First year experiences with a palliative out-patients structure for patients with COPD: a qualitative study of health professionals' expectations and experiences

Dorthe Gaby Bove, Marie Lavesen, Maria Omel Jellington, Kristoffer Bastrup-Madsen Marsaa, Suzanne Forsyth Herling

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: To improve the care of patients with advanced COPD and be able to address their palliative needs a new outpatient organization (CAPTAIN) was developed and implemented. CAPTAIN was inspired by best practice and existing guidelines and changed the traditional organization of an outpatient structure including the roles of nurses and doctors. Only sparse knowledge exists of the health professionals' expectations and experiences to organizational changes in an outpatient setting. This insight is necessary as health professionals are key stakeholders in implementing new structures and successfully transforming knowledge into practice. The aim of this study was to explore the health professionals' expectations and experiences of a new palliative out-patients structure for patients with advanced COPD.

METHODS: The design was interpretive description as described by Thorne. Focus groups and individual interviews were conducted with pulmonary nurses, pulmonary doctors and municipality nurses from 2014 to 2016.

RESULTS: The overall theme was dualism. Both nurses and doctors were pending between aspiration and concern in their expectations to the new structure, meanwhile their actual experiences were pending between perceived gain and improvements versus consequences with the new structure. Nurses' and doctors' existing practice was altered and the new structure required new ways for them to cooperate and ways in which skills from each profession were most efficiently utilized.

CONCLUSION: Nurses and doctors considered the new structure as a quality boost and it fulfilled their hope of improving the quality of care offered to patients with advanced COPD, however with increased work-related stress as a derived consequence.

Original languageEnglish
Article number113
JournalBMC Palliative Care
Volume17
Issue number1
ISSN1472-684X
DOIs
Publication statusPublished - 8. Oct 2018
Externally publishedYes

Keywords

  • Adult
  • Ambulatory Care/economics
  • Attitude of Health Personnel
  • Denmark
  • Disease Progression
  • Female
  • Health Care Rationing
  • Humans
  • Interdisciplinary Communication
  • Male
  • Nurses/psychology
  • Organizational Innovation
  • Palliative Care/organization & administration
  • Physicians/psychology
  • Pulmonary Disease, Chronic Obstructive/physiopathology
  • Qualitative Research
  • Quality Improvement
  • Terminal Care/ethics

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