Palliative care teams in the intensive care unit: a randomised, controlled, feasibility study.
Crit Care Resusc
; 12(1): 28-35, 2010 Mar.
Article
em En
| MEDLINE
| ID: mdl-20196711
ABSTRACT
OBJECTIVES:
To determine whether palliative care teams can improve patient, family and staff satisfaction for patients receiving end-of-life care in the intensive care unit and reduce surrogate markers of health care costs.DESIGN:
Randomised controlled, feasibility study.SETTING:
14-bed general ICU over 29 months in 2006-2008.PARTICIPANTS:
Patients admitted with a terminal or preterminal condition, for whom the treating intensivist considered that escalating or continuing treatment was unlikely to achieve significant improvement in the patient's clinical condition. INTERVENTION A consultation from a palliative care team, in addition to usual ICU end-of-life care. MAIN OUTCOMEMEASURES:
ICU and hospital length of stay, and changes in composite scores of satisfaction obtained from questionnaires administered to families, nursing staff and intensivists.RESULTS:
The study was constrained by significant logistical and methodological problems, including low recruitment and questionnaire completion rates, and the lack of an available validated questionnaire. From a total of 2009 admissions over a 29-month period, 20 patients were enrolled, 10 in each group. There were significant differences in baseline characteristics. There were no statistically significant differences between those who had a consultation with the palliative care team and those who did not in median ICU length of stay (3 days v 5 days, P=0.97), median hospital length of stay (5 days v 11 days, P=0.44), or changes in overall composite satisfaction scores reported by families (-6% v -6%, P=0.91), nursing staff (+5% v +15%, P=0.30), and intensivists (-2% v +2%, P=0.42).CONCLUSION:
This feasibility study was difficult to conduct and did not generate any robust conclusions about the utility of involving palliative care teams in end-of-life care in the ICU. Larger studies are technically possible but unlikely to be feasible. TRIAL REGISTRATION Australian Clinical Trials Registry ACTRN012606000110583.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidados Paliativos
/
Equipe de Assistência ao Paciente
/
Assistência Terminal
/
Satisfação do Paciente
/
Custos de Cuidados de Saúde
Tipo de estudo:
Clinical_trials
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Crit Care Resusc
Assunto da revista:
TERAPIA INTENSIVA
Ano de publicação:
2010
Tipo de documento:
Article