Course of Treatment for Patients with Chronic Obstructive Pulmonary Disease (COPD) at the End of Life and the Support of Visiting Nurses

Abstract

The purpose of this study was to clarify the course of treatment for patients with chronic obstructive pulmonary disease COPD in the terminal stage and examine the support provided by visiting nurses. The participants were eight visiting nurses who had experience caring for patients with end-stage COPD. The mean length of experience as a visiting nurse was 13.8 years (SD±4.8). The collected data were analyzed both qualitatively and descriptively. The results indicated that the support provided by visiting nurses could be categorized into “support that has been continuously provided from the stable period” and “support that is provided in anticipation of progression to the end stage.” From the former, the following four categories were extracted: repeatedly communicating preventive measures for acute exacerbation as well as signs thereof, incorporating the correct methods of using home-based oxygen therapy in the patient’s everyday life, maintaining respiratory function by continuing pulmonary rehabilitation, and providing the patient with support for self-care in maintaining their everyday life. Regarding the latter aspect, the following four categories were extracted: preventing exacerbation of respiratory distress by increasing the number of home visits, collaborating with the visiting nursing team and physicians to help the patient maintain their emotional stability, maintaining the patient’s hope through to the end of their life, and achieving the provision of end-of-life care as requested by the patient.