Acute Crit Care.  2019 Aug;34(3):192-201. 10.4266/acc.2018.00374.

The quality of dying and death for patients in intensive care units: a single center pilot study

• Choi Y
• Park M
• Kang DH
• Lee J
• Moon JY
• Ahn H

• KMID: 2457677
• DOI: http://doi.org/10.4266/acc.2018.00374

Abstract

BACKGROUND
To identify the necessary care for dying patients in intensive care units (ICUs), we designed a retrospective study to evaluate the quality of dying and death (QODD) experienced by the surrogates of patients with medical illness who died in the ICU of a tertiary referral hospital.
METHODS
To achieve our objective, the authors compared the QODD scores as appraised by the relatives of patients who died of cancer under hospice care with those who died in the ICU. For this study, a Korean version of the QODD questionnaire was developed, and individual interviews were also conducted.
RESULTS
Sixteen people from the intensive care group and 23 people from the hospice care group participated in the survey and completed the questionnaire. The family members of patients who died in the ICU declined participation at a high rate (50%), with the primary reason being to avoid bringing back painful memories (14 people, 87.5%). The relatives of the intensive care group obtained an average total score on the 17-item QODD questionnaire, which was significantly lower than that of the relatives of the hospice group (48.7±15.5 vs. 60.3±14.8, P=0.03).
CONCLUSIONS
This work implies that there are unmet needs for the care of dying patients and for the QODD in tertiary hospital ICUs. This result suggests that shared decision making for advance care planning should be encouraged and that education on caring for dying patients should be provided to healthcare professionals to improve the QODD in Korean ICUs.

Keyword

advance care planning; education; end-of-life care; intensive care unit; quality of life; surveys and questionnaires

MeSH Terms

Advance Care Planning
Back Pain
Critical Care*
Decision Making
Delivery of Health Care
Education
Hospice Care
Hospices
Humans
Intensive Care Units*
Pilot Projects*
Quality of Life
Retrospective Studies
Surveys and Questionnaires
Tertiary Care Centers

Figure

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  Figure 1. Flowchart of the survey.

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  Figure 2. Comparison of quality of dying and death (QODD) between the intensive care group and hospice care group.

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