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The experiences of relatives with the practice of palliative sedation: a systematic review.

Abstract：

CONTEXT:Guidelines about palliative sedation typically include recommendations to protect the well-being of relatives. OBJECTIVES:The aim of this study was to systematically review evidence on the experiences of relatives with the practice of palliative sedation. METHODS:PubMed, Embase, Web of Science, PsycINFO, and CINAHL were searched for empirical studies on relatives' experiences with palliative sedation. We investigated relatives' involvement in the decision-making and sedation processes, whether they received adequate information and support, and relatives' emotions. RESULTS:Of the 564 studies identified, 39 were included. The studies (30 quantitative, six qualitative, and three mixed methods) were conducted in 16 countries; three studies were based on relatives' reports, 26 on physicians' and nurses' proxy reports, seven on medical records, and three combined different sources. The 39 studies yielded a combined total of 8791 respondents or studied cases. Caregivers involved relatives in the decision making in 69%-100% of all cases (19 quantitative studies), and in 60%-100% of all cases, relatives were reported to have received adequate information (five quantitative studies). Only two quantitative studies reported on relatives' involvement in the provision of sedation. Despite the fact that the majority of relatives were reported to be comfortable with the use of palliative sedation (seven quantitative studies, four qualitative studies), several studies found that relatives were distressed by the use of sedation (five quantitative studies, five qualitative studies). No studies reported specifically about the support provided to the relatives. CONCLUSION:Relatives' experiences with palliative sedation are mainly studied from the perspective of proxies, mostly professional caregivers. The majority of relatives seems to be comfortable with the use of palliative sedation; however, they may experience substantial distress by the use of sedation.

journal_name

J Pain Symptom Manage

journal_title

Journal of pain and symptom management

authors

Bruinsma SM,Rietjens JA,Seymour JE,Anquinet L,van der Heide A

doi

10.1016/j.jpainsymman.2011.09.006

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

431-45

issue

3

eissn

0885-3924

issn

1873-6513

pii

S0885-3924(12)00093-0

journal_volume

44

pub_type

杂志文章,meta分析,评审

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