• Rebecca T Disler, David C Currow, Jane L Phillips, Tracy Smith, Miriam J Johnson, and Patricia M Davidson.
• University of Technology Sydney, New South Wales, Australia. Disler@uts.edu.au
• Int J Nurs Stud. 2012 Nov 1;49(11):1443-58.

BackgroundEnd-stage chronic obstructive pulmonary disease (COPD) is a debilitating, life-limiting condition. A palliative approach is appropriate for individuals with end-stage COPD, yet currently few interventions embrace this holistic, multidisciplinary and inclusive perspective.ObjectiveTo describe interventions to support a palliative care approach in patients with end-stage COPD.DesignIntegrative review. DATA SOURCES AND REVIEW METHOD: Peer reviewed articles meeting the search criteria were accessed from Medline, PsychINFO, CINAHL and Google Scholar databases as well as Caresearch online resource. The domains of quality palliative care developed by Steinhauser were used as the conceptual framework to synthesise information.ResultsThis review has shown that a range of palliative interventions are used to address the needs of individuals with end-stage COPD. Although evidence exists for discrete elements of palliative management in this patient group, there is limited evidence for health service coordination and models that integrate the multiple domains of palliative care with active management.ConclusionFurther investigation is required to address the complex personal, provider and system elements associated with managing end-stage COPD. A comprehensive and collaborative approach is required to address the complex and varied needs of individuals with end-stage COPD and their families.Copyright © 2012 Elsevier Ltd. All rights reserved.

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