Development of an Early Palliative Care Intervention Based on Person-Centered Care in Intensive Care Units

다국어 초록 (Multilingual Abstract)

Aim(s): Clinical indicators tend to be emphasized among critically ill patients, for whom the maintenance of vital functions is important, while their dignity as human beings tends to be downplayed. However, pain relief and respect for critically ill patients improve the clinical outcomes and experience. Therefore, a need exists for interventions that guarantee the safety and dignity of critically ill patients and provide individual critical care with caregiver participation. The purpose of this study was to develop an early palliative care intervention based on person-centered care in an intensive care unit (ICU).
Method(s): This methodological study was designed to develop early palliative care interventions. Based on the person-centered care theory, a draft intervention was developed by identifying 7 cases of interventions in foreign institutions that provide palliative care in ICUs and conducting a systematic, integrated literature review of palliative care interventions and person-centered care interventions in ICUs. We then conducted individual interviews with 5 health-care providers and 5 caregivers of critically ill patients. Next, we developed a draft protocol for an early palliative care intervention based on person-centered care in ICUs, which 6 experts in intensive and palliative care evaluated for content validity. Finally, a revised version of the early palliative care intervention for patients in ICUs was established.
Result(s): Our early palliative care intervention based on person-centered care in ICUs includes working with the patient’s beliefs and values, engaging authentically, sharing decision-making, being sympathetically present, and providing holistic care. It consists of interventions to be performed within 1 day after admission to the ICU, interventions to be performed within 3 days, and interventions that should be performed daily. In addition, the multidisciplinary team provided interventions. The scale-level content validity index of the draft intervention for early palliative care based on person-centered care in the ICU was 0.88, which was judged as representing a consensus among the experts.
Conclusion(s): We developed an early palliative care intervention based on person-centered care in ICUs. It is a planned and systematic intervention that is provided within 3 days of a patient entering the ICU and is delivered by health-care providers in ICUs. This intervention would be helpful for providing a positive experience for critically ill patients and their caregivers within the philosophy of patient-centered care.