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Review Article
Basic science and research
Barriers and facilitators in the provision of palliative care in adult intensive care units: a scoping review
Christantie Effendy, Yodang Yodang, Sarah Amalia, Erna Rochmawati
Acute Crit Care. 2022;37(4):516-526.   Published online October 18, 2022
DOI: https://doi.org/10.4266/acc.2022.00745
  • 1,423 View
  • 158 Download
AbstractAbstract PDF
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 2005ā€“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.
Review
The End-of-Life Care in the Intensive Care Unit
Jae Young Moon, Yong Sup Shin
Korean J Crit Care Med. 2013;28(3):163-172.
DOI: https://doi.org/10.4266/kjccm.2013.28.3.163
  • 2,882 View
  • 138 Download
  • 7 Citations
AbstractAbstract PDF
The intensive care units (ICUs) provide the best possible medical care to help critically ill patients survive acute threats to their lives. At the same time, the ICU is also the most common place to die. Thus the ICU clinicians should be competent in all aspects for end-of-life (EOL) care. The quality of EOL care in Korean ICUs do not ensure ICU patient's autonomy and dignity at their end-of-life. For examples, several studies present that do-not-resuscitate (DNR) orders are only initiated when the patient's death in imminent. To improve understanding EOL care of terminally ill patients, we summarize 'Recommendations for EOL care in the ICU by the American College of Critical Care Medicine' and 'Consensus guidelines to withdrawing life-sustaining therapies endorsed by Korean Academy of Medical Science'. EOL care will be emerging as a comprehensive area of expertise in Korean ICUs. The ICU clinicians must strive to find the barriers for EOL care in the ICU and develop their processes to improve the care of EOL.

Citations

Citations to this article as recorded by  
  • Comparison of the Characteristics Among Deceased Do-Not-Attempt-Resuscitation (DNAR) Cancer Patients in Hospice and Oncology Wards
    Nan Song, Ja Yun Choi
    Asian Oncology Nursing.2020; 20(1): 10.     CrossRef
  • Relationship of ICU Nurses' Difficulties in End-of-Life Care to Moral Distress, Burnout and Job Satisfaction
    Kkot Bi Jeon, Mihyun Park
    Journal of Korean Academy of Nursing Administration.2019; 25(1): 42.     CrossRef
  • Difficulties in End-of-Life Care and Educational Needs of Intensive Care Unit Nurses: A Mixed Methods Study
    Hyun Sook Kim, Eun Kyoung Choi, Tae Hee Kim, Hye Young Yun, Eun Ji Kim, Jin Ju Hong, Jeong A Hong, Geon Ah Kim, R.N. Sung Ha Kim
    The Korean Journal of Hospice and Palliative Care.2019; 22(2): 87.     CrossRef
  • Factors Influencing Performance of End-of-life Care by ICU Nurses
    Mun Jung Ko, So-Hyun Moon
    Journal of Korean Academy of Psychiatric and Mental Health Nursing.2016; 25(4): 327.     CrossRef
  • Development of an Electronic Document for DNR Informed Consent based on the Electronic Medical Record System
    Ji-Kyeong Park
    The Korean Journal of Health Service Management.2016; 10(3): 99.     CrossRef
  • Evaluation of Informed Consent for Withholding and Withdrawal of Life Support in Korean Intensive Care Units
    Jin Ha Park, Shin Ok Koh, Jin Sun Cho, Sungwon Na
    The Korean Journal of Critical Care Medicine.2015; 30(2): 73.     CrossRef
  • Application of Animation Mobile Electronic Informed Consent in Inpatient of Long-term Care Hospital: Focused on DNR Informed Consent
    Ji-Kyeong Park, Ji-On Kim
    Journal of Digital Convergence.2015; 13(11): 187.     CrossRef
Original Article
A Survey of Patients Who Were Admitted for Life-Sustaining Therapy in Nationwide Medical Institutions
Jong Myon Bae, Joo Young Gong, Jae Ran Lee, Dae Seog Heo, Younsuck Koh
Korean J Crit Care Med. 2010;25(1):16-20.
DOI: https://doi.org/10.4266/kjccm.2010.25.1.16
  • 2,659 View
  • 56 Download
  • 16 Citations
AbstractAbstract PDF
BACKGROUND
The study focused on figuring out the present status and distribution of the underlying diseases of Korean terminally ill patients (TIP) who were on life-support care (LSC) by conducting a nationwide health care survey.
METHODS
The authors of this study requested that the 308 nationwide hospitals that operate intensive care units answer a questionnaire that asked about the number of admitted TIPs and their underlying diseases at 12 Am, 22 July, 2009. The proportion of TIPs among all the admitted patients and the percentages of the TIP's underlying diseases were calculated.
RESULTS
In a total of 83.1% of the eligible hospitals responded, the proportion of TIP was 1.6 of 100 admitted patients. Terminal cancer was the leading underlying disease in the TIPs (42.4%). Five % of the patients on LSC were brain dead. More TIPs were admitted in the national/public or university hospitals than in the private or non-university hospitals.
CONCLUSIONS
Futile treatment seems to be administered to the TIPs in Korean hospitals. The quality of terminal care in Korean hospitals should be improved by the application of socially acceptable LSC guidelines. Timely government health plans, including hospice care, to improve the quality of palliative care should be launched and maintained.

Citations

Citations to this article as recorded by  
  • Attitudes, Perceptions, and Experiences toward End-of-Life Care Decision-Making among Intensive Care Unit Nurses in Korea : An Integrative Review
    JiYeon Choi, Youn-Jung Son, Kyounghoon Lee
    Journal of Korean Critical Care Nursing.2020; 13(1): 27.     CrossRef
  • 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 and Critical Care.2018; 33(2): 95.     CrossRef
  • A literature review on end-of-life care among Korean Americans
    Hye-young K Park, Cristina C Hendrix
    International Journal of Palliative Nursing.2018; 24(9): 452.     CrossRef
  • Attitude, Role Perception and Nursing Stress on Life Sustaining Treatment among Intensive Care Unit Nurses
    Su Jeong Lee, Hye Young Kim
    Korean Journal of Adult Nursing.2017; 29(2): 131.     CrossRef
  • End-of-life communication in Korean older adults: With focus on advance care planning and advance directives
    Dong Wook Shin, Ji Eun Lee, BeLong Cho, Sang Ho Yoo, SangYun Kim, Jun-Hyun Yoo
    Geriatrics & Gerontology International.2016; 16(4): 407.     CrossRef
  • The Current Status of End-of-Life Care in Korea and Legislation of Well-Dying Act
    Ji Eun Lee, Ae Jin Goo, Be Long Cho
    Journal of the Korean Geriatrics Society.2016; 20(2): 65.     CrossRef
  • The Current Status of Medical Decision-Making for Dying Patients in a Medical Intensive Care Unit: A Single-Center Study
    Kyunghwa Shin, Jeong Ha Mok, Sang Hee Lee, Eun Jung Kim, Na Ri Seok, Sun Suk Ryu, Myoung Nam Ha, Kwangha Lee
    Korean Journal of Critical Care Medicine.2014; 29(3): 160.     CrossRef
  • Comparing the Preference for Terminal Care in Nurses and Patients
    Dong Soon Kim, AeYoung So, Kyung-Sook Lee, Jung Sook Choi
    Journal of muscle and joint health.2013; 20(3): 214.     CrossRef
  • Life-Sustaining Medical Treatment for Terminal Patients in Korea
    Dae Seog Heo
    Journal of Korean Medical Science.2013; 28(1): 1.     CrossRef
  • The End-of-Life Care in the Intensive Care Unit
    Jae Young Moon, Yong Sup Shin
    Korean Journal of Critical Care Medicine.2013; 28(3): 163.     CrossRef
  • Factors Affecting Shared Decision Making at End of Life in Korean Adults
    Jo Kae-Hwa, An Gyeong-Ju
    Holistic Nursing Practice.2013; 27(6): 329.     CrossRef
  • On the life-sustaining treatment in Korea
    Yoon-seong Lee
    Journal of the Korean Medical Association.2012; 55(12): 1161.     CrossRef
  • Current status of end-of-life care in Korean hospitals
    Younsuck Koh
    Journal of the Korean Medical Association.2012; 55(12): 1171.     CrossRef
  • Medical Residents' Perception and Emotional Stress on Withdrawing Life-Sustaining Therapy
    Jae Young Moon, Hee Young Lee, Chae-Man Lim, Younsuck Koh
    Korean Journal of Critical Care Medicine.2012; 27(1): 16.     CrossRef
  • Predictive Factor s for City Dweller sā€™ Attitudes toward Death with Dignity
    Kae Hwa Jo, Gyeong Ju An, Gyun Moo Kim, Yeon Ja Kim
    The Korean Journal of Hospice and Palliative Care.2012; 15(4): 193.     CrossRef
  • Charactersitics and issues of guideline to withdrawal of a life-sustaining therapy
    Younsuck Koh, Dae-Seog Heo, Young Ho Yun, Jeong-Lim Moon, Hyoung Wook Park, Ji Tae Choung, Hyo Sung Jung, Bark Jang Byun, Yoon-Seong Lee
    Journal of the Korean Medical Association.2011; 54(7): 747.     CrossRef

ACC : Acute and Critical Care