Background: There is growing interest in the use of a Palliative care approach in Intensive care. However, it tends to remain inconsistent, infrequent or non-existent, as does its acceptance by intensive care physicians. This study sought to explore the perceptions, level of knowledge, perceived barriers, and practices of physicians regarding palliative care practices (PC) in Intensive Care Units (ICU). Methods: Descriptive-correlational study. Participating physicians working in ICU in Colombia (n = 101) completed an ad hoc questionnaire that included subscales of perceptions, knowledge, perceived barriers, and PC practices in ICU. A Structural Equation Model (PLS-SEM) was used to examine the reciprocal relationships between the measured variables and those that could predict interaction practices between the 2 specialties. Results: First, results from the measurement model to examine the validity and reliability of the latent variables found (PC training, favorable perceptions about PC, institutional barriers, and ICU-PC interaction practices) and their indicators were obtained. Second, the structural model found that, a greater number of hours of PC training, a favorable perception of PC and a lower perception of institutional barriers are related to greater interaction between PC and ICU, particularly when emotional or family problems are detected. Conclusions: PC-ICU interactions are influenced by training, a positive perception of PC and less perceived institutional barriers. An integrated ICU-PC model that strengthens the PC training of those who work in ICU and provides clearer guidelines for interaction practices, may help overcome perceived barriers and improve the perception of the potential impact of PC.
ResumenLos cuidados paliativos (CP) mejoran la calidad de vida de pacientes y familias que se enfrentan a problemas asociados con enfermedades amenazantes para la vida, mediante la prevención y alivio del sufrimiento. Sin embargo, diversos estudios muestran bajo conocimiento y percepciones contradictorias frente a los efectos de estos cuidados. Esta investigación indagó sobre la percepción y el nivel de conocimiento sobre los CP de pacientes y cuidadores, en la ciudad de Medellín, mediante una metodología mixta con 19 personas (63.2% cuidadores). No se encontraron diferencias respecto a los conocimientos y percepciones entre ambos grupos (p >.05). Se encontró un nivel de conocimientos general aceptable, exceptuando el conocimiento referente a los síntomas que desde los CP se abarcan y los profesionales encargados de brindar estos cuidados. Así mismo, se encontró que según la percepción que tuvieron cuidadores y pacientes, los CP mejoran la calidad de vida, ayudan a resignificar la muerte y disminuyen la carga asociada a la enfermedad. Palabras claves: Cuidados paliativos, calidad de vida, muerte, sufrimiento, Psicología de la Salud.
AbstractPalliative care improve the quality of life of patients and families that face problems associated with life-threatening diseases, through prevention and suffering relief. However, many studies show low knowledge and contradictory perceptions regarding the effects of this type of care. This study examined the perception and level of knowledge about palliative care of patients and carers in the city of Medellin, using mixed methods with 19 participants (63% are carers). There were no differences found between both groups regarding knowledge and perceptions (p >.05). It was found an acceptable level of knowledge, except for knowledge concerning the symptoms that palliative care covers and the professionals in charge of providing this. Likewise, it was found that, according to the perception that patients and carers had, palliative care improves the quality of life, it helps to reconsider the meaning of death, and reduces the load associated with the disease.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.