by Kazuaki Naya, Hideaki Sakuramoto Introduction In Japan, end-of-life care in intensive care units (ICU) remains inconsistent and often suboptimal, contributing to variability in the quality of dying and death. This study aimed to develop a culturally appropriate nurse-led intervention program to improve the quality of dying and death in Japanese ICU.
Methods Using a structured framework for intervention development, we conducted a systematic and scoping review to identify modifiable factors and effective strategies for end-of-life care in ICUs. Eight evidence-based strategies were synthesized into four core components: symptom management, multidisciplinary bedside conferences, family conferences, and end-of-life care.
A preliminary intervention program was developed and evaluated through expert interviews and web-based surveys to assess its clarity, feasibility, and alignment with the Japanese healthcare system. Results Based on expert feedback, revisions were made to enhance the clarity, feasibility, and alignment with the Japanese healthcare system.
Key improvements included initiating symptom management early upon ICU admission, allowing flexible scheduling of conferences, and incorporating structured tools and frameworks commonly used in Japan.
PLOS ONE (Medicine) published a clinical update in Research Highlights on 10 Apr 2026.
The item focuses on Development and external validity of a nurse-led intervention program to improve palliative care and quality of dying and death in intensive care unit.
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