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. 2021 May 24;2(1):160-167.
doi: 10.1089/pmr.2021.0022. eCollection 2021.

Perception, Beliefs, and Attitudes Regarding Sedation Practices among Palliative Care Nurses and Physicians: A Qualitative Study

Margaux Vieille  1 , Lionel Dany  1   2 , Pierre Le Coz  3 , Sophie Avon  1 , Charlotte Keraval  1 , Sébastien Salas  2   4 , Cécile Bernard  5
Affiliations

Perception, Beliefs, and Attitudes Regarding Sedation Practices among Palliative Care Nurses and Physicians: A Qualitative Study

Margaux Vieille et al. Palliat Med Rep. .

Abstract

Background: Palliative care teams face complex medical situations on a daily basis. These situations require joint reflection and decision making to propose appropriate patient care. Sometimes, sedation is one of the options to be considered. In addition to medical and technical criteria justifying the use of sedation, multiple psychosocial criteria impact the decision making of palliative care teams and guide, give sense to, and legitimize professional practices. Objective: The main goal of this study was to explore perceptions, experiences, and beliefs of palliative care teams about sedation practices in a legislative context (Claeys-Leonetti law, 2016; France), which authorizes continuous deep sedation (CDS) until death. Methods: This is a qualitative study using 28 semistructured interviews with physicians and nurses working in a palliative care team in France (PACA region). All verbal productions produced during interviews were fully transcribed and the contents analyzed. Findings: Content analysis revealed four themes: (1) sedation as a "good death," (2) emotional experiences of sedations, (3) the practice of CDS, and (4) the ambiguous relationship with the Claeys-Leonetti law. Conclusions: This qualitative study provides evidence of a form of "naturalization" of the practice of sedation. However, the Claeys-Leonetti law exacerbates differences of opinion between palliative caregivers on sedation and questions the interest of this law for society and palliative care practices. clinicalTrials.gov identifier: NCT04016038.

Keywords: interviews; palliative care; professionals; qualitative study; sedation.

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Conflict of interest statement

No competing financial interests exist.

References

    1. Cherny NI, Portenoy RK: Sedation in the management of refractory symptoms: Guidelines for evaluation and treatment. J Palliat Care 1994;10:31–38 - PubMed
    1. van Dooren S, vanVeluw HT, van Zuylen L, et al. :. Exploration of concerns of relatives during continuous palliative sedation of their family members with cancer. J Pain Symptom Manage 2009;38:452–459 - PubMed
    1. Quill TE, Byock IR: Responding to intractable terminal suffering: The role of terminal sedation and voluntary refusal of food and fluids. Ann Intern Med 2000;132:408–414 - PubMed
    1. Sedation for terminal distress and in specific and complex situations: Recommendations in adults and specificities at home and in geriatrics. Société française d'accompagnement et de soins palliatifs (SFAP). 2014. http://www.sfap.org/system/files/sedation-phase-terminale.pdf (Last accessed September5, 2020)
    1. Booker R, Bruce A: Palliative sedation and medical assistance in dying: Distinctly different or simply semantics? Nurs Inq 2020;27:e12321. - PMC - PubMed

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