Palliative Care in Survivors of Critical Illness: A Qualitative Study of Post-Intensive Care Unit Program Clinicians.

Background: Survivors of critical illness experience high rates of serious health-related suffering. The delivery of palliative care may assist in decreasing this burden for survivors and their families. Objectives: To understand beliefs, attitudes, and experiences of post-intensive care unit (ICU)...

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Publicado en:Journal of Palliative Medicine Vol. 26; no. 12; pp. 1644 - 1654
Autores principales: Eaton, Tammy L., Lincoln, Taylor E., Lewis, Anna, Davis, Brian C., Sevin, Carla M., Valley, Thomas S., Donovan, Heidi S., Seaman, Jennifer, Iwashyna, Theodore J., Alexander, Sheila, Scheunemann, Leslie P.
Formato: pictorial research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Dec2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2023
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      pub: Mary Ann Liebert, Inc.
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        atl: Palliative Care in Survivors of Critical Illness: A Qualitative Study of Post-Intensive Care Unit Program Clinicians.
      aug:
        au:
          Eaton, Tammy L.
          Lincoln, Taylor E.
          Lewis, Anna
          Davis, Brian C.
          Sevin, Carla M.
          Valley, Thomas S.
          Donovan, Heidi S.
          Seaman, Jennifer
          Iwashyna, Theodore J.
          Alexander, Sheila
          Scheunemann, Leslie P.
        affil: National Clinician Scholars Program (NCSP), VA HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, University of Michigan, Ann Arbor, Michigan, USA.
      sug:
        subj:
          Critically Ill Patients Psychosocial Factors
          Palliative Care
          Survivors
          Intensive Care Units
          Attitude of Health Personnel Evaluation
          Health Services Accessibility
          Survivorship
          Human
          Qualitative Studies
          Semi-Structured Interview
          Implementation Science
          Research, Medical
          Collaboration
          Multidisciplinary Care Team
          Foreign Professional Personnel
          Advance Care Planning
          Descriptive Statistics
          Funding Source
      ab: Background: Survivors of critical illness experience high rates of serious health-related suffering. The delivery of palliative care may assist in decreasing this burden for survivors and their families. Objectives: To understand beliefs, attitudes, and experiences of post-intensive care unit (ICU) program clinicians regarding palliative care and explore barriers and facilitators to incorporating palliative care into critical illness survivorship care. Design: Qualitative inquiry using semistructured interviews and framework analysis. Results were mapped using the Consolidated Framework for Implementation Research. Setting/Subjects: We interviewed 29 international members (United States, United Kingdom, Canada) of the Critical and Acute Illness Recovery Organization post-ICU clinic collaborative. Results: All interprofessional clinicians described components of palliative care as essential to post-ICU clinic practice, including symptom management, patient/family support, facilitation of goal-concordant care, expectation management and anticipatory guidance, spiritual support, and discussion of future health care wishes and advance care planning. Facilitators promoting palliative care strategies were clinician level, including first-hand experience, perceived value, and a positive attitude regarding palliative care. Clinician-level barriers were reciprocals and included insufficient palliative care knowledge, lack of self-efficacy, and a perceived need to protect ICU survivors from interventions the clinician felt may adversely affect recovery or change the care trajectory. System-level barriers included time constraints, cost, and lack of specialty palliative care services. Conclusion: Palliative care may be an essential element of post-ICU clinic care. Implementation efforts focused on tailoring strategies to improve post-ICU program clinicians' palliative care knowledge and self-efficacy could be a key to enhanced care delivery for survivors of critical illness.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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