District nurse interaction in engaging with end-stage chronic obstructive pulmonary disease patients: a mixed methods study

Publisher:
Blackwell Publishing Ltd
Publication Type:
Journal Article
Citation:
Journal of Nursing and Healthcare of Chronic Illness, 2010, 2 pp. 302 - 312
Issue Date:
2010-01
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Aims and objectives. To explore the role of district nurses in caring for people with end-stage chronic obstructive pulmonary disease living in metropolitan London. Background. People with chronic obstructive pulmonary disease experience high symptom burden in their final stages of life. While the majority of end-stage chronic obstructive pulmonary disease patients symptoms are markedly similar to any end-stage chronic illness, these patients have limited access to supportive community services, such as district nursing. District nurses have an established role in end-of-life care in the community, however, this care has mainly focused on patients with terminal malignancy. It is unclear why district nurses established skills in end-of-life care not are not applied to this high needs patient group. Methods. A mixed-method design incorporating face-to-face interviews and mailed survey was chosen to gain a coherent understanding of the perceptions of district nurses in metropolitan London. Forty-three district nurses participated in this mixed method study in 2008. Conclusions. District nurses were found to lack confidence in their own knowledge about, and in their ability to interact with end-stage chronic obstructive pulmonary disease patients. While district nurses did interact with these patients, this was limited to tasks unrelated to chronic obstructive pulmonary disease. Referrers appeared to misunderstand the district nurse role in end-stage care and therefore its application to the care of end-stage chronic obstructive pulmonary disease patients
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