{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:22:54Z","timestamp":1765826574100,"version":"3.48.0"},"reference-count":50,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ministry of Health & Welfare, Republic of Korea","award":["RS-2023-KH137917"],"award-info":[{"award-number":["RS-2023-KH137917"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,5,16]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Critically ill patients in intensive care units (ICUs) receive life-sustaining treatments aimed at restoring or maintaining organ function. ICU admission often involves substantial multidimensional suffering that can burden patients, their families and surrogates. Multidisciplinary palliative care support can help alleviate their sufferings. In South Korea, however, palliative care has not yet been integrated into critical care settings, highlighting the need to explore the feasibility of its implementation within the ICU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This study aims to test the feasibility of a consultation-based palliative care intervention in the ICU. The study will include 20 patients admitted to the ICU of a tertiary hospital due to sudden severe acute brain injury or progressive organ failure, along with their family caregivers. A palliative care team, comprising a social worker and a palliative care physician, will provide consultations to the ICU healthcare professionals based on the palliative care needs, following family counselling. Additional family meetings will be held if necessary. The primary outcomes will include participation rates, family counselling rates and study completion rates. The intervention\u2019s potential impact will be assessed by changes in surrogate decision-making conflict, self-efficacy, depression and anxiety, post-decision regret and the experience of patient-centred and family-centred care. The demand and acceptability of the intervention will be assessed through semi-structured interviews with family surrogates, followed by qualitative analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study will be conducted in accordance with the Declaration of Helsinki and applicable national laws and regulations. The clinical study protocol, along with any protocol amendments and the informed consent form, has been approved by the Institutional Review Board of the Hospital (2404-111-1532). We plan to submit the study results for presentation at conferences and for publication in international peer-reviewed journals. Data will also be made available on request to participants, funding agencies and interested researchers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06490835\">NCT06490835<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-093558","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T05:20:34Z","timestamp":1748496034000},"page":"e093558","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility study protocol: implementing consultation-based high-quality palliative care services in intensive care units"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct06490835","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06490835","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4709-5951","authenticated-orcid":false,"given":"Ye Sul","family":"Jeung","sequence":"first","affiliation":[{"name":"Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1479-3385","authenticated-orcid":false,"given":"Yejin","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3911-9876","authenticated-orcid":false,"given":"Seyeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7408-4436","authenticated-orcid":false,"given":"Yoon Sun","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3616-5627","authenticated-orcid":false,"given":"Tae Jung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"},{"name":"Department of Neurology, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7473-1082","authenticated-orcid":false,"given":"Shin Hye","family":"Yoo","sequence":"additional","affiliation":[{"name":"Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)"},{"name":"Department of Human Systems Medicine, Seoul National University College of Medicine, Jongno-gu, Korea (the Republic of)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"2025121511190135000_15.5.e093558.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12871-018-0574-9","article-title":"Palliative care in intensive care units: why, where, what, who, when, how","volume":"18","author":"Mercadante","year":"2018","journal-title":"BMC Anesthesiol"},{"doi-asserted-by":"publisher","key":"2025121511190135000_15.5.e093558.2","DOI":"10.1097\/01.CCM.0000114816.62331.08"},{"key":"2025121511190135000_15.5.e093558.3","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1001\/jama.2015.18681","article-title":"Toward Better ICU Use at the End of Life","volume":"315","author":"Angus","year":"2016","journal-title":"JAMA"},{"key":"2025121511190135000_15.5.e093558.4","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.7229","article-title":"Association of Surrogate Decision-making Interventions for Critically Ill Adults With Patient, Family, and Resource Use Outcomes: A Systematic Review and Meta-analysis","volume":"2","author":"Bibas","year":"2019","journal-title":"JAMA Netw Open"},{"doi-asserted-by":"publisher","key":"2025121511190135000_15.5.e093558.5","DOI":"10.1056\/NEJMoa1011802"},{"key":"2025121511190135000_15.5.e093558.6","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1513\/AnnalsATS.201611-875OC","article-title":"Six-Month Morbidity and Mortality among Intensive Care Unit Patients Receiving Life-Sustaining Therapy. 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