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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
1Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Jongno-gu, Korea (the Republic of).
BMJ Open
|May 29, 2025
Summary
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.
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.
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