title: Understanding the challenges of palliative care in everyday clinical practice: an example from a COPD action research project.
abstract: Palliative care seeks to improve the quality of life for patients suffering from the impact of life-limiting illnesses. Palliative care encompasses but is more than end-of-life care, which is defined as care during the final hours/days/weeks of life. Although palliative care policies increasingly require all healthcare professionals to have at least basic or non-specialist skills in palliative care, international evidence suggests there are difficulties in realising such policies. This study reports on an action research project aimed at developing respiratory nursing practice to address the palliative care needs of patients with advanced chronic obstructive pulmonary disease (COPD). The findings suggest that interlevel dynamics at individual, team, interdepartmental and organisational levels are an important factor in the capacity of respiratory nurses to embed non-specialist palliative care in their practice. At best, current efforts to embed palliative care in everyday practice may improve end-of-life care in the final hours/days/weeks of life. However, embedding palliative care in everyday practice requires a more fundamental shift in the organisation of care.
authors.affiliation: School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland.
authors.forename: Geralyn
authors.initials: G
authors.lastname: Hynes
authors.affiliation: Naas General Hospital, Co Kildare, Ireland.
authors.forename: Fiona
authors.initials: F
authors.lastname: Kavanagh
authors.affiliation: Naas General Hospital, Co Kildare, Ireland.
authors.forename: Christine
authors.initials: C
authors.lastname: Hogan
authors.affiliation: Naas General Hospital, Co Kildare, Ireland.
authors.forename: Kitty
authors.initials: K
authors.lastname: Ryan
authors.affiliation: Naas General Hospital, Co Kildare, Ireland.
authors.forename: Linda
authors.initials: L
authors.lastname: Rogers
authors.affiliation: Naas General Hospital, Co Kildare, Ireland.
authors.forename: Jenny
authors.initials: J
authors.lastname: Brosnan
authors.affiliation: School of Business, Trinity College Dublin, Dublin 2, Ireland.
authors.forename: David
authors.initials: D
authors.lastname: Coghlan
mesh_terms: D000368:Aged; D006302:Health Services Research; D006801:Humans; D008875:Middle Aged; D009732:Nursing Care / Q000523:psychology; D015279:Organizational Culture; D010166:Palliative Care / Q000379:methods* / Q000523:psychology; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing*; D011788:Quality of Life; D013727:Terminal Care / Q000379:methods
keywords: action research; acute care; palliative care; practice development; respiratory nursing