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Title: Palliative and end-of-life care in intensive care units in low- and middle-income countries : a systematically constructed scoping review
Authors: Rao, Seema Rajesh 
Salins, Naveen 
Joshi, Udita 
Patel, Jatin 
Remawi, Bader 
Simha, Srinagesh 
Preston, Nancy 
Walshe, Catherine 
Keywords: Intensive care units - Asia;Terminal care - Africa;Palliative treatment - Asia;Terminal care - Asia;Palliative treatment - Developing countries;Palliative treatment - Africa;Terminal care - Developing countries;Intensive care units - Africa;Intensive care units - Developing countries
Issue Date: Oct-2022
Publisher: Elsevier
Abstract: Purpose: Death is common in intensive care units, and integrating palliative care enhances outcomes. Most research has been conducted in high-income countries. The aim is to understand what is known about the type and topics of research on the provision of palliative care within intensive care units in low- and middle-income countries MATERIALS AND METHODS: Scoping review with nine databases systematically searched for literature published in English on palliative care in intensive care units in low- and middle- income settings (01/01/1990 to 31/05/2021). Two reviewers independently checked search results and extracted textual data, which were analyzed and represented as themes. Results: Thirty papers reported 19 empirical studies, two clinical case reports and six discussion papers. Papers originated from Asia and Africa, primarily using observational designs and qualitative approaches, with no trials or other robust evaluative or comparative studies. No studies directly sought data from patients or families. Five areas of research focus were identified: withholding and withdrawing treatment; professional knowledge and skills; patient and family views; culture and context; and costs of care. Conclusions: Palliative care in intensive care units in low-and middle-income countries is understudied. Research focused on the specific needs of intensive care in low- and middle-income countries is required to ensure optimal patient outcomes.
Description: An article published in : Journal of Critical Care 71 (2022) 154115
DOI: 10.1016/j.jcrc.2022.154115
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