Barriers to implementing palliative care in intensive care units: perceptions of physicians and nurses in Jordan

Abstract

Background: Palliative care (PC) aims to relieve a person's suffering and provide the best possible quality of life (QoL) to people with chronic illnesses. Despite the significant impact of PC services on the QoL of patients, barriers exist that prevent healthcare providers from facilitating PC in intensive care units (ICUs). Aim: The purpose of this study was to explore the perceived barriers to implementing PC in ICUs. Methods: A qualitative approach was used to conduct 17 semi-structured interviews with clinicians across two ICUs (urban and suburban) in Jordan. Thematic analysis was used for the transcribed interviews. Results: Five main themes emerged: the ICU is a demanding and complex care environment; lack of preparation to implement PC; PC is a nicety, not a necessity; healthcare system-related barriers; and lack of cultural acceptance of PC. Lack of knowledge and training was identified as a major barrier for the effective implementation of PC by both physicians and nurses. Conclusion: Equipping healthcare providers with the knowledge and expertise to provide PC is essential to dispel myths related to PC and facilitate PC provision. Developing an interdisciplinary care team will support the effective implementation of PC services in any setting. Establishing national PC policies will foster the ethical and legal practice of PC in Jordan.