Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov 25;15(1):12.
doi: 10.1186/s13010-020-00096-1.

The impact of caring for dying patients in intensive care units on a physician's personhood: a systematic scoping review

Joshua Tze Yin Kuek  1   2 , Lisa Xin Ling Ngiam  1   2 , Nur Haidah Ahmad Kamal  1   2 , Jeng Long Chia  1   2 , Natalie Pei Xin Chan  1   2 , Ahmad Bin Hanifah Marican Abdurrahman  1   2 , Chong Yao Ho  1   2 , Lorraine Hui En Tan  1   2 , Jun Leng Goh  1   2 , Michelle Shi Qing Khoo  1   2 , Yun Ting Ong  1   2 , Min Chiam  3 , Annelissa Mien Chew Chin  4 , Stephen Mason  5 , Lalit Kumar Radha Krishna  6   7   8   9   10   11   12
Affiliations

The impact of caring for dying patients in intensive care units on a physician's personhood: a systematic scoping review

Joshua Tze Yin Kuek et al. Philos Ethics Humanit Med. .

Abstract

Background: Supporting physicians in Intensive Care Units (ICU)s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review (SSR) is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for ICU physicians.

Methods: An SSR adopts the Systematic Evidenced Based Approach (SEBA) to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis (Split Approach) is adopted.

Results: Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed.

Conclusion: This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support.

Keywords: Death and dying; Intensive care unit (ICU); Personhood; Physicians; Resilience; Ring theory of personhood (RToP).

PubMed Disclaimer

Conflict of interest statement

All authors declare that there was no conflict of interest.

Figures

Fig. 1
Fig. 1
The SEBA Approach
Fig. 2
Fig. 2
PRISMA Flow Chart
Fig. 3
Fig. 3
Krishna and Alsuwaigh (2015)‘s Ring Theory of Personhood
Fig. 4
Fig. 4
Resilience and Concession
Fig. 5
Fig. 5
Cylinder Model
Fig. 6
Fig. 6
The Sphere Model
See this image and copyright information in PMC

References

    1. Phua J, Weng L, Ling L, Egi M, Lim CM, Divatia JV, Shrestha BR, Arabi YM, Ng J, Gomersall CD, Nishimura M, Koh Y, Du B, Asian Critical Care Clinical Trials Group. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med. 2020;8(5):506–17. 10.1016/S2213-2600(20)30161-2. - PMC - PubMed
    1. Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anaesth. 2020;67(5):568–576. doi: 10.1007/s12630-020-01591-x. - DOI - PMC - PubMed
    1. Sasangohar F, Jones SL, Masud FN, Vahidy FS, Kash BA. Provider burnout and fatigue during the COVID-19 pandemic: lessons learned from a high-volume intensive care unit. Anesth Analg. 2020. - PMC - PubMed
    1. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3):e203976. doi: 10.1001/jamanetworkopen.2020.3976. - DOI - PMC - PubMed
    1. Adams JG, Walls RM. Supporting the Health Care Workforce During the COVID-19 Global Epidemic. JAMA. 2020;323(15):1439–40. 10.1001/jama.2020.3972. - PubMed

Publication types