Palliative Care in the Intensive Care Unit: An Integrative Review of Intensive Care Unit Health Care Professionals' Views and Experiences.

Abstract

Background: It has become more common for patients with long-term diseases or receiving aggressive cancer treatments to need intensive care. Research about palliative care in the intensive care unit (ICU) largely focuses on decision-making in relation to end-of-life care and organ donation. Few studies examine the current evidence about how palliative care in its wider conceptualization is understood by intensive care health care professionals.

Objectives: To synthesize the literature on ICU health care professionals' experiences and views of providing palliative care in the ICU.

Methods: This was an integrative review where data were assessed and analyzed using Whittemore and Knafl's approach.

Results: Four themes were identified in the synthesis: the meaning of palliative care, relationships with families, multidisciplinary working, and preparation for providing palliative care.

Discussion: Our findings suggest there is variation in how palliative care in the ICU is conceptualized and interpreted. Intensive care unit professionals need enhanced competencies and training to develop their confidence in providing palliative care and improve role clarity. Such training should focus on serious illness conversations with patients/families and interdisciplinary teamwork. Integration of palliative consultants into the ICU could be further developed.