A Qualitative Study of the Role of Palliative Care During the COVID-19 Pandemic: Perceptions and Experiences Among Critical Care Clinicians, Hospital Leaders, and Spiritual Care Providers

Abstract

Background Palliative care offers a unique skill set in response to challenges posed by the COVID-19 pandemic, with expertise in advance care planning, symptom management, family communication, end-of-life care, and bereavement. However, few studies have explored palliative care’s role during the pandemic and changes in perceptions and utilization of the specialty among health and spiritual care providers and hospital leaders. Objective To explore the utilization, perceptions, and understanding of palliative care among critical care clinicians, hospital leaders, and spiritual care providers during the pandemic. Design We conducted a qualitative study employing semi-structured, in-depth interviews. Setting/participants We conducted the study at a tertiary academic medical center in Boston, Massachusetts, USA. Between August and October 2020, we interviewed 25 participants from 3 informant groups: (1) critical care physicians, (2) hospital leaders, and (3) spiritual care providers. Results Respondents recognized that palliative care’s role increased in importance during the pandemic. Palliative care served as a bridge between providers, patients, and families; supported provider well-being; and contributed to hospital efficiency. The pandemic reinforced participants’ positive perceptions of palliative care, increased their understanding of the scope of the specialty’s practice, and inspired physicians to engage more with palliative care. Respondents indicated the need for more palliative care providers and advocated for their role in bereavement support and future pandemic response. Conclusion Findings highlight evolving and increased utilization of palliative care during the pandemic, suggesting a need for greater investment in palliative care programs and for palliative care involvement in public health emergency preparedness and response.

“Palliative care is so much more than that”: a qualitative study exploring experiences of hospice staff and bereaved carers during the COVID-19 pandemic

“…Similarly, in Italy, Franchini et al (22) found that staff providing home palliative care services faced both patient-related and practice-related challenges, which required different communication methods and patient and family education, but staff felt a sense of satisfaction with their role during the first wave of the pandemic. In a hospital setting in the USA, Vesel et al (23) found that palliative care served as a bridge between providers, patients, and families and reinforced positive perceptions of palliative care.…”