{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T19:16:20Z","timestamp":1792264580367,"version":"4.4.0"},"reference-count":54,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100024749","name":"National Institute for Health Research Applied Research Collaboration East of England","doi-asserted-by":"publisher","award":["GRU 16\/136\/54"],"award-info":[{"award-number":["GRU 16\/136\/54"]}],"id":[{"id":"10.13039\/501100024749","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat&amp;#65533;Care"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The majority of deaths from chronic obstructive pulmonary disease (COPD) occur in low- and middle-income countries. Primary palliative care is commonly proposed as the best model to ensure access to appropriate care. However, the existing evidence on needs, models and outcomes comes from high-income settings. The purpose of the study was to determine the experiences of adults with COPD attending primary care, their informal caregivers and healthcare professionals to identify current care provided and gaps in this care in primary care settings in South Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Cross-sectional qualitative interview study collected in-depth data from three stakeholder groups: adults with COPD attending one of five primary care settings, informal carers of patients and healthcare professionals. The cross-national research team developed a coding frame through inductive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study participants comprised 22 COPD patients, 19 family caregivers and 22 healthcare professionals. Four main themes emerged. (1) Importance of communication to quality primary palliative care, with poor health literacy regarding the diagnosis and its progression. (2) Symptoms and concerns among patients and caregivers, with multidimensional impact on social participation, poverty and family mental health. (3) The role of health systems in promoting quality primary palliative care, with unreliable drug supply, the need for rapid access pathways during exacerbations and continuity of care from the acute sector through primary care into the home. (4) Patient preferences and agency, with patients favouring holistic assessment, self-management and adequate information and consultation to participate in decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Palliative care health literacy for COPD patients, families and staff attending primary settings may ensure well-planned continuous care, symptom management and support care at home.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26323524251390910","type":"journal-article","created":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T03:51:01Z","timestamp":1761969061000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["A qualitative study of the palliative care needs of primary care patients with COPD: Experiences of COPD patients, their families and healthcare professionals"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7602-6168","authenticated-orcid":false,"given":"Liz","family":"Gwyther","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, University of Cape Town, South Africa"},{"name":"Division of Interdisciplinary Palliative Care and Medicine, University of Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1997-429X","authenticated-orcid":false,"given":"Lindsay","family":"Farrant","sequence":"additional","affiliation":[{"name":"Division of Interdisciplinary Palliative Care and Medicine, University of Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy","family":"Hunter","sequence":"additional","affiliation":[{"name":"Division of Interdisciplinary Palliative Care and Medicine, University of Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olona","family":"Mzimkulu","sequence":"additional","affiliation":[{"name":"Division of Interdisciplinary Palliative Care and Medicine, University of Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2991-8160","authenticated-orcid":false,"given":"Kennedy","family":"Nkhoma","sequence":"additional","affiliation":[{"name":"Florence Nightingale Faculty of Nursing Midwifery &amp; Palliative Care, Cicely Saunders Institute, Kings College London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9653-8689","authenticated-orcid":false,"given":"Richard","family":"Harding","sequence":"additional","affiliation":[{"name":"Florence Nightingale Faculty of Nursing Midwifery &amp; Palliative Care, Cicely Saunders Institute, Kings College London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00685-8"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61853-3"},{"key":"e_1_3_3_4_2","volume-title":"Burden of Disease Study 2019 (GBD 2019) Results","author":"Global Burden of Disease Collaboration Network","year":"2019","unstructured":"Global Burden of Disease Collaboration Network. Burden of Disease Study 2019 (GBD 2019) Results. Institute for Health Metrics and Evaluation (IHME), 2019."},{"key":"e_1_3_3_5_2","unstructured":"World Health Organisation. Chronic obstructive pulmonary disease (COPD) Fact Sheet 2024. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/chronic-obstructive-pulmonary-disease-(copd). Accessed 8 March 2025."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.10.65"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2011-201518"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.04.007"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0000000000000303"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2013.11.009"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S395834"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2011.11.012"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJnew.8421"},{"issue":"1","key":"e_1_3_3_14_2","first-page":"17","article-title":"Epidemiology and challenges of managing COPD in sub-Saharan Africa","volume":"2","author":"Magitta F.","year":"2018","unstructured":"Magitta F. Epidemiology and challenges of managing COPD in sub-Saharan Africa. Acta Sci Med Sci 2018; 2(1): 17\u201323.","journal-title":"Acta Sci Med Sci"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2011.11.005"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJnew.8424"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(18)30060-2"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61303-9"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-1253"},{"key":"e_1_3_3_20_2","author":"Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease (2024 report)","year":"2024","unstructured":"Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease (2024 report). Global Initiative for Chronic Obstructive Lung Disease, Inc. 2024.","journal-title":"Global Initiative for Chronic Obstructive Lung Disease, Inc"},{"issue":"4","key":"e_1_3_3_21_2","first-page":"435","article-title":"Diagnosis of airway obstruction in primary care in the UK: the CADRE (COPD and Asthma Diagnostic\/management REassessment) programme 1997\u20132001","volume":"1","author":"Pearson M","year":"2006","unstructured":"Pearson M, Ayres JG, Sarno M, et al. Diagnosis of airway obstruction in primary care in the UK: the CADRE (COPD and Asthma Diagnostic\/management REassessment) programme 1997\u20132001. Int J Chron Obstruct Pulmon Dis 2006; 1(4): 435\u2013443.","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.091784"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S449659"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-9-50"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1038\/npjpcrm.2016.36"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.3132\/pcrj.2009.00009"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-8-143"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2014.01.004"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-463"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163241248324"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(14)70226-7"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32127-X"},{"key":"e_1_3_3_33_2","volume-title":"Integrating palliative care and symptom relief into primary health care: a WHO guide for planners, implementers and managers","author":"World Health Organization","year":"2018","unstructured":"World Health Organization. Integrating palliative care and symptom relief into primary health care: a WHO guide for planners, implementers and managers. Geneva: World Health Organisation, 2018."},{"key":"e_1_3_3_34_2","unstructured":"Department of Health Republic of South Africa 2017. https:\/\/www.health.gov.za\/wp-content\/uploads\/2020\/11\/NationalPolicyFrameworkandStrategyonPalliativeCare20172022.pdf (accessed 20 July 2025)."},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2021.1987044"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-048742"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1179\/1743291X13Y.0000000056"},{"key":"e_1_3_3_39_2","article-title":"A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance","volume":"374","author":"Skivington K","year":"2021","unstructured":"Skivington K, Matthews L, Simpson SA, et al. A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance. BMJ 2021; 374: n2061.","journal-title":"BMJ"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.3402\/qhw.v9.26152"},{"issue":"1","key":"e_1_3_3_42_2","first-page":"111","article-title":"The ideal clinic in South Africa: progress and challenges in implementation","volume":"2017","author":"Hunter JR","year":"2017","unstructured":"Hunter JR, Chandran TM, Asmall S, et al. The ideal clinic in South Africa: progress and challenges in implementation. S Afr Health Rev 2017; 2017(1): 111\u2013123.","journal-title":"S Afr Health Rev"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00010104"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S215859"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2018-211589"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S160982"},{"key":"e_1_3_3_47_2","first-page":"271","article-title":"Primary care physician perceptions on the diagnosis and management of chronic obstructive pulmonary disease in diverse regions of the world","volume":"7","author":"Aisanov Z","year":"2012","unstructured":"Aisanov Z, Bai C, Bauerle O, et al. Primary care physician perceptions on the diagnosis and management of chronic obstructive pulmonary disease in diverse regions of the world. Int J Chron Obstruct Pulmon Dis 2012; 7: 271\u2013282.","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1080\/15412555.2020.1824217"},{"issue":"5","key":"e_1_3_3_49_2","article-title":"Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care","volume":"2022","author":"Cross AJ","year":"2022","unstructured":"Cross AJ, Cross AJ, Liang J, et al. Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care. Cochrane Database Syst Rev 2022; 2022(5): CD012652.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-003330"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-054386"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2022-008843"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2013.0051"},{"key":"e_1_3_3_54_2","first-page":"1002","article-title":"Exercise and pulmonary rehabilitation for people with chronic lung disease in LMICs: challenges and opportunities","volume":"7","author":"Singh SJ","year":"2019","unstructured":"Singh SJ, Halpin DMG, Salvi S, et al. Exercise and pulmonary rehabilitation for people with chronic lung disease in LMICs: challenges and opportunities. Lancet 2019; 7: 1002\u20131004.","journal-title":"Lancet"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5838"}],"container-title":["Palliative Care and Social Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26323524251390910","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/26323524251390910","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26323524251390910","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:04:05Z","timestamp":1777597445000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/26323524251390910"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":54,"alternative-id":["10.1177\/26323524251390910"],"URL":"https:\/\/doi.org\/10.1177\/26323524251390910","relation":{},"ISSN":["2632-3524","2632-3524"],"issn-type":[{"value":"2632-3524","type":"print"},{"value":"2632-3524","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"article-number":"26323524251390910"}}