Exploration of Concerns of Relatives During Continuous Palliative Sedation of Their Family Members with Cancer
Exploration of Concerns of Relatives During Continuous Palliative Sedation of Their Family Members with Cancer
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DOI：
10.1016/j.jpainsymman.2008.11.011
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发表时间：
2009-09-01
影响因子：
4.7
通讯作者：
van der Rijt, Carin C. D.
中科院分区：
文献类型：
--
作者：
van Dooren, Silvia;van Veluw, Hetty T. M.;van der Rijt, Carin C. D.
亲属在持续姑息性镇静期间的经验数据很少。因为这些亲属可能是与患者关系最密切的人，所以评估他们可能经历的负担很重要。我们的目的是探讨和评估亲属的关注，在连续姑息镇静的家庭成员承认急性姑息治疗单位。通过回顾性多学科记录研究，我们获得了持续姑息镇静期间亲属关注的数据。2001年10月至2004年10月，45例患者在开始持续姑息镇静后死亡。在51%的病例中，亲属在开始治疗后表示担忧。关注点可以分为三个主题：对持续姑息性镇静目的的关注（27%），与患者福祉相关的关注（29%），以及与亲属自身福祉相关的关注（18%）。除了镇静持续时间外，患者和镇静特征在亲属没有和没有表达担忧的镇静剂之间没有显着差异。持续姑息性镇静的中位持续时间为46小时，而非持续姑息性镇静的中位持续时间为19.5小时（P < 0.05）。关注的性质和程度都表明，亲属在持续姑息镇静期间需要持续的信息和专业指导。提供护理人员指导和明确的过程文件是至关重要的，不可或缺的。J Pain Symptom Manage 2009;38：452-459. (C)2009年美国癌症疼痛缓解委员会。公开.关于Elsevier Inc. All rights reserved.
Data on the experiences of relatives during continuous palliative sedation are scarce. Because these relatives may be the ones most closely involved with the patient, it is important to evaluate the possible burdens that they experience. We aimed to explore and evaluate concerns of relatives during continuous palliative sedation of their family members admitted to an acute palliative care unit. Through retrospective multidisciplinary record research, we obtained data on concerns of the relatives during the period that continuous palliative sedation took place. From October 2001 to October 2004, 45 patients died after starting continuous palliative sedation. In 51% of the cases, the relatives expressed concerns after starting the therapy. Concerns could be distinguished into three main themes: concerns about the aim of continuous palliative sedation (27%), concerns related to the well-being of the patient (29%), and concerns related to the well-being of relatives themselves (18%). Patient and sedation characteristics did not differ significantly between sedations in which relatives did and did not express concerns, except for the duration of the sedation. The median duration of the continuous palliative sedation when concerns were expressed was 46 hours, compared with 19.5 hours when this was not the case (P < 0.05). Both the nature and extent of the concerns suggest that relatives are in need of continuous information and professional guidance during continuous palliative sedation of their family members. Availability of caregiver guidance and clear process documentation are crucial and indispensable in providing this. J Pain Symptom Manage 2009;38:452-459. (C) 2009 U.S. Cancer Pain Relief Committee. Published. by Elsevier Inc. All rights reserved.