What are the triggers for palliative care referral in burn intensive care units? Results from a qualitative study based on healthcare professionals' views, clinical experiences and practices

André Filipe Ribeiro; Sandra Martins Pereira; Rui Nunes; Pablo Hernández-Marrero

doi:10.1177/02692163241229962

What are the triggers for palliative care referral in burn intensive care units? Results from a qualitative study based on healthcare professionals' views, clinical experiences and practices

André Filipe Ribeiro^*, Sandra Martins Pereira, Rui Nunes, Pablo Hernández-Marrero

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

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 five Burn Intensive Care Units reference centres across Portugal were invited; three participated. Inclusion criteria: Professionals with experience/working in these settings. A total of 15 professionals (12 nurses and 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 systematisation 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.

Original language	English
Pages (from-to)	297-309
Number of pages	13
Journal	Palliative Medicine
Volume	38
Issue number	3
DOIs	https://doi.org/10.1177/02692163241229962
Publication status	Published - 19 Feb 2024

Keywords

Palliative care
Burns
Critical care
Referral and consultation
Triggers
Qualitative research methods

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/02692163241229962Licence: CC BY

72707263Final published version, 803 KBLicence: CC BY

http://hdl.handle.net/10400.14/44074Licence: CC BY

Cite this

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title = "What are the triggers for palliative care referral in burn intensive care units? Results from a qualitative study based on healthcare professionals' views, clinical experiences and practices",

abstract = "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{\textquoteright} 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{\textquoteright} views, experiences and practices. Design: Qualitative study using in-depth interviews. Setting/participants: All five Burn Intensive Care Units reference centres across Portugal were invited; three participated. Inclusion criteria: Professionals with experience/working in these settings. A total of 15 professionals (12 nurses and 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{\textquoteright} 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{\textquoteright} views, clinical experiences and practices. The systematisation 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.",

keywords = "Palliative care, Burns, Critical care, Referral and consultation, Triggers, Qualitative research methods",

author = "Ribeiro, {Andr{\'e} Filipe} and Pereira, {Sandra Martins} and Rui Nunes and Pablo Hern{\'a}ndez-Marrero",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = feb,

day = "19",

doi = "10.1177/02692163241229962",

language = "English",

volume = "38",

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What are the triggers for palliative care referral in burn intensive care units? Results from a qualitative study based on healthcare professionals' views, clinical experiences and practices. / Ribeiro, André Filipe; Pereira, Sandra Martins; Nunes, Rui et al.
In: Palliative Medicine, Vol. 38, No. 3, 19.02.2024, p. 297-309.

Research output: Contribution to journal › Article › peer-review

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T1 - What are the triggers for palliative care referral in burn intensive care units? Results from a qualitative study based on healthcare professionals' views, clinical experiences and practices

AU - Ribeiro, André Filipe

AU - Pereira, Sandra Martins

AU - Nunes, Rui

AU - Hernández-Marrero, Pablo

N1 - Publisher Copyright: © The Author(s) 2024.

PY - 2024/2/19

Y1 - 2024/2/19

N2 - 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 five Burn Intensive Care Units reference centres across Portugal were invited; three participated. Inclusion criteria: Professionals with experience/working in these settings. A total of 15 professionals (12 nurses and 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 systematisation 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.

AB - 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 five Burn Intensive Care Units reference centres across Portugal were invited; three participated. Inclusion criteria: Professionals with experience/working in these settings. A total of 15 professionals (12 nurses and 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 systematisation 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.

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SP - 297

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JO - Palliative Medicine

JF - Palliative Medicine

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What are the triggers for palliative care referral in burn intensive care units? Results from a qualitative study based on healthcare professionals' views, clinical experiences and practices

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

CEGE: Research Center in Management and Economics

PAL-RES: Integrated care: Transferring, integrating, and evaluating complex and comprehensive palliative care interventions, organizational models, knowledge, philosophy, experiences, and practices across healthcare provision through (bio)ethics empirical research

Cite this

What are the triggers for palliative care referral in burn intensive care units? Results from a qualitative study based on healthcare professionals' views, clinical experiences and practices

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Projects

CEGE: Research Center in Management and Economics

PAL-RES: Integrated care: Transferring, integrating, and evaluating complex and comprehensive palliative care interventions, organizational models, knowledge, philosophy, experiences, and practices across healthcare provision through (bio)ethics empirical research

Cite this