P0450 / #919: END OF LIFE CARE PRACTICES IN PICUS IN BRAZIL

Le résumé fourni par la source

Aims & Objectives: Professionals often quote cultural and socio-economic differences to explain lower indices of Withdrawal of Life-Sustaining Therapy (WLST) in Brazil compared to developed countries’ PICUs. We aimed to study the Brazilian PICU team’s perspectives on End of Life (EoL) care. Methods: A survey tested beforehand, containing Likert style answers and few open questions, was sent via email to professionals in 3 PICUs in Brazil’s center-south hospitals (A.Private, B.Public and a C.University Oncology) as a pilot study. Institutional ethics committees, Gov. research registry and individual consent were obtained. During the 3 months (09-11/2019), 3 reminders were sent. Three open questions were applied, and a thematic analysis was taken. Results: Overall 136 surveys returned (response rate: 23% total; Physicians: A.31%, B.25%, and C.60%), Overall 35% Physicians, 31% Nurses, 20% Nurses technicians and 14% Physiotherapists responded. Only 25% of professionals consider their EOL care excellent or very good. The majority (65%) indicated that the main barrier to implement WLST was the families’ cultural/ social context. Common words were “cultural”, “hope”, “fear” and “family”, as in “The family always hopes for a miracle, making decisions difficult.” Professional’s attitude was the second most common reason (15%), albeit it was the highest reason for Oncology PICU professionals (73%). “Death is a failure”; “Team does not know how to reason with families or openly talk about prognosis”. Conclusions: Brazilian professionals consider their EoL care not adequate and quote families’ resistance and high hopes for a cure as the main reasons for not practicing active WLST. Further studies are needed in this field.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.