Concerns of family members of patients receiving palliative sedation therapy
Concerns of family members of patients receiving palliative sedation therapy
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DOI：
10.1007/s00520-004-0678-2
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发表时间：
2004-12-01
影响因子：
3.1
通讯作者：
Uchitomi, Y
中科院分区：
文献类型：
--
作者：
Morita, T;Ikenaga, M;Uchitomi, Y
目的：癌症末期病人通常需要进行症状镇静，这可能会给他们的家人带来巨大的痛苦。本研究的目的是收集生动的家庭描述他们的经验，姑息镇静治疗。方法：本报告是多中心问卷调查的补充分析。我们对185名接受姑息性镇静治疗的患者家属描述的48份陈述进行了内容分析。结果：患者接受姑息性镇静治疗时，家属报告内疚、无助、身心疲惫。他们关心镇静剂病人是否感到痛苦，希望知道已尽了最大努力，希望为病人的死亡做好准备，希望在镇静剂之前告诉病人重要的事情，希望了解病人的痛苦，并希望医疗专业人员有尊严地对待病人。结论：为了减轻家属的痛苦，临床医生应该了解家属的情绪困扰，确保昏迷的病人没有痛苦，让家属放心，尽管尽最大努力缓解症状，症状确实难以缓解，提供信息和协调情况，使家属能够为病人死亡做好准备，并在镇静前告诉病人重要的事情，帮助家属分担病人的痛苦，并将病人治疗得与清醒时一样
Purpose: Symptomatic sedation is often required in terminally ill cancer patients and could cause significant distress to their families. The aim of this study was to gather vivid family descriptions about their experiences in palliative sedation therapy. Methods: This report is an additional analysis of a multicenter questionnaire survey. We performed content analysis on 48 statements described by 185 bereaved family members of patients who received palliative sedation therapy. Results: Family members reported guilt, helplessness, and physical and emotional exhaustion when patients received palliative sedation therapy. They were concerned about whether sedated patients experienced distress, wished to know that the maximum efforts had been made, wished to prepare for patient death, wished to tell important things to patients before sedation, wished to understand patients' suffering, and wanted medical professionals to treat patients with dignity. Conclusions: To alleviate family distress, clinicians should understand families' emotional distress, ensure that unconscious patients feel no distress, reassure family members that the symptoms are truly refractory despite maximum efforts for symptom relief, give information and coordinate the situation to enable families to prepare for patient death and to tell important things to patients before sedation, help families to share patients' suffering, and treat patients the same as when they remained conscious.