Palliative Care, Medicine and Hospice Nursing

Biography

Biography: Naouma Siouta

Abstract

Challenges concerning the design and implementation of Palliative Care (PC) studies have been published for cancer but remain unknown for chronic disease. This study reports the difficulties faced during a PC study for patients with Chronic Heart Failure (CHF) and Chronic Obstructive Pulmonary Disease (COPD) in the University Hospital of Leuven. A before and after intervention study was performed in cardiology and pulmonology wards to investigate if the quality of life, the symptom control, the quality of care and the levels of PC integration would improve after the implementation of an Early Integrated PC intervention. Eligible patients were asked to complete the Can Help Lite Questionnaire, the POS Questionnaire and an ad-hoc questionnaire for integration of PC. Patients and their informal caregiver completed the questionnaires at the inclusion moment and after three months. Significant challenges were faced with recruitment that doubled the duration of the pre-intervention phase and led to changes in the recruitment process. The majority of eligible patients refused to participate due to physical/emotional symptoms. Some of the healthcare providers were skeptical and reluctant towards the researcher that was not a member of the treating team and the overall theme of the research. Their standard work overload may have been another adverse factor. The recruitment of PC patients for empirical PC studies in both cancer and chronic disease remains a challenging issue. In the long run, the mentality of health-care personnel towards PC should change. In the meantime, we recommend that recruitment timelines should be longer than what is usually estimated in order to avoid shortcomings, as well as time-schedule and budgetary revisions. It is also possible that being a member of the treatment team may alleviate the challenges observed.