Insights from critical care clinicians, patients and families from culturally and linguistically diverse backgrounds about end-of-life care in the intensive care unit: a scoping review
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Le résumé fourni par la source
BACKGROUND: Patients and families from culturally and linguistically diverse (CALD) backgrounds face distinct challenges during end-of-life care (EOLC) in intensive care unit (ICU) settings, where communication, cultural expectations and decision-making may conflict with clinical norms. These complexities have important implications for intensive and palliative care teams. OBJECTIVES: To map literature on clinician, patient and family perspectives on end-of-life communication with CALD populations in ICUs, and identify barriers and facilitators to culturally responsive care. DESIGN: This scoping review followed Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. The protocol was registered with the Open Science Framework and published in BMJ Open. Screening, review and data extraction were conducted by multiple reviewers using Covidence and the Joanna Briggs Institute tool, with findings synthesised through inductive thematic analysis. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was to identify barriers and facilitators to communication between clinicians, patients and families from CALD backgrounds during EOLC. Secondary outcomes were to map the scope of evidence, describe study characteristics and participant demographics, and summarise themes on cultural sensitivity, clinician awareness, family involvement, decision-making and integration of support services. RESULTS: Thirty of 766 screened studies were included. Three themes emerged: communication challenges; cultural sensitivity and humility and decision-making and support. Barriers included limited access to palliative care, language discordance, underuse of interpreters, clinician discomfort and conflicting care expectations. Facilitators included structured meetings, inclusive practices and interdisciplinary collaboration. CONCLUSIONS: Structural, communicative and cultural barriers undermine equitable EOLC for CALD patients. Embedding palliative care principles, cultural responsiveness and shared decision-making into ICU practice requires coordinated input from a multidisciplinary team involving physicians, nurses, social workers, spiritual care, psychologists and interpreters. System-level reforms in training, service delivery and research are needed to ensure person-centred care. PROTOCOL REGISTRATION: Registered with BMJ Open DOI: 10.1136/bmjopen-2024-090168.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Insights from critical care clinicians, patients and families from culturally and linguistically diverse backgrounds about end-of-life care in the intensive care unit: a scoping review
- Date Crossref
- 01/12/2025
- Éditeur
- BMJ
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Royal Adelaide Hospital Department of Intensive Care Medicine pays non établi dans la noticeÉtablissement de santé
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The University of Adelaide pays non établi dans la noticeUniversité ou école supérieure
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Monash University Peninsula Clinical School pays non établi dans la noticeUniversité ou école supérieure
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University of Auckland pays non établi dans la noticeUniversité ou école supérieure
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Auckland District Health Board pays non établi dans la noticeÉtablissement de santé
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Flinders University Research Centre for Palliative Care pays non établi dans la noticeUniversité ou école supérieure
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Epworth Hospital Department of Intensive Care Medicine pays non établi dans la noticeÉtablissement de santé
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Peninsula Health pays non établi dans la noticeÉtablissement de santé
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Dandenong Hospital Department of Intensive Care Medicine pays non établi dans la noticeÉtablissement de santé
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Faculty of Health and Medical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Auckland Adult Emergency Department pays non établi dans la noticeInstitution
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School of Nursing pays non établi dans la noticeUniversité ou école supérieure
Department of Intensive Care Medicine — Royal Adelaide Hospital, The University of Adelaide et Peninsula Clinical School — Monash University, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.