Multi-stakeholder perspectives of palliative care needs in advanced COPD: a qualitative study

Patients with advanced chronic obstructive pulmonary disease(COPD) endure severe physical and psychological suffering, face heavier socioeconomic burdens, and experience long-term unmet needs for palliative care. This study aims to explore the multidimensional needs of patients at an advanced stage of disease, with the goal of developing customised palliative care services tailored to their specific requirements.

Between October 2024 and April 2025, semi-structured interviews were conducted with 38 participants recruited from a tertiary general hospital in Urumqi, Xinjiang Uygur Autonomous Region, China. The participants included patients with advanced COPD, their corresponding family caregivers, and healthcare professionals. Data were analysed using Braun and Clarke's thematic analysis approach.

The analysis revealed that the palliative care needs of patients with advanced COPD arise from a dynamic framework comprising two interrelated dimensions, rather than a simple checklist. The first dimension encompasses two core needs that run throughout a patient's entire life journey: the challenges in maintaining identity and the empowerment and support system requirements. The second dimension is the time-based disease progression pillar, representing 'Needs across the disease trajectory', which encompasses needs during stable periods, acute exacerbations and the end-of-life stage.

The palliative care needs of patients with advanced COPD must be addressed, as they directly impact quality of life and dignity during the final stages of life. Efforts should focus on developing systematic interventions that are culturally appropriate and policy-driven.