Impact of COVID-19 on care at the end of life during the first months of the pandemic from the perspective of healthcare professionals from different settings: a qualitative interview study (the CO-LIVE study).
COVID-19
End-of-life Care
Palliative Care
Qualitative Research
Quality of Care
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
06 03 2023
06 03 2023
Historique:
entrez:
6
3
2023
pubmed:
7
3
2023
medline:
9
3
2023
Statut:
epublish
Résumé
The objective of this study is to better understand how the COVID-19 outbreak impacted the different domains of the palliative care approach to end-of-life care from the perspective of healthcare professionals (HCPs) from different professions, working in different settings during the first months of the COVID-19 outbreak in the Netherlands. An in-depth qualitative interview study among 16 HCPs of patients who died between March and July 2020 in different healthcare settings in the Netherlands. The HCPs were recruited through an online survey about end-of-life care. Maximum variation sampling was used. Data were analysed following the principles of thematic analysis. Several aspects impacted the quality of the palliative care approach to care at the end of life. First, COVID-19 was a new disease and this led to challenges in the physical domain of end-of-life care, for example, a lack of knowledge on how to manage symptoms and an unreliable clinical view. Second, the high workload HCPs experienced impacted the quality of end-of-life care, especially in the emotional, social and spiritual domains, since they only had time for urgent, physical care. Third, COVID-19 is a contagious disease and measures taken to prevent the spread of the virus hampered care for both patients and relatives. For example, because of the visiting restrictions, HCPs were not able to provide emotional support to relatives. Finally, the COVID-19 outbreak also had a potentially positive impact in the longer term, for example, more awareness of advance care planning and the importance of end-of-life care that includes all the domains. The palliative care approach, which is key to good end-of-life care, was often negatively influenced by the COVID-19 pandemic, predominantly in the emotional, social and spiritual domains. This was related to a focus on essential physical care and prevention of the spread of COVID-19.
Identifiants
pubmed: 36878652
pii: bmjopen-2022-063267
doi: 10.1136/bmjopen-2022-063267
pmc: PMC9990162
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e063267Informations de copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
BMJ. 2020 Apr 15;369:m1472
pubmed: 32295758
Palliat Med. 2021 May;35(5):843-851
pubmed: 33784908
Lancet. 2020 May 9;395(10235):1467-1469
pubmed: 32333842
Palliat Med. 2021 Sep;35(8):1480-1491
pubmed: 34053347
Health Soc Care Community. 2022 Nov;30(6):e4165-e4174
pubmed: 35403763
J R Soc Med. 2022 Jun;115(6):220-230
pubmed: 35133216
N Engl J Med. 2020 Jun 11;382(24):e88
pubmed: 32289215
Crit Care Med. 2021 Jun 1;49(6):e585-e597
pubmed: 33591018
Palliat Med. 2021 May;35(5):852-861
pubmed: 33775169
Ann Intern Med. 2021 Apr;174(4):493-500
pubmed: 33284683
BJGP Open. 2021 Aug 24;5(4):
pubmed: 34117014
Palliat Med. 2021 May;35(5):830-842
pubmed: 33825567
Int J Environ Res Public Health. 2022 Feb 13;19(4):
pubmed: 35206293
CMAJ. 2020 Apr 14;192(15):E400-E404
pubmed: 32234725
Palliat Med. 2021 Jul;35(7):1225-1237
pubmed: 34034585
J Soc Work End Life Palliat Care. 2022 Jan-Mar;18(1):46-62
pubmed: 35067207
Palliat Med. 2021 Jul;35(7):1249-1257
pubmed: 34006159