Palliative care historically focuses on cancer patients. It is important to gain more insight into the end-of-life (EoL) care for chronic obstructive pulmonary disease (COPD) patients. The aim of this systematic review was to identify the EoL care needs of patients with advanced COPD. A computerized literature search was performed to identify relevant studies. Papers were obtained from searches of MEDLINE, CINAHL and PubMed databases (timespan: 2001 to November 2010). Studies were included that reported original data on EoL care in patients with advanced COPD. A total of 58 articles were identified in the different databases. 18 studies met the inclusion criteria.
The findings reveal that advanced COPD patients have significantly poorer physical, psycho-spiritual and social functioning. They suffered from multiple complicated symptoms that are usually poorly controlled. They also experienced a high degree of emotional-spiritual distress and social isolation, but these usually managed to inadequately and may even be ignored. They had high levels of information need of the disease process regarding the illness itself, likely future symptoms and their management and information about EoL treatment options. In addition, health care professionals tend to avoid discussion of communication with these patients in order to explore clinical issues and end-of-life care issues. As a result, theses patients' needs in terms of EoL care are unmet. The findings of these studies all call for palliative care will benefit to advanced COPD patients.
Future research should further assess how best to apply the palliative care to COPD patients.
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