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Feasibility study protocol: implementing consultation-based high-quality palliative care services in intensive care

Ye Sul Jeung1, Yejin Kim1, Seyeon Kim1

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This study explores integrating palliative care into South Korean intensive care units (ICUs) to reduce patient and family suffering. Findings will inform future critical care palliative support.

Keywords:
Decision MakingIntensive Care UnitsPALLIATIVE CARE

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Area of Science:

  • Critical Care Medicine
  • Palliative Care
  • Health Services Research

Background:

  • Critically ill patients in intensive care units (ICUs) experience significant suffering, often compounded by the lack of integrated palliative care.
  • Palliative care support is crucial for alleviating suffering in patients and families but is not yet standard in South Korean ICUs.
  • This highlights a need to assess the feasibility of implementing palliative care within the ICU setting.

Purpose of the Study:

  • To test the feasibility of a consultation-based palliative care intervention in the ICU.
  • To evaluate the potential impact of palliative care on surrogate decision-making, patient/family-centered care, and psychological outcomes.
  • To assess the demand and acceptability of this intervention among family surrogates.

Main Methods:

  • A consultation-based palliative care intervention was implemented in an ICU for 20 patients with severe acute brain injury or organ failure.
  • A palliative care team provided consultations to ICU staff, counselled families, and conducted additional meetings as needed.
  • Outcomes included participation and completion rates, changes in surrogate decision-making conflict, self-efficacy, depression, anxiety, regret, and patient/family-centered care experiences, assessed via interviews.

Main Results:

  • Primary outcomes (participation, counselling, completion rates) will be reported.
  • The intervention's impact on surrogate decision-making conflict, self-efficacy, depression, anxiety, and post-decision regret will be assessed.
  • Qualitative analysis of semi-structured interviews will determine the intervention's demand and acceptability.

Conclusions:

  • The study will provide crucial data on the feasibility and acceptability of integrating palliative care into South Korean ICUs.
  • Findings will inform the development and implementation of palliative care services in critical care settings.
  • This research addresses a significant gap in critical care support for patients and families in South Korea.