Førde R, Aasland O G, Falkum E, Breivik H, Kaasa S
Legeforeningens forskningsinstitutt Postboks 1152 Sentrum 0107 Oslo.
Tidsskr Nor Laegeforen. 2001 Mar 30;121(9):1085-8.
In May 2000, the Norwegian Medical Association appointed a working group to propose guidelines for the practice of palliative sedation to dying patients (terminal sedation). The present study is part of this work. The aim of the study was to register to what extent this form of palliation is used in Norwegian hospitals, on what indications, how decisions are reached, and whether the treatment is considered necessary. The definition of palliative sedation given was: induction and maintenance of sleep for the relief of pain or other types of suffering in a patient close to death. The intention is exclusively to relieve intractable pain, not to shorten the patient's life.
An anonymous questionnaire was sent to 364 Norwegian hospital departments that might have experience with palliative sedation. Results are reported partly as free text comments and partly as frequencies of predetermined response alternatives.
58% of the questionnaires were returned. 22% of the respondents had given palliative sedation to a dying patient during the last 12 months, and more than half of the physicians found this intervention sometimes necessary. Pain was the most frequent indication; none of the respondents claimed to haven given sedation exclusively based on depression/anxiety. Lack of resources still seems to be an obstacle to optimal palliative care in Norway.
Though it has some methodological weaknesses, this study confirms the need for national guidelines.
2000年5月，挪威医学协会任命了一个工作组，负责提出针对临终患者实施姑息性镇静（终末期镇静）的指导方针。本研究是这项工作的一部分。该研究的目的是记录这种姑息治疗形式在挪威医院中的使用程度、使用指征、如何做出决策以及该治疗是否被认为是必要的。所给出的姑息性镇静的定义为：诱导并维持睡眠，以缓解濒死患者的疼痛或其他类型的痛苦。其目的仅仅是缓解难以忍受的疼痛，而非缩短患者的生命。
向364个可能有姑息性镇静经验的挪威医院科室发送了一份匿名问卷。结果部分以自由文本评论的形式呈现，部分以预先设定的回答选项的频率呈现。
58%的问卷被收回。22%的受访者在过去12个月内对临终患者实施过姑息性镇静，且超过半数的医生认为这种干预有时是必要的。疼痛是最常见的指征；没有受访者声称仅基于抑郁/焦虑而给予镇静。资源匮乏似乎仍是挪威提供最佳姑息治疗的一个障碍。
尽管本研究存在一些方法学上的不足，但证实了制定国家指导方针的必要性。
