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Palliative Care in Intensive Care Units: Nurses' Perspectives on Challenges and Strategies
Daniela Filipa Almeida da Cunha1,2, José Carlos Fernandes Alves1,3, Ana Jorge Santos Marques1,4
1Center for Interdisciplinary Research in Health, Faculty of Health Sciences and Nursing, Catholic University of Portugal, Porto, Portugal.
Nursing in Critical Care
|December 19, 2025
Summary
Intensive care nurses face challenges integrating palliative care, including communication barriers and training needs. Addressing these through education and policy can improve end-of-life care quality.
Area of Science:
- Nursing
- Palliative Care
- Intensive Care Medicine
Background:
- Palliative care integration in intensive care units (ICUs) is crucial for quality end-of-life care.
- Barriers hinder effective implementation of palliative care in ICUs.
- Nurses' perspectives on palliative care in Portuguese ICUs are underexplored.
Purpose of the Study:
- To explore challenges and strategies for palliative care provision by ICU nurses.
- To utilize Kolcaba's Comfort Theory as a guiding framework.
Main Methods:
- Qualitative descriptive design.
- Data collected via a questionnaire with open-ended questions.
- Bardin's content analysis informed by Kolcaba's Comfort Theory.
Main Results:
- Five comfort categories emerged: physical, psychospiritual, sociocultural, environmental, and organizational.
- Nurses identified barriers: therapeutic obstinacy, insufficient training, organizational constraints.
- Strategies proposed: enhanced communication, teamwork, and education.
Conclusions:
- Kolcaba's Comfort Theory effectively interprets multidimensional comfort in ICU palliative care.
- Findings illuminate nurses' perceptions of structural and cultural barriers.
- Theory-informed nursing knowledge can improve education, policy, and care models for better palliative care integration.
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