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@article{2220000, author = {Prokopová, Tereza and Hudec, Jan and Vrbica, Kamil and Stašek, Jan and Pokorná, Andrea and Štourač, Petr and Rusinová, Kateřina and Kerpnerová, Paulína and Štěpánová, Radka and Svobodník, Adam and Maláska, Jan}, article_location = {London}, article_number = {1}, doi = {http://dx.doi.org/10.1186/s13054-022-04066-1}, keywords = {Palliative care; COVID 19; Moral distress; Pandemic; Inappropriate care; Ethical climate; Survey}, language = {eng}, issn = {1364-8535}, journal = {Critical Care}, title = {Palliative care practice and moral distress during COVID-19 pandemic (PEOpLE-C19 study): a national, cross-sectional study in intensive care units in the Czech Republic}, url = {https://ccforum.biomedcentral.com/articles/10.1186/s13054-022-04066-1}, volume = {26}, year = {2022} }
TY - JOUR ID - 2220000 AU - Prokopová, Tereza - Hudec, Jan - Vrbica, Kamil - Stašek, Jan - Pokorná, Andrea - Štourač, Petr - Rusinová, Kateřina - Kerpnerová, Paulína - Štěpánová, Radka - Svobodník, Adam - Maláska, Jan PY - 2022 TI - Palliative care practice and moral distress during COVID-19 pandemic (PEOpLE-C19 study): a national, cross-sectional study in intensive care units in the Czech Republic JF - Critical Care VL - 26 IS - 1 SP - 1-14 EP - 1-14 PB - BMC SN - 13648535 KW - Palliative care KW - COVID 19 KW - Moral distress KW - Pandemic KW - Inappropriate care KW - Ethical climate KW - Survey UR - https://ccforum.biomedcentral.com/articles/10.1186/s13054-022-04066-1 N2 - Background: Providing palliative care at the end of life (EOL) in intensive care units (ICUs) seems to be modified during the COVID-19 pandemic with potential burden of moral distress to health care providers (HCPs). We seek to assess the practice of EOL care during the COVID-19 pandemic in ICUs in the Czech Republic focusing on the level of moral distress and its possible modifiable factors. Methods: Between 16 June 2021 and 16 September 2021, a national, cross-sectional study in intensive care units (ICUs) in Czech Republic was performed. All physicians and nurses working in ICUs during the COVID-19 pandemic were included in the study. For questionnaire development ACADEMY and CHERRIES guide and checklist were used. A multivariate logistic regression model was used to analyse possible modifiable factors of moral distress. Results: In total, 313 HCPs (14.5% out of all HCPs who opened the questionnaire) fully completed the survey. Results showed that 51.8% (n = 162) of respondents were exposed to moral distress during the COVID-19 pandemic. 63.1% (n = 113) of nurses and 71.6% of (n = 96) physicians had experience with the perception of inappropriate care. If inappropriate care was perceived, a higher chance for the occurrence of moral distress for HCPs (OR, 1.854; CI, 1.057-3.252; p = 0.0312) was found. When patients died with dignity, the chance for moral distress was lower (OR, 0.235; CI, 0.128-0.430; p < 0.001). The three most often reported differences in palliative care practice during pandemic were health system congestion, personnel factors, and characteristics of COVID-19 infection. Conclusions: HCPs working at ICUs experienced significant moral distress during the COVID-19 pandemic in the Czech Republic. The major sources were perceiving inappropriate care and dying of patients without dignity. Improvement of the decision-making process and communication at the end of life could lead to a better ethical and safety climate. ER -
PROKOPOVÁ, Tereza, Jan HUDEC, Kamil VRBICA, Jan STAŠEK, Andrea POKORNÁ, Petr ŠTOURAČ, Kateřina RUSINOVÁ, Paulína KERPNEROVÁ, Radka ŠTĚPÁNOVÁ, Adam SVOBODNÍK a Jan MALÁSKA. Palliative care practice and moral distress during COVID-19 pandemic (PEOpLE-C19 study): a national, cross-sectional study in intensive care units in the Czech Republic. \textit{Critical Care}. London: BMC, 2022, roč.~26, č.~1, s.~1-14. ISSN~1364-8535. Dostupné z: https://dx.doi.org/10.1186/s13054-022-04066-1.
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