title: Interventions to support a palliative care approach in patients with chronic obstructive pulmonary disease: an integrative review.
abstract: BACKGROUND
  End-stage chronic obstructive pulmonary disease (COPD) is a debilitating, life-limiting condition. A palliative approach is appropriate for individuals with end-stage COPD, yet currently few interventions embrace this holistic, multidisciplinary and inclusive perspective.
  
  
  OBJECTIVE
  To describe interventions to support a palliative care approach in patients with end-stage COPD.
  
  
  METHODS
  Integrative review. DATA SOURCES AND REVIEW METHOD: Peer reviewed articles meeting the search criteria were accessed from Medline, PsychINFO, CINAHL and Google Scholar databases as well as Caresearch online resource. The domains of quality palliative care developed by Steinhauser were used as the conceptual framework to synthesise information.
  
  
  RESULTS
  This review has shown that a range of palliative interventions are used to address the needs of individuals with end-stage COPD. Although evidence exists for discrete elements of palliative management in this patient group, there is limited evidence for health service coordination and models that integrate the multiple domains of palliative care with active management.
  
  
  CONCLUSIONS
  Further investigation is required to address the complex personal, provider and system elements associated with managing end-stage COPD. A comprehensive and collaborative approach is required to address the complex and varied needs of individuals with end-stage COPD and their families.
authors.affiliation: University of Technology Sydney, New South Wales, Australia. Disler@uts.edu.au
authors.forename: Rebecca T
authors.initials: RT
authors.lastname: Disler
authors.forename: David C
authors.initials: DC
authors.lastname: Currow
authors.forename: Jane L
authors.initials: JL
authors.lastname: Phillips
authors.forename: Tracy
authors.initials: T
authors.lastname: Smith
authors.forename: Miriam J
authors.initials: MJ
authors.lastname: Johnson
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
mesh_terms: D006801:Humans; D010166:Palliative Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing* / Q000628:therapy