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    Rights statement: This is the author’s version of a work that was accepted for publication in Journal of Critical Care. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Critical Care, 71, 154115, 2022 DOI: 10.1016/j.jcrc.2022.154115

    Accepted author manuscript, 353 KB, PDF document

    Embargo ends: 27/07/23

    Available under license: CC BY-NC-ND: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

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Palliative and end-of-life care in intensive care units in low- and middle-income countries: A systematically constructed scoping review

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E-pub ahead of print
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Article number154115
<mark>Journal publication date</mark>31/10/2022
<mark>Journal</mark>Journal of Critical Care
Volume71
Number of pages13
Publication StatusE-pub ahead of print
Early online date27/07/22
<mark>Original language</mark>English

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.

Bibliographic note

This is the author’s version of a work that was accepted for publication in Journal of Critical Care. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Critical Care, 71, 154115, 2022 DOI: 10.1016/j.jcrc.2022.154115