Attitude, Educational Needs, and Challenges Faced by Physicians in Managing End-of-Life Care for Critically Ill COVID-19 Patients in Critical Care Settings During the COVID-19 Pandemic

Abstract

INTRODUCTION: End-of-life (EOL) decision-making is particularly sensitive and complex, especially during the COVID-19 pandemic. This study aimed to assess the attitudes, educational needs, and challenges faced by doctors working in critical care settings in providing EOL care for critically ill COVID-19 patients during the pandemic. MATERIALS AND METHODS: A structured questionnaire comprising four sections was utilized to assess the attitudes of critical care unit doctors at the Hospital Universiti Sains Malaysia and Hospital Selayang, Malaysia. The questionnaire captured responses related to the attitudes, educational needs, and challenges of the physicians in the management of critically ill COVID-19 patients. RESULTS: The respondents generally agreed that EOL care is an essential clinical competency during the pandemic, with a mean score of 3.44 ± 0.87. There was strong recognition of diverse educational needs related to EOL care, encompassing both clinical and ethical aspects, with average mean scores exceeding 3 across relevant items. The physicians also identified several significant barriers to delivering effective EOL care, including the absence of standardized protocols or dedicated services (p=0.001), insufficient training (p=0.006), and time constraints (p=0.007). CONCLUSION: Overall, doctors in critical care settings demonstrated a positive attitude toward the role of EOL care for critically ill COVID-19 patients during the pandemic. A clearer understanding of their attitudes, challenges, and educational needs can help inform strategies to enhance the development and integration of EOL care in critical care settings moving forward.