Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/115365
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Type: Journal article
Title: A conceptual model: Redesigning how we provide palliative care for patients with chronic obstructive pulmonary disease
Author: Philip, J.
Crawford, G.
Brand, C.
Gold, M.
Miller, B.
Hudson, P.
Smallwood, N.
Lau, R.
Sundararajan, V.
Citation: Palliative and Supportive Care, 2018; 16(4):452-460
Publisher: Cambridge University Press
Issue Date: 2018
ISSN: 1478-9515
1478-9523
Statement of
Responsibility: 
Jennifer Philip, Gregory Crawford, Caroline Brand, Michelle Gold, Belinda Miller, Peter Hudson, Natasha Smallwood, Rosalind Lau and Vijaya Sundararajan
Abstract: Background: Despite significant needs, patients with chronic obstructive pulmonary disease (COPD) make limited use of palliative care, in part because the current models of palliative care do not address their key concerns. Ojective: Our aim was to develop a tailored model of palliative care for patients with COPD and their family caregivers. Method: Based on information gathered within a program of studies (qualitative research exploring experiences, a cohort study examining service use), an expert advisory committee evaluated and integrated data, developed responses, formulated principles to inform care, and made recommendations for practice. The informing studies were conducted in two Australian states: Victoria and South Australia. Results: A series of principles underpinning the model were developed, including that it must be: (1) focused on patient and caregiver; (2) equitable, enabling access to components of palliative care for a group with significant needs; (3) accessible; and (4) less resource-intensive than expansion of usual palliative care service delivery. The recommended conceptual model was to have the following features: (a) entry to palliative care occurs routinely triggered by clinical transitions in care; (b) care is embedded in routine ambulatory respiratory care, ensuring that it is regarded as "usual" care by patients and clinicians alike; (c) the tasks include screening for physical and psychological symptoms, social and community support, provision of information, and discussions around goals and preferences for care; and (d) transition to usual palliative care services is facilitated as the patient nears death. Significance of results: Our proposed innovative and conceptual model for provision of palliative care requires future formal testing using rigorous mixed-methods approaches to determine if theoretical propositions translate into effectiveness, feasibility, and benefits (including economic benefits). There is reason to consider adaptation of the model for the palliative care of patients with other nonmalignant conditions.
Keywords: Chronic obstructive pulmonary disease
Integrated care
Models of care
Palliative care
Rights: © Cambridge University Press 2017
DOI: 10.1017/S147895151700044X
Grant ID: NHMRC
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