Continuous palliative sedation until death: a qualitative study of palliative care clinicians' experiences

被引：5

作者：

Guite-Verret, Alexandra ^{[1
,2
]}

Boivin, Jessica ^{[2
,3
,4
]}

Hanna, Andrew M. R. ^{[5
]}

Downar, James ^{[5
,6
]}

Bush, Shirley H. ^{[5
,6
,7
]}

Marcoux, Isabelle ^{[2
,8
]}

Guay, Diane ^{[2
,9
]}

Tapp, Diane ^{[2
,4
,10
]}

Lapenskie, Julie ^{[5
,7
]}

Gagnon, Bruno ^{[2
,4
,5
,11
]}

机构：

[1] Univ Quebec Montreal, Dept Psychol, Montreal, PQ, Canada

[2] Reseau Quebecois Rech Soins Palliat & Fin Vie, Quebec City, PQ, Canada

[3] Univ Laval, Fac Med, Dept Social & Prevent Med, Quebec City, PQ, Canada

[4] Univ Laval Res Ctr, CHU Quebec, Quebec City, PQ, Canada

[5] Bruyere Res Inst, Ottawa, ON, Canada

[6] Univ Ottawa, Dept Med, Ottawa, ON, Canada

[7] Univ Ottawa, Ottawa Hosp Res Inst, Ottawa, ON, Canada

[8] Univ Ottawa, Fac Hlth Sci, Ottawa, ON, Canada

[9] Univ Sherbrooke, Fac Med & Hlth Sci, Quebec City, PQ, Canada

[10] Univ Laval, Fac Nursing, Quebec City, PQ, Canada

[11] Univ Laval, Dept Family & Emergency Med, Quebec City, PQ, Canada

来源：

BMC PALLIATIVE CARE | 2024年 / 23卷 / 01期

关键词：

Continuous palliative sedation; Deep sedation; Palliative care; End-of-life care; Assisted dying; Medical assistance in dying; Euthanasia; Qualitative; PRACTITIONERS PERSPECTIVES; HOME-CARE; PHYSICIANS; LIFE; END; ATTITUDES; NURSES; EUTHANASIA; AWARENESS; HOSPICE;

D O I：

10.1186/s12904-024-01426-2

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background The practice of continuous palliative sedation until death is the subject of much medical and ethical debate, which is reflected in the inconsistency that persists in the literature regarding the definition and indications of palliative sedation.Aim This study aims to gain a better understanding of palliative care clinicians' experiences with continuous palliative sedation.Design We conducted a qualitative study based on focus group discussions.Setting/participants We conducted six focus groups with a total of 28 palliative care clinicians (i.e., 15 nurses, 12 physicians, and 1 end-of-life doula) from diverse care settings across Canada, where assisted dying has recently been legalized.Results An interpretative phenomenological analysis was used to consolidate the data into six key themes: responding to suffering; grappling with uncertainty; adapting care to ensure ongoing quality; grounding clinical practice in ethics; combining medical expertise, relational tact, and reflexivity; and offering an alternative to assisted death.Conclusions Interaction with the patient's family, uncertainty about the patient's prognosis, the concurrent practice of assisted dying, and the treatment of existential suffering influence the quality of sedation and indicate a lack of clear palliative care guidelines. Nevertheless, clinicians exhibit a reflective and adaptive capacity that can facilitate good practice.

引用

页数：11

共 52 条

[1] International variations in clinical practice guidelines for palliative sedation: a systematic review [J].