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A Mixed Methods Evaluation of a Pilot Multidisciplinary Breathlessness Support Service
Amanda Drury1,2, Julie Goss3, Jide Afolabi3
1School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
A hospice-based Multidisciplinary Breathlessness Support Service (MBSS) is feasible and acceptable for chronic breathlessness. Addressing misconceptions about hospice care and improving service integration are key for sustained reach and effectiveness.
Area of Science:
- Palliative Care
- Respiratory Medicine
- Health Services Research
Background:
- Breathlessness support services improve quality of life but are mainly in hospital/home settings.
- Limited research exists on implementing such services in hospice outpatient environments.
Purpose of the Study:
- To evaluate the adaptation and implementation of a hospice-based Multidisciplinary Breathlessness Support Service (MBSS) in Ireland.
- To understand factors influencing the reach, adoption, implementation, and maintenance of the MBSS.
Main Methods:
- Sequential explanatory mixed methods design.
- Longitudinal questionnaires, medical record audit, and post-discharge interviews with patients (n=10).
- Cross-sectional interviews with caregivers (n=1) and healthcare professionals (n=5). Data integrated deductively using the RE-AIM framework.
Main Results:
- The hospice-based MBSS is feasible and acceptable for individuals with chronic breathlessness.
- Potential threats to sustainability include hospice preconceptions, lack of standardized discharge pathways, and primary care access.
- Integration of mixed methods data illuminated factors influencing MBSS reach, adoption, implementation, and maintenance.
Conclusions:
- An adapted multidisciplinary breathlessness support intervention is feasible and acceptable in a hospice context.
- Addressing misconceptions about hospice settings is crucial for patient referral.
- Improved service integration is needed for consistent referral and discharge processes to ensure optimal reach and maintenance.
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