End of life in the intensive care unit: knowledge and practice of clinicians from Karachi, Pakistan

Salahuddin, Nawal; Shafqat, Saad; Mapara, S.; Khan, Saeed; Siddiqui, Saad; Manasia, Roshan; Ahmad, Ayesha

doi:10.1111/j.1445-5994.2007.01595.x

Cited by 17 publications

(23 citation statements)

References 17 publications

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“…A study of critical care nurses and physicians in Karachi in 2008 reported that 69% of the participants had adequate knowledge. 16 The knowledge level in our study did not tally with the respondents' attitude toward brain death. Surprisingly, 43.2% disagreed with the global consensus that brain death is equivalent to absolute clinical death.…”

Section: Discussioncontrasting

confidence: 64%

Deceased-Donor Organ Transplantation: Knowledge and Attitudes Among Health Care Professionals Managing Critically Ill Patients in Karachi

Siddiqui¹,

Nizami²,

Raza³

et al. 2012

Exp Clin Transplant

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Objectives: Adequate knowledge and positive attitudes of health care professionals regarding deceased-donor organ transplants lead to higher donation consent rates. This study assessed the knowledge and attitudes of health care professionals toward this issue in the light of recent organ transplant legislation in Pakistan. Materials and Methods: Health care professionals in critical care areas of 2 hospitals in Karachi were selected (n=243) and asked to complete a questionnaire regarding their knowledge and attitudes toward deceased-donor organ transplants. Results: In all, 58.8% of the participants were physicians and 41.2% were nurses; 91.4% correctly identified brain death; 51.5% expressed support for deceased-donor organ transplants; 56.8% had concerns of religious rulings against deceased organ donation; 67.5% felt that a government body could not run such a system fairly; 56.4% of the respondents would consider receiving a deceaseddonor organ if needed, but only 35.3% would donate after their own death. Only 42.7% and 37% were willing to approach patients and families for consent for a deceased-donor organ transplant, respectively. Most of those unwilling felt that the patient could refuse, become upset and aggressive, and lose trust in the health care professionals. Conclusions: Before implementing a deceaseddonor organ transplant system in hospitals, health care professionals should attend a training program regarding their concerns. This would increase motivation when approaching patients/patients' families for consent, thus increasing deceased-donor consent rates.

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Section: Discussioncontrasting

confidence: 64%

Deceased-Donor Organ Transplantation: Knowledge and Attitudes Among Health Care Professionals Managing Critically Ill Patients in Karachi

Siddiqui¹,

Nizami²,

Raza³

et al. 2012

Exp Clin Transplant

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“…Another study showed that uncertainties and discrepancies between physicians and nurses in terms of understanding were obvious in the process of the disconnection of the patient from the vital devices (35). It should be noted that most nursing systems have reached such uncertainties in different fields, although, such communities have been different in terms of religion and culture.…”

Section: Discussionmentioning

confidence: 99%

Explaining nurses' experiences of caring for brain dead patients: a content analysis

et al. 2018

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BackgroundCaring for patients with brain death diagnosis is the heaviest of duties for nurses, and, due to the complexities and stressors, it is the biggest challenge of nursing in an intensive care unit.ObjectiveThis qualitative research aimed to disclose the nurses’ experience of caring for brain-dead patients.MethodsThe present study was a qualitative research using a content analysis, where the data collection process included 21 semi-structured and in-depth interviews with intensive care nurses, physicians, head nurses, a transplantation committee coordinator, and the authority of the organ procurement unit. Adequate data were collected from March 2014 until the saturation point was reached in June 2016. Data were analyzed simultaneously with data collection using qualitative content analysis with a conventional approach.ResultsQualitative content analysis of data resulted in two themes and eight subthemes, reflecting the analysis of nurses’ experiences of caring for brain-dead patients. The themes included “Challenges of right and duty requirement,” and “turbulent confrontation with successive chains of tension”. Finally, the main themes of “resonance of stress and internal conflict in care” were abstracted.ConclusionThe findings deepened our understanding and knowledge of the issue. Despite all the stress, nurses care for potential organ donors, and this results in preserving the organs’ viability for donation. Nurses’ problems and challenges in this caring process should be considered by policymakers of health and treatment systems and a supportive model be designed for nurses in the intensive care unit.

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“…A study of over 600 Turkish intensive care nurses found that 40% of the respondents agreed with the statement that withholding or withdrawing medical care was considered unethical (Badir et al, ). In a study of Pakistani ICU physicians and nurses, 28% reported that they consider their medical duty to sustain life at all costs (Salahuddin et al, ).…”

Section: Introductionmentioning

confidence: 99%

Nurses' perceptions of intensive care unit palliative care at end of life

Ganz

Sapir

2018

Nursing in Critical Care

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Background Significant barriers can block the provision of palliative care at the end of life in the intensive care unit (ICU). However, the relationship between perceptions of ICU quality palliative care and barriers to palliative care at the end of life is not well documented. Aims and objectives To describe ICU nurses' perceptions of quality palliative end‐of‐life care, barrier intensity and frequency to palliative care and their association with one another. Design This was a descriptive, correlational, cross‐sectional design. Methods A convenience sample of 126 ICU nurses from two hospitals in Israel was recruited for the study. Participants completed three pencil‐and‐paper questionnaires (a personal characteristics questionnaire, the Quality of Palliative Care in the ICU and a revised Survey of Oncology Nurses' Perceptions of End‐of‐Life Care). Respondents were recruited during staff meetings or while on duty in the ICU. Ethical approval was obtained for the study from participating hospitals. Results The item mean score of the quality of palliative end‐of‐life care was 7·5/10 (SD = 1·23). The item mean barrier intensity and frequency scores were 3·05/5 (SD = 0·76) and 3·30/5 (SD = 0·61), respectively. A correlation of r = 0·46, p < 0·001 was found between barrier frequency and intensity and r = −0·19, p = 0·04 between barrier frequency and quality palliative end‐of‐life care. Conclusions ICU nurses perceived the quality of palliative care at the end of life as moderate despite reports of moderate barrier levels. The frequency of barriers was weakly associated with quality palliative end‐of‐life care. However, barrier intensity did not correlate with quality palliative end‐of‐life care at a statistically significant level. Further research that investigates other factors associated with quality ICU palliative care is recommended. Relevance to clinical practice Barriers to palliative care are still common in the ICU. Increased training and education are recommended to decrease barriers and improve the quality of ICU palliative care.

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End of life in the intensive care unit: knowledge and practice of clinicians from Karachi, Pakistan

Cited by 17 publications

References 17 publications

Deceased-Donor Organ Transplantation: Knowledge and Attitudes Among Health Care Professionals Managing Critically Ill Patients in Karachi

Deceased-Donor Organ Transplantation: Knowledge and Attitudes Among Health Care Professionals Managing Critically Ill Patients in Karachi

Explaining nurses' experiences of caring for brain dead patients: a content analysis

Nurses' perceptions of intensive care unit palliative care at end of life

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