Making Palliative Care Work in Chronic Respiratory Diseases : A Nurse-Led Model

Article Article scientifique Revue de la littérature Making Palliative Care Work in Chronic Respiratory Diseases : A Nurse-Led Model eng 2026-09-03 author Guerreiro Ivan Pneumology Division, Geneva University Hospitals. Electronic address: Ivan.guerreiro@hug.ch. 631408 author Matis Caroline Palliative Medicine Division, Geneva University Hospitals; University of Geneva, Faculty of Medicine, Geneva, Switzerland. 705461 author Fusi-Schmidhauser Tanja 0000-0002-6270-1035 University of Geneva, Faculty of Medicine, Geneva, Switzerland; Palliative and Supportive Care Clinic, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Department of Internal Medicine, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland; Department of Rehabilitation and Geriatrics, University of Geneva, Switzerland. 915491 dept de réadaptation et gériatrie (MIGRG) author Lounnas Samia UNAIDS, United Nation Office, Geneva, Switzerland. author Baptista Peixoto Befecadu Filipa Alexandra Research and Implementation Fellow, Research and Implementation Care Lab, Care Directorate, Geneva University Hospitals, Geneva, Switzerland. 444442 author Berra Gregory Pneumology Division, Geneva University Hospitals. 596274 author Bergeron Anne Pneumology Division, Geneva University Hospitals; University of Geneva, Faculty of Medicine, Geneva, Switzerland. 981702 Département de médecine (DEMED) author Pautex Sophie Marie Palliative Medicine Division, Geneva University Hospitals; University of Geneva, Faculty of Medicine, Geneva, Switzerland. 37604 dept de réadaptation et gériatrie (MIGRG) author Hentsch Lisa Palliative Medicine Division, Geneva University Hospitals; University of Geneva, Faculty of Medicine, Geneva, Switzerland. 594583 10.1016/j.chest.2026.08.040 42692287 0012-3692 https://www.sciencedirect.com/science/article/pii/S0012369226065402 Palliative care (PC) is defined as a holistic, multidisciplinary, person-centered approach aimed at relieving symptoms and improving quality of life (QoL) for individuals with serious health-related disease. Although recommended by major respiratory societies, patients with advanced chronic respiratory diseases (CRD) continue to have insufficient access to PC, often limited to end-of-life (EoL) care. Compared with patients with lung cancer, patients with CRD experience greater symptom burden, are less informed about their illness, and are less involved in decision-making. Early PC has been shown to improve QoL, reduce depression, decrease avoidable hospitalizations, and support better EoL trajectories. To improve PC providing for patients living with CRD, an interdisciplinary, nurse-led, outpatient PC consultation model was developed and iteratively refined guided by the Plan-Do-Study-Act cycle, as an implementation framework. Patients are referred to the consultation based on symptom burden, decline in respiratory status, frailty, need for discussion on treatment choice, or caregiver strain. During the initial consultation, a PC physician and nurse explore patient and caregiver perceptions of PC, provide information about the aim of this service, and conduct a comprehensive symptom assessment. Follow-up is primarily coordinated by the specialist PC nurse, who ensures symptom evaluation, care coordination, and knowledge on pharmacological and non-pharmacological interventions. Integrative therapies such as hypnosis, reflexology, and Touch-Massage® are also offered, along with discussions around advance care planning when desired. Early, needs-based PC can be effectively integrated into CRD trajectories when delivered through a nurse-led interdisciplinary model of coordination. Chronic respiratory disease Non-pharmacological intervention Nurse-led interventions Palliative care Pneumology Dewey 616 Dewey 618.97 65 Département de réadaptation et gériatrie 22B 56 Département de médecine 221 false 436 Médecine palliative 709 1430 Maladies interstitielles et de l'immunodéprimé 1057 Chest 92fdd12e-b628-482e-821e-18182a9bb652 Article (Published version) Public CHEST_pre-proof_LH_2026.pdf 4336310 application/pdf CC BY-4.0 7a158018670a6138932589793e84d7aac060070b0db67300dcd26bebd839eba2 openAccess Faculté de médecine / Section de médecine clinique / Département de réadaptation et gériatrie Faculté de médecine / Section de médecine clinique / Département de médecine

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Baptista Peixoto Befecadu, Filipa Alexandra