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医疗保健提供者应如何告知临终镇静?一项针对姑息治疗专业人员的定性研究。

How should health care providers inform about palliative sedation? A qualitative study with palliative care professionals.

作者信息

Cocker Allan, Singy Pascal, Jox Ralf J

机构信息

Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland.

Liaison Psychiatry, CHUV, University of Lausanne, Lausanne, Switzerland.

出版信息

Eur J Cancer Care (Engl). 2022 Sep;31(5):e13602. doi: 10.1111/ecc.13602. Epub 2022 Apr 29.

Abstract

OBJECTIVE

In Switzerland, palliative sedation consists of using sedatives to relieve terminally ill patients. It is divided into several steps, with one of them consisting of informing patients and relatives about the procedure. In the current recommendations, there is a lack of orientation about how and when this discussion should take place. Hence, we aim to explore perceptions and experiences of palliative care professionals regarding these questions.

METHODS

Qualitative semi-structured interviews with five physicians and five nurses working in specialised palliative care were conducted. They were then analysed with thematic analysis.

RESULTS

Results showed a uniformity around definition, goals and indications of palliative sedation. However, there was a lack of consistency regarding the process of delivering this information to patients and relatives. Finally, some participants strongly opposed the idea of systematically informing patients in specialised palliative care, while others were more divided on this question.

CONCLUSION

Despite a common understanding of the concept of palliative sedation, there is no standard practice when informing patients on palliative sedation among palliative care professionals. Therefore, this study demonstrates the need for further guidelines on this question and calls for a better understanding and knowledge of palliative sedation among health professionals outside palliative care.

摘要

目的

在瑞士,姑息性镇静是指使用镇静剂来缓解晚期患者的痛苦。它分为几个步骤,其中之一是向患者及其亲属告知该程序。在当前的建议中,缺乏关于如何以及何时进行这种讨论的指导。因此,我们旨在探讨姑息治疗专业人员对这些问题的看法和经验。

方法

对五名从事专业姑息治疗的医生和五名护士进行了定性半结构化访谈。然后采用主题分析法对访谈结果进行分析。

结果

结果显示,在姑息性镇静的定义、目标和适应症方面存在一致性。然而,在向患者及其亲属传达这些信息的过程中缺乏一致性。最后,一些参与者强烈反对在专业姑息治疗中系统地告知患者的想法,而另一些人在这个问题上则存在更多分歧。

结论

尽管对姑息性镇静的概念有共同的理解,但在姑息治疗专业人员中,在告知患者姑息性镇静方面没有标准做法。因此,本研究表明需要就此问题制定进一步的指导方针,并呼吁姑息治疗以外的卫生专业人员更好地理解和了解姑息性镇静。

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Palliative Sedation for the Terminally Ill Patient.晚期病危患者的缓和性镇静治疗。
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