Acute and Critical Care

Original Articles

Rapid response system
Resident and nurse attitudes toward a rapid response team in a tertiary hospital in South Korea: Sung Yoon Lim, Ho Geol Woo, Jong Sun Park, Young-Jae Cho, Jae Ho Lee, Yeon Joo Lee; Acute Crit Care. 2025;40(1):29-37. Published online February 12, 2025; DOI: https://doi.org/10.4266/acc.004272

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Background
Residents and nurses who activate rapid response teams (RRTs) are well positioned to offer insights on its effectiveness. Here, we assess such evaluation of RRTs and identify barriers to activation in a 1,400-bed teaching hospital.
Methods
We conducted a 24-item Likert-scale survey from January to May 2017 among residents and ward nurses with RRT experience. Factor analysis was used to identify the barriers.
Results
This study comprised 305 nurses and 53 residents, most of whom were satisfied with their RRT experiences. Factor analysis showed that lack of awareness of activation criteria was a major barrier, with only 21.4% and 22.2% participants, respectively, confident about their knowledge of activation protocols. Of the survey respondents, 85.7% reported first contacting the doctor before activating the RRT. Despite the protocol, 66.7% first discussed the decision with other staff, and 71.5% called the RRT when the patient’s condition worsened despite management.
Conclusions
Nurses and residents value RRTs but face barriers in initiation, primarily due to a lack of confidence in applying the activation criteria. Many prefer to consult a doctor or manage the patient before calling the RRT.

Citations

Citations to this article as recorded by

The effect of nurses' perceptions and satisfaction with hospital rapid response teams on burnout related to emergency situations in Korea: a cross-sectional study
Bumin Kim, Nahyun Kim
Journal of Korean Biological Nursing Science.2025; 27(2): 234. CrossRef

Nursing
Palliative care knowledge and attitudes toward end-of-life care among intensive care unit nurses in Jordan: Khaldoun Mohammad Hamdan, Ahmad M. Al-Bashaireh, Mohammad Al-Dalahmeh, Ahmad Rajeh Saifan, Maha Alkaid Albqoor, Abeer M. Shaheen; Acute Crit Care. 2023;38(4):469-478. Published online November 28, 2023; DOI: https://doi.org/10.4266/acc.2023.00430

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Abstract PDF

Background
There is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study’s purpose was to examine nurses’ knowledge and attitudes toward palliative care.
Methods
A cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data.
Results
We measured nurses’ knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean, 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type.
Conclusions
ICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.

Citations

Citations to this article as recorded by

The effect of moral distress experienced by intensive care nurses on end-of-life care attitudes and care behaviours: a single-centre cross-sectional and correlational study
Pakize Özyürek, İbrahim Kılıç, Ahmet Akarsu, Öznur Gürlek Kısacık
BMC Nursing.2026;[Epub] CrossRef
Core competency in palliative care among intensive care unit nurses: A latent profile analysis
Qin Guan, Xiaoling Zhu, Zhipeng Xue, Mengyun Peng
Nursing in Critical Care.2025;[Epub] CrossRef
Knowledge, attitudes, and self-efficacy regarding palliative care among Palestinian nurses in intensive care units
Bilal Awad, Ahmad Batran, Malakeh Z. Malak, Ahmad Ayed, Anas Shehadeh, Bahaa Alassoud, Moath Abu Ejheisheh
BMC Nursing.2025;[Epub] CrossRef
Soulful support: Exploring critical care nurses' spiritual caregiving towards end‐of‐life scenario
Ayman Mohamed El‐Ashry, Sameh Eltyebani, Shimmaa Mohamed Elsayed, Mahmoud Abdelwahab Khedr, Mona Metwally El‐Sayed, Mohamed Adel Ghoneam, Haitham Mokhtar Mohamed Abdallah
Nursing in Critical Care.2025;[Epub] CrossRef
Palliative Care Knowledge, Attitudes, and Self-Competence of Nurses Working in Hospital Settings
Mona Ibrahim Hebeshy, Darcy Copeland
Journal of Palliative Care.2025;[Epub] CrossRef
Towards enhancing palliative care competencies through comprehensive training for nurses and physicians in resource-limited settings: a cross-sectional study
Mohammad Alhaddar, Heba Falna, Haya Sultan, Hammoda Abu-Odah, Mohammad Khleif, Shahenaz Najjar
BMC Nursing.2025;[Epub] CrossRef
Empowering critical care nurses: bridging knowledge gaps in palliative care
Halima A. Almahrizi, Fawwaz Alaloul, Ohood K. Al Mamari, Esther K. Rani, Zayoon A. Al Mahrizi, Salma A. Al Harthy, Zakariya Al-Naamani
BMC Nursing.2025;[Epub] CrossRef
Spiritual and cultural influences on end-of-life care decision-making: a comparative analysis of the Arab Middle East and the United Kingdom
Hanan Hamdan Alshehri, Chris McParland, Hibah Abdulrahim Bahri, Bridget Johnston
Current Opinion in Supportive & Palliative Care.2025; 19(4): 242. CrossRef
The Correlation Between Nurses' Knowledge and Attitudes and the Provision of Patients' Spiritual Care in the High Care Unit
Hidayatul Rahmi, Rebbi Permata Sari Rebbi, Revi Neini Iqbal, Willady Rasyid
Journal of Health Sciences and Epidemiology.2025; 3(1): 51. CrossRef
Knowledge of undergraduate nursing students about palliative care
Aruna Jothishanmugam
Journal of Education and Health Promotion.2025;[Epub] CrossRef
Investigation of the Relationship between Personality Traits of Intensive Care Nurses and Their Attitudes and Behaviours towards End-of-life Care
Fırat Demir, Cansu Polat Dünya, İlknur Özkan
Sağlık Bilimleri Üniversitesi Hemşirelik Dergisi.2024; 6(3): 243. CrossRef
Knowledge and attitude towards palliative care and associated factors among nurse: a cross-sectional descriptive study
Saeedeh Rafiee, Ismail Azizi-Fini, Zahra-Sadat Banihashemi, Safoura Yadollahi
BMC Nursing.2024;[Epub] CrossRef
Knowledge, Attitudes, and Determinants of Palliative Care Among Nurses: A Descriptive Study
Kalkidan Girma, Gebremedhin Desta, Saba Tsegaye, Melkamu Tesfaye
Journal of Integrative Nursing and Palliative Care.2023; 4(1): 108. CrossRef

Ethics
Transcultural Adaptation and Validation of Quality of Dying and Death Questionnaire in Medical Intensive Care Units in South Korea: Jun Yeun Cho, Jinwoo Lee, Sang-Min Lee, Ju-Hee Park, Junghyun Kim, Youlim Kim, Sang Hoon Lee, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Yeon Joo Lee; Acute Crit Care. 2018;33(2):95-101. Published online May 31, 2018; DOI: https://doi.org/10.4266/acc.2017.00612

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182 Download
11 Web of Science
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Abstract PDF Supplementary Material

Background
Providing palliative care to dying patients in the intensive care unit (ICU) has recently received much attention. Evaluating the quality of dying and death (QODD) is important for appropriate comfort care in the ICU. This study aimed to validate the Korean version of the QODD questionnaire.
Methods
This study included decedents in the ICUs of three tertiary teaching hospitals and one secondary hospital from June 2016 to May 2017. ICU staff members were asked to complete the translated QODD questionnaire and the visual analogue scale (VAS) questionnaire within 48 hours of patient death. The validation process consisted of evaluating construct validity, internal consistency, and interrater reliability.
Results
We obtained 416 completed questionnaires describing 255 decedents. The QODD score was positively correlated with the 100-VAS score (Pearson correlation coefficient, 0.348; P<0.001). An evaluation of the internal consistency presented favorable results (calculated Cronbach’s alpha if a given item exceeded 0.8 in all items). The interrater reliability revealed no concordance between doctors and nurses.
Conclusions
The QODD questionnaire was successfully translated and validated in Korean medical ICUs. We hope further studies that use this valuable instrument will be conducted in Korea.

Citations

Citations to this article as recorded by

Development, Translation, and Validation of the Japanese Quality of Dying and Death Questionnaire for Families of ICU Patients
Kazuaki Naya, Hideaki Sakuramoto, Yuki Kuroiwa, Rika Hamano, Chihiro Kawaguchi, Hina Yamamoto, Wakana Sugihara, Kyoka Horita, Ami Nakaue, Hiromi Iwashita
Cureus.2025;[Epub] CrossRef
Impact of Interprofessional Communication and Person-centered Care on Perceived Quality of Death in Intensive Care Units by Nurses: A Cross-Sectional Study
Hye-Jin Kim, So-Hi Kwon
Korean Journal of Adult Nursing.2025; 37(2): 153. CrossRef
Assessing prioritization of a good death across Brazil, Italy, Japan, and the United States: A psychometric evaluation
Sarah E. Clem, Todd D. Becker, Paul Sacco, John G. Cagle
Death Studies.2025; : 1. CrossRef
Factors associated with the quality of dying and death and missed nursing care
Shahin Gahramani, Mokhtar Mahmoudi, Nouri, Sina Valiee
International Journal of Palliative Nursing.2024; 30(4): 190. CrossRef
A systematic review of instruments measuring the quality of dying and death in Asian countries
Shuo Xu, Yue Fang, Hanzhang Chen, Kang Sun, Chen Zhang, Yang Liu
Quality of Life Research.2023; 32(7): 1831. CrossRef
Translation, Validity and Internal Consistency of the Quality of Dying and Death Questionnaire for Brazilian families of patients that died from cancer: a cross-sectional and methodological study
Bianca Sakamoto Ribeiro Paiva, Talita Caroline de Oliveira Valentino, Mirella Mingardi, Marco Antonio de Oliveira, Julia Onishi Franco, Michelle Couto Salerno, Helena Palocci, Tais Cruz de Melo, Carlos Eduardo Paiva
Sao Paulo Medical Journal.2023;[Epub] CrossRef
Russian nurses’ readiness for transcultural care of palliative patients
Nataliya Kasimovskaya, Natalia Geraskina, Elena Fomina, Svetlana Ivleva, Maria Krivetskaya, Nina Ulianova, Marina Zhosan
BMC Palliative Care.2023;[Epub] CrossRef
Change in perception of the quality of death in the intensive care unit by healthcare workers associated with the implementation of the “well-dying law”
Ye Jin Lee, Soyeon Ahn, Jun Yeun Cho, Tae Yun Park, Seo Young Yun, Junghyun Kim, Jee-Min Kim, Jinwoo Lee, Sang-Min Lee, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Yeon Joo Lee
Intensive Care Medicine.2022; 48(3): 281. CrossRef
Factors Associated with Quality of Dying and Death in Korean Intensive Care Units: Perceptions of Nurses
Haeyoung Lee, Seung-Hye Choi
Healthcare.2021; 9(1): 40. CrossRef
Validation of the Chinese Version of the Quality of Dying and Death Questionnaire for Family Members of ICU Patients
Xing-ping Han, Xu Mei, Jing Zhang, Ting-ting Zhang, Ai-ni Yin, Fang Qiu, Meng-jie Liu
Journal of Pain and Symptom Management.2021; 62(3): 599. CrossRef
Validation of the Quality of Dying and Death Questionnaire among the Chinese populations
Ying Wang, Mandong Liu, Wallace Chi Ho Chan, Jing Zhou, Iris Chi
Palliative and Supportive Care.2021; 19(6): 694. CrossRef
The quality of dying and death for patients in intensive care units: a single center pilot study
Yanghwan Choi, Myoungrin Park, Da Hyun Kang, Jooseon Lee, Jae Young Moon, Heejoon Ahn
Acute and Critical Care.2019; 34(3): 192. CrossRef
Factors Associated With Quality of Death in Korean ICUs As Perceived by Medical Staff: A Multicenter Cross-Sectional Survey
Jun Yeun Cho, Ju-Hee Park, Junghyun Kim, Jinwoo Lee, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Sang-Min Lee, Jae-Ho Lee, Choon-Taek Lee, Yeon Joo Lee
Critical Care Medicine.2019; 47(9): 1208. CrossRef

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