Feasibility and Acceptability of Consultation-Based Palliative Care in a Korean Intensive Care Unit

Introduction: Critically ill patients and their families in intensive care units (ICUs) face multidimensional challenges in decision-making. In South Korea, where palliative care (PC) is not routinely integrated into ICU care, structured PC interventions remain limited. This pilot study aimed to evaluate the feasibility and acceptability of a consultation-based PC intervention designed to enhance psychosocial and decision-making support for families of ICU patients with serious illness.


Methods: This was a prospective, single-arm, pre–post feasibility study conducted in the emergency ICU of a tertiary hospital. Adult patients with severe acute brain injury or progressive organ failure and their family caregivers were enrolled. The intervention included structured family counselling by a social worker, followed by a PC consultation involving a PC physician and social worker. Feasibility was assessed by recruitment, intervention completion, and data collection rates. Acceptability was evaluated through satisfaction scores. Exploratory outcomes included changes in surrogate decision-making conflict and psychological distress.


Results: Among 35 eligible cases, 14 (40%) dyads were enrolled and completed the intervention and follow-up. The most common ICU diagnoses were renal failure/metabolic derangement (35.7%), severe infection (28.6%), and cardiac arrest (21.4%). The median time from enrollment to PC consultation was 2.5 days (IQR 0–5). Median satisfaction scores were 5.0 (consultation) and 4.3 (counselling). The Decisional Conflict Scale score significantly decreased from 29.9 to 25.6 (p=0.048), with improvement in the values clarity subdomain. There were no significant changes in anxiety or depression scores. The survival-to-discharge rate was 84.6%. Median ICU and hospital lengths of stay were 34 and 41 days, respectively.


Conclusions: This study demonstrated that a consultation-based PC intervention was feasible and acceptable in a Korean ICU setting. It was associated with improved decision-making outcomes and high family satisfaction. These findings inform the development of structured ICU-based PC models for broader implementation.