Autor(es): Ribeiro, André Filipe ; Pereira, Sandra Martins ; Nunes, Rui ; Hernández-Marrero, Pablo
Data: 2024
Identificador Persistente: http://hdl.handle.net/10400.14/44074
Origem: Veritati - Repositório Institucional da Universidade Católica Portuguesa
Assunto(s): Palliative care; Burns; Critical care; Referral; Triggers; Qualitative research
Background: Burns are a global public health problem, accounting for around 300,000 deaths annually. Burns have significant consequences for patients, families, healthcare teams and systems. Evidence suggests that the integration of palliative care in burn intensive care units improves patients’ comfort, decision-making processes, and family care. Research is needed on how to optimise palliative care referrals. Aim: To identify triggers for palliative care referral in critically burned patients based on professionals’ views, experiences, and practices. Design: Qualitative study using in-depth interviews. Setting/participants: All 5 Burn Intensive Care Units reference centres across Portugal were invited; 3 participated. Inclusion criteria: Professionals with experience/working in these settings. 15 professionals (12 nurses, 3 physicians) participated. Reflexive thematic analysis was performed. Results: Three main triggers for palliative care referral were identified: (i) Burn severity and extension, (ii) Co-morbidities, and (iii) Multiorgan failure. Other triggers were also generated: (i) Rehabilitative palliative care related to patients’ suffering and changes in body image, (ii) Family suffering and/or dysfunctional and complex family processes, (iii) Long stay in the burn intensive care unit, and (iv) Uncontrolled pain. Conclusions: This study identifies triggers for palliative care in burn intensive care units based on professionals’ views, clinical experiences and practices. The systematization and use of triggers could help streamline referral pathways and strengthen the integration of palliative care in burn intensive care units. Research is needed on the use of these triggers in clinical practice to enhance decision-making processes, early and high-quality integrated palliative care and proportionate patient and family centred care.
