Dataset Information

GP discussion of prognosis with patients with severe chronic obstructive pulmonary disease: a qualitative study.

ABSTRACT:

Background

Recent research shows that health professionals do not communicate about prognosis with patients with chronic obstructive pulmonary disease (COPD) as openly as with patients who have cancer.

Aim

To identify strategies that general practitioners (GPs) can use to facilitate discussion of prognosis with patients who have COPD.

Design of study

Telephone interviews of 15 GPs and five respiratory consultants on the topic of discussing prognosis with patients who have severe COPD.

Setting

Participating doctors worked in the Auckland region of New Zealand.

Method

GPs and consultants were selected purposively to detect unique and shared patterns from diversity in how prognosis is discussed with patients with severe COPD. An interview guide was developed from a literature review and results of our earlier postal survey of GPs. Transcripts of audiotaped interviews were analysed independently and then together by three authors, using a general inductive approach.

Results

Seven strategies were identified that GPs had used or could use to facilitate discussion of prognosis with patients with COPD. These were: be aware of implications of diagnosis; use uncertainty to ease discussion; build relationship with patients; be caring and respectful; begin discussion early in disease course; identify and use opportunities to discuss prognosis; and work as a team.

Conclusion

A number of suggested strategies can be used to facilitate discussion of prognosis with patients who have severe COPD.

SUBMITTER: Halliwell J

PROVIDER: S-EPMC1326107 | biostudies-literature | 2004 Dec

REPOSITORIES: biostudies-literature

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Publications

GP discussion of prognosis with patients with severe chronic obstructive pulmonary disease: a qualitative study.

Halliwell Joan J Mulcahy Patrick P Buetow Stephen S Bray Yvonne Y Coster Gregor G Osman Liesl M LM

The British journal of general practice : the journal of the Royal College of General Practitioners 20041201 509

<h4>Background</h4>Recent research shows that health professionals do not communicate about prognosis with patients with chronic obstructive pulmonary disease (COPD) as openly as with patients who have cancer.<h4>Aim</h4>To identify strategies that general practitioners (GPs) can use to facilitate discussion of prognosis with patients who have COPD.<h4>Design of study</h4>Telephone interviews of 15 GPs and five respiratory consultants on the topic of discussing prognosis with patients who have s ...[more]

PMID: 15588534

Similar Datasets

Project description:ObjectivesTo understand the perspectives of people with severe chronic obstructive pulmonary disease (COPD) as their illness progresses, and of their informal and professional carers, to inform provision of care for people living and dying with COPD.DesignUp to four serial qualitative interviews were conducted with each patient and nominated carer over 18 months. Interviews were transcribed and analysed both thematically and as narratives.Participants21 patients, and 13 informal carers (a family member, friend, or neighbour) and 18 professional carers (a key health or social care professional) nominated by the patients.SettingPrimary and secondary care in Lothian, Tayside, and Forth Valley, Scotland, during 2007-9.ResultsEleven patients died during the study period. Our final dataset comprised 92 interviews (23 conducted with patient and informal carer together). Severe symptoms that caused major disruption to normal life were described, often in terms implying acceptance of the situation as a "way of life" rather than an "illness." Patients and their informal carers adapted to and accepted the debilitating symptoms of a lifelong condition. Professional carers' familiarity with the patients' condition, typically over many years, and prognostic uncertainty contributed to the difficulty of recognising and actively managing end stage disease. Overall, patients told a "chaos narrative" of their illness that was indistinguishable from their life story, with no clear beginning and an unanticipated end described in terms comparable with attitudes to death in a normal elderly population.ConclusionsOur findings challenge current assumptions underpinning provision of end of life care for people with COPD. The policy focus on identifying a time point for transition to palliative care has little resonance for people with COPD or their clinicians and is counter productive if it distracts from early phased introduction of supportive care. Careful assessment of possible supportive and palliative care needs should be triggered at key disease milestones along a lifetime journey with COPD, in particular after hospital admission for an exacerbation.

Dataset Information

GP discussion of prognosis with patients with severe chronic obstructive pulmonary disease: a qualitative study.

Background

Aim

Design of study

Setting

Method

Results

Conclusion

Publications

GP discussion of prognosis with patients with severe chronic obstructive pulmonary disease: a qualitative study.

Similar Datasets

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