Table 1 Description of the palliative care intervention
1. | Symptom management |
- Assessment of symptoms with the Edmonton Symptom Assessment Scale | |
- If intensity of pain, dyspnea, mood, anxiety and appetite >4 and patient agrees: patients will be referred to home based specialist palliative care team or another specialist (dieticians, pulmonologist, psychiatrist…) | |
- Symptom management will follow the palliative care guidelines of the University Hospital of Geneva. | |
- Non pharmacological interventions such as relaxation will be promoted according to Booth [42] | |
2. | Understanding of illness and coping with the disease: |
- History of disease made with the patient | |
- Experience of patient with breathlessness | |
- Information about dyspnea and the disease (discussion and booklet) | |
- Information about morphine if needed (discussion and booklet) | |
3. | Anticipation |
- Values of the patients (what is important for you) | |
- Patient preferences for end-of-life care: hospitalization f.ex | |
- Information about advance directives, nomination of surrogate decision maker (booklet and discussion) | |
4. | Relatives support |
- Identification of the most important relative | |
- Assessment of their needs | |
- Provision of available resources | |
5. | Social support |
- Assessment of needs (financial, administrative.) | |
- Provision of available resources | |
6. | Spiritual support |
- Assessment of needs | |
- Provision of avalables ressources | |
7. | Coordination of the health professionals |
- Listing of the health professionals involved in the situation | |
- Discussion with them of goals of care |