Palliative Care Consultations in the Neuro-ICU: A Qualitative Study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-10

AUTHORS

Len N. Tran, Anthony L. Back, Claire J. Creutzfeldt

ABSTRACT

BACKGROUND: Integration of palliative care (PC) into the neurological intensive care unit (neuro-ICU) is increasingly recommended, but evidence regarding the best practice is lacking. We conducted a qualitative analysis exploring current practices and key themes of specialist PC consultations in patients admitted to a single neuro-ICU. METHODS: We retrospectively identified all patients who were admitted to the neuro-ICU for ≥24 h and received a PC consultation between January and August 2014. We reviewed PC consultation notes and neuro-ICU progress notes from the electronic health records of these patients. We performed content analysis on the PC notes. RESULTS: Twenty-five neuro-ICU patients (4 %) received a PC consultation over 8 months with the most prevalent reason of clarifying goals of care. The main distinctions between patients with and those without (n = 580) a PC consultation were ICU length of stay (median 8.2 vs. 2.8 days) and death in the neuro-ICU (56 % vs. 11 %). The most prevalent themes addressed in the PC consultation notes were (1) discussing prognosis, (2) eliciting patient and family values, (3) understanding medical options, and (4) identifying conflict. CONCLUSIONS: PC consultations in the neuro-ICU emphasize family coping and decision-making by helping discuss prognosis and exploring patient and family values as well as their ability to understand the medical information. Several features suggest that earlier integration of PC into neuro-ICU care may enhance both coping and the decision-making process. More... »

PAGES

266-272

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12028-016-0283-5

DOI

http://dx.doi.org/10.1007/s12028-016-0283-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1028373501

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27230967


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