Table 1 Potential barriers of discussing the prognosis end-stage of COPD [22-24]

1) Unwillingness to discuss end of life care

2) Lack of communication (not sure which doctor will be taking care of me)

3) Ignoring not to discuss the issue

4) Lack of knowledge what type of care available

5) Loss of hope

1) Lack of confidence (ill-prepared to discuss the issue adequately)

2) Lack of time in busy surgery (increasing workload)

3) Uncertain about the information to provide about the prognosis in advance COPD

4) Lack of patient education about the end stage of COPD

5) Not in the priority list

6) Lack of resources and facilities