Article Text
Abstract
Objectives The complex care needs and high mortality of critically ill patients in intensive care unit (ICU) warrants a team approach. While studies have affirmed the integral role of palliative care teams in ICU, little is known about the ICU healthcare professional’s perception on how this integration affects the care of the critically ill.
This study examines their perception of how integration of palliative care into ICU practice affects interprofessional collaborative practices and relationships in the delivery of care.
Methods A qualitative study was conducted in 13 focus group discussions with 54 ICU healthcare professionals recruited through purposive sampling. Data were analysed using a qualitative descriptive approach reflecting uninterpreted participants’ description of their experiences in its most unbiased manner.
Results ICU clinicians perceived that palliative care integration into the ICU enhanced care of patients and team dynamics in three areas: (1) bridging care, (2) cultural shift and (3) empowering, advocating and enhancing job satisfaction. Enhanced collaborative efforts between disciplines led to improved mutual understanding, shared-decision making and alignment of care goals. There was a shift in perception of dying as a passive process, to an active process of care where various healthcare professionals could work together to optimise symptom control and support grieving families. Team members felt empowered to advocate for patients, improving their sense of job fulfilment.
Conclusions Palliative care integration enhanced perception of collaborative practices in caring for the dying. Future studies could use empirical methods to measure collaboration and patient outcomes to further understand team dynamics.
- Quality of life
- Terminal care
- Communication
Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information. The data included as online supplemental information can be published.
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Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information. The data included as online supplemental information can be published.
Footnotes
Contributors CHP is the guarantor of the study and also contributed in the following: (1) Design of the research work and analysis of data, (2) Drafted the article and revised it critically for publication. HSK contributed in the following: (1) Drafted the article and revised it critically for publication. S-LA (1) Analysis of the data and (2) Revised the article critically for publication. MYHK contributed in the following: (1) Revised the article critically for publication, (2) Approved the version to be published. AH contributed in the following: (1) Design of the research work and analysis of data, (2) Revised the article critically for publication and (3) Approved the version to be published.
Funding This work was supported by the National Healthcare Group, Health Outcomes and Medical Education Research (NHG-HOMER), Singapore. The grant number is NHG-HOMER FY16/B01.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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