Primary palliative care recommendations for critical care clinicians

Ito, Kaori; George, Naomi; Wilson, Jennifer G.; Bowman, Jason; Aaronson, Emily; Ouchi, Kei

doi:10.1186/s40560-022-00612-9

Cited by 21 publications

(14 citation statements)

References 72 publications

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“…26 The review has focused on the critical care setting because most patients in this setting would benefit from palliative care. 27 Health literacy articles that were included were those that measured the health literacy of a surrogate decision-maker by an instrument. In addition, articles that were included were those that explored health care communication during palliative care conversations.…”

Section: Methodsmentioning

confidence: 99%

“…Critical care has been defined as a unit dedicated to the medical and nursing management of patients who have or are at risk of life-threatening organ dysfunction 26 . The review has focused on the critical care setting because most patients in this setting would benefit from palliative care 27 . Health literacy articles that were included were those that measured the health literacy of a surrogate decision-maker by an instrument.…”

Section: Methodsmentioning

confidence: 99%

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Health Literacy of Surrogates and Communication Issues in Palliative Care Conversations in Critical Care

Baltazar

Popejoy

2022

J Hosp Palliat Nurs

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Worldwide, 56.8 million persons are estimated to require palliative care. Critically ill patients benefit from palliative care by improving their quality of life through symptom management. Resistance to palliative care exists from surrogate decision-makers because of low health literacy and communication issues with providers. This research reviewed the literature to identify how health literacy and health care communication influenced palliative care conversations with decision-making surrogates and health outcomes of critically ill patients. The review included articles between 2011 and 2022 using the terms communication, health literacy, palliative care, critical care, intensive care, ICU, surrogate decision maker, family, and caregiver in PubMed, CINAHL, and Google Scholar. Fourteen articles were included. Quality was assessed through Joanna Briggs Institute appraisal tools. Health literacy of surrogates was not found to be significant for patient outcomes. However, there were significant differences between clinician and surrogate communication influenced by surrogates' previous health care experiences. Early communication about prognosis was important for surrogates. Structured communication approaches were preferred by surrogates. Limitations of the review included primarily White participants, small variability of research sites, and a few number of articles. Future research needs to study the effects of surrogate health literacy of critically ill patients on willingness to accept palliative care.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Health Literacy of Surrogates and Communication Issues in Palliative Care Conversations in Critical Care

Baltazar

Popejoy

2022

J Hosp Palliat Nurs

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“…As a clinical field that emerged in the 1990s, palliative care is defined by the World Health Organization (WHO) as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through prevention and relief of suffering by means of early identification, impeccable assessment, and treatment of pain and other problems: physical, psychological and spiritual" [2]. Up to 75% of patients admitted to the intensive care units (ICUs) experience distressful symptoms [3]. The critical feature of the disease, the invasive treatments and the uncertainty of prognosis make the ICU a "hell" for critically ill patients and their families.…”

Section: Introductionmentioning

confidence: 99%

“…The concept, principles and methods of palliative treatment have been gradually introducing into ICU clinical practice. The importance of providing palliative care in the ICU is well recognized by various studies to alleviate physical symptoms, to set patient-centered goals of care, and to provide end-of-life care [3]. Currently, about 10% to 30% of the dead patients in the world die in ICU [4].…”

Section: Introductionmentioning

confidence: 99%

Palliative Care in the Intensive Care Unit: Not Just End-of-life Care

et al. 2022

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Initially, palliative care in the intensive care unit (ICU) was designed to improve hospice care. Today it has emerged as a core component of ICU care. ICU palliative care should follow the ethical principles of autonomy, beneficence, nonmaleficence, justice and fidelity. To integrate primary palliative care and professional palliative care into ICU care management, there are different modes: integrative, consultative, and a combined approach. All ICU patients should receive palliative care which includes symptom management and shared decision-making. Further research is needed to explore how to provide the best palliative care for ICU patients and their families.

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“…The provision of PC has shown many benefits including improved quality of life and reduced hospital admission and hospital stays [2]. Due to its benefits, the provision of PC is encouraged to be integrated into a health system, including in the intensive care unit (ICU) [3][4][5]. The provision of PC in the ICU is increasing, and all patients admitted to ICU should receive PC, which includes symptom management, patient-centered care, and shared-decision making [1,6,7].…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators in the provision of palliative care in adult intensive care units: a scoping review

et al. 2022

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The provision of palliative care in the intensive care unit (ICU) is increasing. While some scholars have suggested the goals of palliative care to not be aligned with the ICU, some evidence show benefits of the integration. This review aimed to explore and synthesize research that identified barriers and facilitators in the provision of palliative care in the ICU. This review utilized Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review guidelines based on population, concept, and context. We searched for eligible studies in five electronic databases (Scopus, PubMed, ProQuest, Science Direct, and Sage) and included studies on the provision of palliative care (concept) in the ICU (context) that were published in English between 2005–2021. We describe the provision of palliative care in terms of barriers and facilitators. We also describe the study design and context. A total of 14 papers was included. Several barriers and facilitators in providing palliative care in the ICU were identified and include lack of capabilities, family boundaries, practical issues, cultural differences. Facilitators of the provision of palliative care in an ICU include greater experience and supportive behaviors, i.e., collaborations between health care professionals. This scoping review demonstrates the breadth of barriers and facilitators of palliative care in the ICU. Hospital management can consider findings of the current review to better integrate palliative care in the ICU.

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Primary palliative care recommendations for critical care clinicians

Cited by 21 publications

References 72 publications

Health Literacy of Surrogates and Communication Issues in Palliative Care Conversations in Critical Care

Health Literacy of Surrogates and Communication Issues in Palliative Care Conversations in Critical Care

Palliative Care in the Intensive Care Unit: Not Just End-of-life Care

Barriers and facilitators in the provision of palliative care in adult intensive care units: a scoping review

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