Barriers and facilitators in the provision of palliative care in critical care: A qualitative descriptive study of nurses’ perspectives
Bibliographic record
Abstract
Intensive care units are providing increasing amounts of palliative care. Accordingly, integrating palliative care as a component of comprehensive critical care has been identified as a necessity. The purpose of this study was to explore what critical care nurses perceive as barriers and facilitators in the provision of palliative care in the critical care setting. We conducted a qualitative descriptive study between 2016 and 2017. Eleven critical care nurses working within an intensive care unit in a tertiary care western Canadian hospital participated in this study. Semi-structured individual interviews were conducted with each participant and data was interpreted using thematic analysis. Key barriers and facilitators identified were related to communication, end-of-life decision making, the life- saving mentality of the ICU, exposure to palliative care education, and the strengths and perils of the critical care environment. The results of this study provide insight into the initiatives and resources that are required to enhance the provision of palliative care in the critical care setting.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.024 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.008 | 0.009 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".