The Practice of Providing Palliative Care in the Situation of the COVID-19 Pandemic in the Perspective of Physicians and Nurses - Survey Study (PEOpLe-C19-EN Study)
Conditions: COVID-19 Pandemic, End-of-life
Sponsor: Masaryk University

Title: The practice of providing palliative care in the situation of the COVID-19 pandemic in
the perspective of physicians and nurses – survey study (PEOpLe-C19 study)
Authors:
Tereza Prokopova M.D.1
Jan Hudec M.D.1
Kamil Vrbica M.D.1
Jan Stasek M.D., EDIC1
Kateřina Rusinova M.D. MgA., Ph.D.2
prof. Andrea Pokorna PhDr., Ph.D.3
Jan Malaska M.D., Ph.D., EDIC1
Affiliations:
1) Department of Anesthesiology and Intensive Care Medicine, University Hospital Brno and
Faculty of Medicine, Masaryk University, Brno, Czech Republic.
2)Department of Anaesthesiology and Intensive Care, First Faculty of Medicine, Charles
University in Prague and General University Hospital in Prague, Prague, Czech Republic
3)Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech
Republic
Description: Pandemic of coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome
coronavirus 2) causing the disease COVID-19 (Coronavirus Disease 2019) overwhelmed
healthcare and brought new challenges and stressful situations. In a short time, intensive
care units (ICU) capacities were filled in many countries and regions. Due to the need for an
excessive number of patients requiring intensive care, physicians and nurses who do not
routinely provide care to critically ill patients or do not have the appropriate training
(non-ICU clinician) were involved in the care of COVID-19 patients. In this context, ICU
directly dedicated to caring for patients with COVID-19 ARDS (Acute Respiratory Distress
Syndrome) was also opened. Non-ICU clinicians were more or less involved together with the
standard ICU staff in palliative care, including End-of-Life decision (EOLD) making, even in a
situation of limited, scarce resources (equipment or personnel). New workplace and scope of
work, which did not correspond to the standard activity or education, most likely led to an
increased stress load. EOLD can also be one of the factors leading to increased stress levels.
The project aims to describe the practice of palliative care for patients with COVID-19 in a
situation of pandemic COVID-19 and to identify factors leading to possible moral distress
related to EOLD.
Target group: Healthcare providers (physicians and nurses) providing care to patients with
COVID-19 admitted at ICU in the period of COVID-19 pandemic. (ICU – intensive care unit is
defined in this study as a department with the possibility of mechanical ventilation)
Primary outcome: Description of the practice of providing palliative care, including EOLD
practice in patients with COVID-19 admitted at ICU in COVID-19 pandemic.
Secondary outcome:
a) Identify factors leading to moral distress during the COVID-19 pandemic

b) Describe possible different factors of moral distress by profession
HO: The process of providing palliative care, including End-of-life decisions, do not differ
according to the type of workplace, demographic characteristics of healthcare providers,
their education and job title. The level of moral distress in the situation of the COVID-19
pandemic in the period 2020/2021 was the same as before the pandemic. Factors associated
with moral distress did not differ according to the communication, workplace safety, not
even by job title.
Period of study: 1st July 2021 – 31st December 2021
Type of project: standard research
Study design:
-Study type: observational descriptive non-interventional study
-Model of observational study: a survey study
-Time perspective: prospective
-Biological material: none
-Number of groups/cohorts: 2 – (physicians and nurses)
Randomisation: Purposive sampling (Participants were included because they met inclusion
criteria.
Exclusion criteria: Healthcare professionals who did not manage COVID-19 patients admitted
at the ICU in the situation of COVID-19 pandemic in the period 2020/2021.
Risks/BIAS: Survey studies have their limitations, and the proposed survey is no exception.
The risk is an insufficient research sample. The risk will be eliminated by choosing suitable
research assistants and contact persons and cooperating with professional organisations. The
use of professional contacts and web portals focused on the provision of intensive care.
Ethics Committee: An application has been submitted by the Ethics Committee, Faculty of
Medicine, Masaryk University, Brno.