title: An end-of-life care nurse service for people with COPD and heart failure: stakeholders' experiences.
abstract: BACKGROUND
  End-of-life care (EOLC) has historically been associated with cancer care. However, demographic changes indicate that future provision must also cater for other long term conditions (LTC). An EOLC-LTC service, delivered by palliative care nurses, is currently being piloted in one area in the East Midlands with patients with cardiac and respiratory disease. In order to inform future commissioning, it is important to gain the views and experiences of those involved with the service.
  
  
  OBJECTIVE
  This study aimed to explore patients, and their partners, views and experiences of the EOLC-LTC service.
  
  
  METHODS
  Semi-structured interviews were used as part of a case study design, involving six cases. Each case consisted of the patient, their nominated family member/carer and key healthcare professionals involved in their care as identified by the patient. This paper reports on the findings from the interviews conducted with the six patients and their family member/carers. Data were analysed thematically.
  
  
  RESULTS
  From the interviews, the following themes were identified: experiences managing a long term cardio-respiratory condition, the nurse service, building a close/therapeutic relationship and fragmentation and integration.
  
  
  CONCLUSIONS
  This study has shown that the EOLC-LTC service is welcomed and highly regarded by patients and their family members/carers. Further studies are required to explore the views and experiences of other key stakeholders and to evaluate how well the pilot operates within the wider care pathway.
authors.affiliation: Florence Nightingale Foundation Professor of Clinical Nursing Practice Research, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow.
authors.forename: Bridget
authors.initials: B
authors.lastname: Johnston
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Coole
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham.
authors.forename: Melanie
authors.initials: M
authors.lastname: Jay Narayanasamy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D004739:England; D005260:Female; D058005:General Practitioners; D006333:Heart Failure / Q000451:nursing*; D064946:Hospice and Palliative Care Nursing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009726:Nurses; D064691:Nurses, Community Health; D009739:Nursing Services; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing*; D036301:Qualitative Research; D018454:Spouses; D013727:Terminal Care; D006113:United Kingdom
keywords: COPD; End-of-life care; Evaluation; Heart failure