Palliative-Care-Konzepte für Patienten und Familien

Jeder zehnte Mensch in Deutschland stirbt auf einer Intensivstation. In der Diskussion um Überversorgung am Lebensende gewinnen palliative Ansätze, die Selbstbestimmung und Lebensqualität in den Mittelpunkt stellen, an Bedeutung. Welche evidenzbasierten Interventionen für den Einsatz auf Intensivstationen geeignet und umsetzbar sind, haben die Autoren in ihrer Masterarbeit untersucht. Die wichtigsten Ergebnisse werden in diesem Beitrag zusammengefasst.

• Literatur

• 1 Ruppert S, Heindl P. Divergenz oder Kongruenz von Palliative Care und Critical Care. In: Ruppert S, Heindl P (Hrsg.). Palliative Critical Care. Palliative Pflegemaßnahmen auf der Intensivstation. Berlin: Springer Berlin; 2019: 83-98
• 2 Fleischmann-Struzek C, Mikolajetz A, Reinhart K. et al Hospitalization and intensive therapy at the end of life. Dtsch Arztebl Int 2019; 116: 653-60
• 3 Adler K, Schlieper D, Kindgen-Milles D. et al Integration der Palliativmedizin in die Intensivmedizin: Systematische Übersichtsarbeit. Anaesthesist 2017; 66: 660-6
• 4 Graw JA, Spies CD, Wernecke KD. et al Managing end-of-life decision making in intensive care medicine – a perspective from Charité Hospital, Germany. PLoS One 2012; 07: e46446
• 5 Hartog CS, Schwarzkopf D, Riedemann NC. et al End-of-life care in the intensive care unit: A patient-based questionnaire of intensive care unit staff perception and relatives’ psychological response. Palliat Med 2015; 29: 336-45
• 6 Piers RD, Azoulay E, Ricou B. et al Perceptions of appropriateness of care among European and Israeli intensive care unit nurses and physicians. JAMA 2011; 306: 2694-703
• 7 Harvey G, Kitson A. PARiHS revisited: From heuristic to integrated framework for the successful implementation of knowledge into practice. Implement Sci 2016; 11: 33
• 8 Harvey G, Kitson A. Promoting action on research implementation in health services: The integrated-PARIHS framework. In: Nilsen P, Birken SA (Hrsg.). Handbook on Implementation Science. Northampton: Edward Elgar Publishing 2020: 114-43
• 9 Lincoln T, Shields AM, Buddadhumaruk P. et al Protocol for a randomised trial of an interprofessional team-delivered intervention to support surrogate decision-makers in ICUs. BMJ Open 2020; 10: e033521
• 10 Daly BJ, Douglas SL, O’Toole E. et al Effectiveness trial of an intensive communication structure for families of long-stay ICU patients. Chest 2010; 138: 1340-8
• 11 Lautrette A, Darmon M, Megarbane B. et al A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 2007; 356: 469-78
• 12 Wessman BT, Sona C, Schallom M. Improving caregivers’ perceptions regarding patient goals of care/end-of-life issues for the multidisciplinary critical care team. J Intensive Care Med 2017; 32: 68-76
• 13 Kawashima T, Tanaka M, Kawakami A. et al Nurses’ contribution to end-of-life family conferences in critical care: A Delphi study. Nurs Crit Care 2020; 25: 305-12
• 14 Brooks LA, Bloomer MJ, Manias E. Culturally sensitive communication at the end-of-life in the intensive care unit: A systematic review. Aust Crit Care 2019; 32: 516-23
• 15 Wysham NG, Mularski RA, Schmidt DM. et al Long-term persistence of quality improvements for an intensive care unit communication initiative using the VALUE strategy. J Crit Care 2014; 29: 450-4
• 16 Krimshtein NS, Luhrs CA, Puntillo KA. et al Training nurses for interdisciplinary communication with families in the intensive care unit: An intervention. J Palliat Med 2011; 14: 1325-32
• 17 Curtis JR, Ciechanowski PS, Downey L. et al Development and evaluation of an interprofessional communication intervention to improve family outcomes in the ICU. Contemp Clin Trials 2012; 33: 1245-54
• 18 Curtis JR, Treece PD, Nielsen EL. et al Randomized trial of communication facilitators to reduce family distress and intensity of end-of-life care. Am J Respir Crit Care Med 2016; 193: 154-62
• 19 Coombs M, Puntillo KA, Franck LS. et al Implementing the SCCM family-centered fare guidelines in critical care nursing practice. AACN Adv Crit Care 2017; 28: 138-47
• 20 Rietjens JAC, Sudore RL, Connolly M. et al Definition and recommendations for advance care planning: An international consensus supported by the European Association for Palliative Care. Lancet Oncol 2017; 18: e543-e551
• 21 Nicolasora N, Pannala R, Mountantonakis S. et al If asked, hospitalized patients will choose whether to receive life-sustaining therapies. J Hosp Med 2006; 01: 161-7
• 22 Yamamoto K, Yonekura Y, Hayama J. et al Advance Care Planning for intensive care patients during the perioperative period: A qualitative study. SAGE Open Nurs 2021; 7: 23779608211038845
• 23 Jox RJ, Krebs M, Fegg M. et al Limiting life-sustaining treatment in German intensive care units: A multiprofessional survey. J Crit Care 2010; 25: 413-9
• 24 Gerritsen RT, Jensen HI, Koopmans M. et al Quality of dying and death in the ICU. The euroQ2 project. J Crit Care 2018; 44: 376-82
• 25 Latour JM, Fulbrook P, Albarran JW. EfCCNa survey: European intensive care nurses’ attitudes and beliefs towards end-of-life care. Nurs Crit Care 2009; 14: 110-21
• 26 Riessen R, Bantlin C, Wiesing U. et al Therapiezieländerungen auf einer internistischen Intensivstation. Einfluss von Willensäußerungen der Patienten auf Therapieentscheidungen. Med Klin Intensivmed Notfmed 2013; 108: 412-8
• 27 Weixler D, Likar R, Falkner A. Bedingungen des Sterbens an Österreichs anästhesiologischen Intensivstationen, eine Querschnittuntersuchung. Palliativmedizin 2015; 16: 26-32
• 28 Makoul G, Clayman ML. An integrative model of shared decision making in medical encounters. Patient Educ Couns 2006; 60: 301-12
• 29 White DB, Braddock CH, Bereknyei S. et al Toward shared decision making at the end of life in intensive care units: Opportunities for improvement. Arch Intern Med 2007; 167: 461-7
• 30 Sprung CL, Woodcock T, Sjokvist P. et al Reasons, considerations, difficulties and documentation of end-of-life decisions in European intensive care units: The ETHICUS Study. Intensive Care Med 2008; 34: 271-7
• 31 Schimmer C, Gorski A, Özkur M. et al Policies of withholding and withdrawal of life-sustaining treatment in critically ill patients on cardiac intensive care units in Germany: A national survey. Interact Cardiovasc Thorac Surg 2012; 14: 294-9
• 32 Michalsen A, Long AC, DeKeyser Ganz F. et al Interprofessional shared decision-making in the ICU: A systematic review and recommendations from an expert panel. Crit Care Med 2019; 47: 1258-66
• 33 Martz K, Alderden J, Bassett R. et al Outcomes associated with a nurse-driven palliative care screening tool in the intensive care unit. Crit Care Nurse 2020; 40: 23-9
• 34 Downar J, Delaney JW, Hawryluck L. et al Guidelines for the withdrawal of life-sustaining measures. Intensive Care Med 2016; 42: 1003-17
• 35 Paruk F, Kissoon N, Hartog CS. et al The Durban World Congress Ethics Round Table conference report: III. Withdrawing mechanical ventilation – the approach should be individualized. J Crit Care 2014; 29: 902-7
• 36 Efstathiou N, Vanderspank-Wright B, Vandyk A. et al Terminal withdrawal of mechanical ventilation in adult intensive care units: A systematic review and narrative synthesis of perceptions, experiences and practices. Palliat Med 2020; 34: 1140-64
• 37 Kompanje EJO, van der Hoven B, Bakker J. Anticipation of distress after discontinuation of mechanical ventilation in the ICU at the end of life. Intensive Care Med 2008; 34: 1593-9
• 38 Lanken PN, Terry PB, Delisser HM. et al An official American Thoracic Society clinical policy statement: Palliative care for patients with respiratory diseases and critical illnesses. Am J Respir Crit Care Med 2008; 177: 912-27
• 39 Staudacher D. „Comfort“ als „Spitze des Pflegebewusstseins“ in Palliative Care. In: Steffen-Bürgi B, Schärer-Santschi E, Staudacher D, Monteverde S (Hrsg.). Lehrbuch Palliative Care. 3. Aufl. Bern: Hogrefe; 2017: 415-22
• 40 Durán-Crane A, Laserna A, López-Olivo MA. et al Clinical practice guidelines and consensus statements about pain management in critically ill end-of-life patients: A systematic review. Crit Care Med 2019; 47: 1619-26
• 41 Puntillo K, Nelson JE, Weissman D. et al Palliative care in the ICU: Relief of pain, dyspnea, and thirst – a report from the IPAL-ICU Advisory Board. Intensive Care Med 2014; 40: 235-48
• 42 Lee D, Higgins PA. Adjunctive therapies for the chronically critically ill. AACN Adv Crit Care 2010; 21: 92-106
• 43 Thrane SE, Hsieh K, Donahue P. et al Could complementary health approaches improve the symptom experience and outcomes of critically ill adults? A systematic review of randomized controlled trials. Complement Ther Med 2019; 47: 102166
• 44 Aghaie B, Rejeh N, Heravi-Karimooi M. et al Effect of nature-based sound therapy on agitation and anxiety in coronary artery bypass graft patients during the weaning of mechanical ventilation: A randomised clinical trial. Int J Nurs Stud 2014; 51: 526-38
• 45 Cook D, Swinton M, Toledo F. et al Personalizing death in the intensive care unit: The 3 Wishes Project: A mixed-methods study. Ann Intern Med 2015; 163: 271-9
• 46 Vanstone M, Neville TH, Swinton ME. et al Expanding the 3 Wishes Project for compassionate end-of-life care: A qualitative evaluation of local adaptations. BMC Palliat Care 2020; 19: 93
• 47 Neville TH, Agarwal N, Swinton M. et al Improving end-of-life care in the intensive care unit: Clinicians’ experiences with the 3 Wishes Project. J Palliat Med 2019; 22: 1561-7
• 48 Takaoka A, Tam B, Vanstone M. et al Scale-up and sustainability of a personalized end-of-life care intervention: A longitudinal mixed-methods study. BMC Health Serv Res 2021; 21: 218
• 49 Yeung E, Sadowski L, Levesque K. et al Initiating and integrating a personalized end-of-life care project in a community hospital intensive care unit: A qualitative study of clinician and implementation team perspectives. J Eval Clin Pract 2021; 27 (06) 1281-90
• 50 Neville TH, Clarke F, Takaoka A. et al Keepsakes at the end of life. J Pain Symptom Manage 2020; 60: 941-7