Unit:
Κατεύθυνση Μονάδες Εντατικής Θεραπείας και Επείγουσα ΝοσηλευτικήLibrary of the School of Health Sciences
Author:
Emmanouil Katerina
Supervisors info:
Αντωνία Καλογιάννη, Αναπληρώτρια Καθηγήτρια, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Ιωάννης Καλεμικεράκης, Αναπληρωτής Καθηγητής, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Γεωργία Τουλιά, Αναπληρώτρια Καθηγήτρια, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Original Title:
Εφαρμογή πρακτικών μη κλιμάκωσης ή/και απόσυρσης της υποστηρικτικής θεραπείας στη ΜΕΘ, απόψεις και στάσεις ιατρών και νοσηλευτών: Συστηματική βιβλιογραφική ανασκόπηση
Translated title:
Practices regarding withholding or withdrawing of life sustaining treatment in ICU, opinions and attitudes of physicians and nurses: A systematic literature review
Summary:
Introduction: It is a widely accepted fact that critically ill patients, who would otherwise flatline can be supported with life-sustaining therapies. Withholding and withdrawal of life-sustaining treatments are implemented when treatment is deemed futile. These practices precede the majority of deaths in the Intensive Care Unit.
Aim: This systematic review aimed to investigate the opinions and attitudes of physicians and nurses regarding the practices of withholding and withdrawal of life-sustaining treatments in the ICU.
Material and Methods: Studies were searched that investigated the opinions and/or attitudes of physicians and nurses regarding the implementation of withholding and/or withdrawal of supportive care in the ICU. The relevant Greek and international literature was thorough searched in the Pubmed database. The keywords used are withholding AND withdrawing AND ICU and the search was mainly focused on titles, summaries or keywords for publications from 2009 to 2020. The languages used to complete this work are the Greek and the English ones.
Results: Fifteen studies were included in the systematic literature review. From the findings, it emerged that the opinions and attitudes of doctors and nurses vary, regarding withholding or withdrawal of life-sustaining treatments in the ICU. According to the of physicians’ and nurses’ opinions, withholding and withdrawal of life-sustaining treatments are not the same decision (morally). Their attitude to withholding is more positive than to withdrawal of life-sustaining treatments. The most important factors in making a withholding and withdrawal of life-sustaining treatments appeared to be, the expected quality of life, the expected suffering, the futility of the treatment, the legal exposure, etc. Nurses and patients' relatives should be involved in the procedure of end-of-life decision-making.
Conclusions: There is a need for further research to fill the end-of-life legislative gap and to develop clear guidelines from the scientific societies of countries that do not have them, for the implementation of withholding or/and withdrawal of life-sustaining treatments in the ICU.
Main subject category:
Health Sciences
Keywords:
Withholding of life-sustaining treatment, Withdrawal of life-sustaining treatment, End-of-life decisions, ICU, Opinions of health professionals
