational and medical agenda, focus on prognostication and patient categorisation, time constraints, lack of confidence and skills in psychological support and end of life conversations, lack of patient support needs assessment, lack of referable services, service location, managing expectations (commissioners and patients), and non-compliance. Facilitators included: longevity of patient-HCP relationships, listening skills, accessibility and patient expertise. Some HCPs described the facilitative effect of the study interviews for reflection on their clinical practice. Stakeholder views of actionable-responses will be reported.

Conclusion: Actioning stakeholder-endorsed responses to HCP barriers and facilitators to meeting needs could improve care and support of patients and carers living with advanced COPD.
Original languageEnglish
PagesP0277
DOIs
Publication statusPublished - Jun 2016
Event9th World Research Congress of the European Association for Palliative Care - Dublin, Ireland
Duration: 9 Jun 201611 Jun 2016

Conference

Conference9th World Research Congress of the European Association for Palliative Care
Country/TerritoryIreland
Period9/06/1611/06/16

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