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

J 2022

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

PROKOPOVÁ, Tereza, Jan HUDEC, Kamil VRBICA, Jan STAŠEK, Andrea POKORNÁ et. al.

Basic information

Original name

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

Authors

PROKOPOVÁ, Tereza (203 Czech Republic, belonging to the institution), Jan HUDEC (203 Czech Republic, belonging to the institution), Kamil VRBICA (203 Czech Republic, belonging to the institution), Jan STAŠEK (203 Czech Republic, belonging to the institution), Andrea POKORNÁ (203 Czech Republic, belonging to the institution), Petr ŠTOURAČ (203 Czech Republic, belonging to the institution), Kateřina RUSINOVÁ (203 Czech Republic), Paulína KERPNEROVÁ (703 Slovakia), Radka ŠTĚPÁNOVÁ (203 Czech Republic), Adam SVOBODNÍK (203 Czech Republic, belonging to the institution) and Jan MALÁSKA (203 Czech Republic, guarantor, belonging to the institution)

Edition

Critical Care, London, BMC, 2022, 1364-8535

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30221 Critical care medicine and Emergency medicine

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Critical Care

Impact factor

Impact factor: 15.100

RIV identification code

RIV/00216224:14110/22:00126748

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1186/s13054-022-04066-1

UT WoS

000827745400001

Keywords in English

Palliative care; COVID 19; Moral distress; Pandemic; Inappropriate care; Ethical climate; Survey

Abstract

V originále

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.

Links

CZ.02.1.01/0.0/0.0/16_013/0001826, interní kód MU
(CEP code: EF16_013/0001826)

Name: CZECRIN_PRO PACIENTY - zavádění inovativních moderních terapií

Investor: Ministry of Education, Youth and Sports of the CR, Priority axis 1: Strengthening capacities for high-quality research

LM2018128, research and development project

Name: Český národní uzel Evropské sítě infrastruktur klinického výzkumu (Acronym: CZECRIN)

Investor: Ministry of Education, Youth and Sports of the CR

TL02000360, research and development project

Name: Rozhodování o zdravotní péči v závěru života (Acronym: DECAREL)

Investor: Technology Agency of the Czech Republic

Citovat

PROKOPOVÁ, Tereza, Jan HUDEC, Kamil VRBICA, Jan STAŠEK, Andrea POKORNÁ, Petr ŠTOURAČ, Kateřina RUSINOVÁ, Paulína KERPNEROVÁ, Radka ŠTĚPÁNOVÁ, Adam SVOBODNÍK and 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. Critical Care. London: BMC, 2022, vol. 26, No 1, p. 1-14. ISSN 1364-8535. Available from: https://dx.doi.org/10.1186/s13054-022-04066-1.

@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 and 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, vol.~26, No~1, p.~1-14. ISSN~1364-8535. Available from: https://dx.doi.org/10.1186/s13054-022-04066-1.

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