Factors associated with healthcare providers' satisfaction with end-of-life care in the intensive care unit: A systematic review

Abstract

Background: We aimed to synthesize published data on and identify factors associated with healthcare providers' satisfaction with end-of-life care for critically ill adults.

Methods: Electronic databases were searched from inception to January 23, 2023. We included trials involving adults admitted to intensive care units (ICUs) or high-dependency units to evaluate palliative care interventions.

Study selection: The inclusion criteria were as follows: 1) Adult patients (age ≥18 years) or their family members admitted to the ICU or a high-dependency unit; 2) ICU palliative care interventions; 3) Randomized and non-randomized controlled trials; and 4) Full-text, peer-reviewed articles published in English. Two reviewers screened and extracted the data and assessed bias risk. The primary outcome was an improvement in the healthcare providers' satisfaction based on the validated scales.

Results: Out of 12 studies, 9 investigated combined dimension intervention. Healthcare providers' satisfaction improved in 6/7 (85.7%) of the studies testing educational intervention, 5/7 (71.4%) studies testing the effectiveness of palliative care team involvement, 4/5 (80%) of studies testing communication interventions, while 0/2 (0%) study testing ethic consultations.

Conclusions: Most of the tested palliative care interventions were associated with improved healthcare provider satisfaction in intensive care units. The impacts of such intervention on mental health and burden remain to be investigated in this field.

Keywords: End-of-life care; Healthcare provider satisfaction; Intensive care unit; Palliative care.