Abstract

End-of-life care in ICUs is often inadequate because of factors such as lack of communication between patients and health care providers, lack of patient- and family-centered care and lack of emotional and psychosocial support. The objective of this study was to determine the attitudes and practices of physicians and nurses attending patients and providing critical care on end-of-life care. This was a cross-sectional study comprising of45 respondents including Physicians and Nurses. Subjects were collected purposively and data was collected by face-to-face interviews through a semi-structured pretested questionnaire and data were collected in the ICU of 3 hospitals in Dhaka, Bangladesh. Signed consent was obtained from the participants and the results were shared among the participants. Data was analyzed using statistical software namely SPSS version 20 for Windows and both descriptive and inferential analysis was used, as appropriate. There was one more male than female respondent, more than half of the doctors had a Bachelor degree and more than two thirds of the nurses had a Diploma. More than half of the doctors and nearly half of the nurses had formal education or training in critical care. Among the doctors, 37% had 1-5 years and 62% of nurses had 6-10 years of ICU experience. Overall, 80% reported that they wanted to be involved in decision making of end of life care, and 76% were satisfied with decision making in end of life care. Most respondents said their ability was sufficient to make decisions about end of life treatment. Most said it was time consuming discussing end of life decisions with the patients and family members. Two thirds did not think decisions for end of life care were usually taken quickly. More than half thought that ‘do not resuscitate' orders should be present. Nearly half agreed that withholding or withdrawing life support is unethical and disagreed that withholding and withdrawing are ethically the same. Sixty percent thought financial costs to society are an important factor in influencing decisions on the extent of life support therapy to provide to a patient. Most let the family attend the meetings with the medical team. Moreover, most respondents fully informed the family about all aspects of the plan of care of the patient. More than half permitted the family to visit outside of regular visiting hours. Half asked the family how they are coping. The association between feeling that it is sex, difficult to approach a dying patient and to ask the family how they are coping with occupation of the respondent, was found statistically significant (p value.