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Agnes Van Der Heide - One of the best experts on this subject based on the ideXlab platform.
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Palliative Sedation: The end of heated debate?
Palliative medicine, 2018Co-Authors: Judith A.c. Rietjens, Johannes J M Van Delden, Agnes Van Der HeideAbstract:After more than 15 years of engagement in research on Palliative Sedation, we dare to pose that it is among the most challenging topics in end-of-life care. The first publications on Palliative Sedation appeared in this journal as early as 20 years ago. Chater et al.1 stressed the need for proper terminology and proposed to abandon the term “terminal Sedation.” While Palliative Sedation has remained the most commonly used term ever since, it has also become clear that simply using a common term does not guarantee the use of a common concept, leave alone common practices. [...]
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Continuous Palliative Sedation: not only a response to physical suffering.
Journal of palliative medicine, 2014Co-Authors: Siebe J. Swart, Johannes J M Van Delden, Agnes Van Der Heide, Lia Van Zuylen, Wouter W.a. Zuurmond, Roberto S. G. M. Perez, Paul J. Van Der Maas, Judith A.c. RietjensAbstract:Abstract Background: Palliative Sedation is a medical intervention aimed at relieving symptoms that can no longer be controlled by conventional treatment. Ample knowledge is available regarding the nature of such symptoms, but there is no in-depth information regarding how health care workers decide about Palliative Sedation. Objective: The study objective was to investigate considerations concerning the indications for continuous Palliative Sedation (CPS) and issues that influence these considerations. Design: The study consisted of qualitative interviews regarding patients who had recently received CPS. Setting/subjects: The study involved physicians and nurses working in general practice, nursing homes, and hospitals. Measurement: Analyses by a multidisciplinary research team used the constant comparative method. Results: Together with physical symptoms, psychological and existential suffering may combine to produce a refractory state for which other treatment options than CPS were not available or con...
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Opinions of the Dutch public on Palliative Sedation: a mixed-methods approach
British Journal of General Practice, 2013Co-Authors: Hilde T H Van Der Kallen, Johannes J M Van Delden, Judith A.c. Rietjens, Herman J Bueving, Natasja J H Raijmakers, Alex A. Van Der Male, Agnes Van Der HeideAbstract:Background: Palliative Sedation is defined as deliberately lowering a patient’s consciousness, to relieve intolerable suffering from refractory symptoms at the end of life. Palliative Sedation is considered a last resort intervention in end-of-life care that should not be confused with euthanasia. Aim: To inform healthcare professionals about attitudes of the general public regarding Palliative Sedation. Design and setting: A cross-sectional survey among members of the Dutch general public followed by qualitative interviews. Method: One thousand nine hundred and sixty members of the general public completed the questionnaire, which included a vignette describing Palliative Sedation (response rate 78%); 16 participants were interviewed. Results: In total, 22% of the responders indicated knowing the term ‘Palliative Sedation’. Qualitative data showed a variety of interpretations of the term. Eighty-one per cent of the responders agreed with the provision of sedatives as described in a vignette of a patient with untreatable pain and a life expectancy of
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Opinions of the Dutch public on Palliative Sedation: a mixed-methods approach.
The British journal of general practice : the journal of the Royal College of General Practitioners, 2013Co-Authors: Hilde T H Van Der Kallen, Johannes J M Van Delden, Judith A.c. Rietjens, Herman J Bueving, Natasja J H Raijmakers, Alex A. Van Der Male, Agnes Van Der HeideAbstract:Palliative Sedation is defined as deliberately lowering a patient's consciousness, to relieve intolerable suffering from refractory symptoms at the end of life. Palliative Sedation is considered a last resort intervention in end-of-life care that should not be confused with euthanasia. To inform healthcare professionals about attitudes of the general public regarding Palliative Sedation. design and setting: A cross-sectional survey among members of the Dutch general public followed by qualitative interviews. One thousand nine hundred and sixty members of the general public completed the questionnaire, which included a vignette describing Palliative Sedation (response rate 78%); 16 participants were interviewed. In total, 22% of the responders indicated knowing the term 'Palliative Sedation'. Qualitative data showed a variety of interpretations of the term. Eighty-one per cent of the responders agreed with the provision of sedatives as described in a vignette of a patient with untreatable pain and a life expectancy of <1 week who received sedatives to alleviate his suffering. This percentage was somewhat lower for a patient with a life expectancy of <1 month (74%, P = 0.007) and comparable in the case where the physician gave sedatives with the aim of ending the patient's life (79%, P = 0.54). Most of the general public accept the use of Palliative Sedation at the end of life, regardless of a potential life-shortening effect. However, confusion exists about what Palliative Sedation represents. This should be taken into account by healthcare professionals when communicating with patients and their relatives on end-of-life care options.
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opinions of the dutch public on Palliative Sedation a mixed methods approach
British Journal of General Practice, 2013Co-Authors: Hilde T H Van Der Kallen, Johannes J M Van Delden, Judith A.c. Rietjens, Herman J Bueving, Natasja J H Raijmakers, Alex A. Van Der Male, Agnes Van Der HeideAbstract:Background: Palliative Sedation is defined as deliberately lowering a patient’s consciousness, to relieve intolerable suffering from refractory symptoms at the end of life. Palliative Sedation is considered a last resort intervention in end-of-life care that should not be confused with euthanasia. Aim: To inform healthcare professionals about attitudes of the general public regarding Palliative Sedation. Design and setting: A cross-sectional survey among members of the Dutch general public followed by qualitative interviews. Method: One thousand nine hundred and sixty members of the general public completed the questionnaire, which included a vignette describing Palliative Sedation (response rate 78%); 16 participants were interviewed. Results: In total, 22% of the responders indicated knowing the term ‘Palliative Sedation’. Qualitative data showed a variety of interpretations of the term. Eighty-one per cent of the responders agreed with the provision of sedatives as described in a vignette of a patient with untreatable pain and a life expectancy of <1 week who received sedatives to alleviate his suffering. This percentage was somewhat lower for a patient with a life expectancy of <1 month (74%, P = 0.007) and comparable in the case where the physician gave sedatives with the aim of ending the patient’s life (79%, P = 0.54). Conclusion: Most of the general public accept the use of Palliative Sedation at the end of life, regardless of a potential life-shortening effect. However, confusion exists about what Palliative Sedation represents. This should be taken into account by healthcare professionals when communicating with patients and their relatives on end-of-life care options. (aut. ref.)
Judith A.c. Rietjens - One of the best experts on this subject based on the ideXlab platform.
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Palliative Sedation: The end of heated debate?
Palliative medicine, 2018Co-Authors: Judith A.c. Rietjens, Johannes J M Van Delden, Agnes Van Der HeideAbstract:After more than 15 years of engagement in research on Palliative Sedation, we dare to pose that it is among the most challenging topics in end-of-life care. The first publications on Palliative Sedation appeared in this journal as early as 20 years ago. Chater et al.1 stressed the need for proper terminology and proposed to abandon the term “terminal Sedation.” While Palliative Sedation has remained the most commonly used term ever since, it has also become clear that simply using a common term does not guarantee the use of a common concept, leave alone common practices. [...]
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Continuous Palliative Sedation: not only a response to physical suffering.
Journal of palliative medicine, 2014Co-Authors: Siebe J. Swart, Johannes J M Van Delden, Agnes Van Der Heide, Lia Van Zuylen, Wouter W.a. Zuurmond, Roberto S. G. M. Perez, Paul J. Van Der Maas, Judith A.c. RietjensAbstract:Abstract Background: Palliative Sedation is a medical intervention aimed at relieving symptoms that can no longer be controlled by conventional treatment. Ample knowledge is available regarding the nature of such symptoms, but there is no in-depth information regarding how health care workers decide about Palliative Sedation. Objective: The study objective was to investigate considerations concerning the indications for continuous Palliative Sedation (CPS) and issues that influence these considerations. Design: The study consisted of qualitative interviews regarding patients who had recently received CPS. Setting/subjects: The study involved physicians and nurses working in general practice, nursing homes, and hospitals. Measurement: Analyses by a multidisciplinary research team used the constant comparative method. Results: Together with physical symptoms, psychological and existential suffering may combine to produce a refractory state for which other treatment options than CPS were not available or con...
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Opinions of the Dutch public on Palliative Sedation: a mixed-methods approach
British Journal of General Practice, 2013Co-Authors: Hilde T H Van Der Kallen, Johannes J M Van Delden, Judith A.c. Rietjens, Herman J Bueving, Natasja J H Raijmakers, Alex A. Van Der Male, Agnes Van Der HeideAbstract:Background: Palliative Sedation is defined as deliberately lowering a patient’s consciousness, to relieve intolerable suffering from refractory symptoms at the end of life. Palliative Sedation is considered a last resort intervention in end-of-life care that should not be confused with euthanasia. Aim: To inform healthcare professionals about attitudes of the general public regarding Palliative Sedation. Design and setting: A cross-sectional survey among members of the Dutch general public followed by qualitative interviews. Method: One thousand nine hundred and sixty members of the general public completed the questionnaire, which included a vignette describing Palliative Sedation (response rate 78%); 16 participants were interviewed. Results: In total, 22% of the responders indicated knowing the term ‘Palliative Sedation’. Qualitative data showed a variety of interpretations of the term. Eighty-one per cent of the responders agreed with the provision of sedatives as described in a vignette of a patient with untreatable pain and a life expectancy of
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Opinions of the Dutch public on Palliative Sedation: a mixed-methods approach.
The British journal of general practice : the journal of the Royal College of General Practitioners, 2013Co-Authors: Hilde T H Van Der Kallen, Johannes J M Van Delden, Judith A.c. Rietjens, Herman J Bueving, Natasja J H Raijmakers, Alex A. Van Der Male, Agnes Van Der HeideAbstract:Palliative Sedation is defined as deliberately lowering a patient's consciousness, to relieve intolerable suffering from refractory symptoms at the end of life. Palliative Sedation is considered a last resort intervention in end-of-life care that should not be confused with euthanasia. To inform healthcare professionals about attitudes of the general public regarding Palliative Sedation. design and setting: A cross-sectional survey among members of the Dutch general public followed by qualitative interviews. One thousand nine hundred and sixty members of the general public completed the questionnaire, which included a vignette describing Palliative Sedation (response rate 78%); 16 participants were interviewed. In total, 22% of the responders indicated knowing the term 'Palliative Sedation'. Qualitative data showed a variety of interpretations of the term. Eighty-one per cent of the responders agreed with the provision of sedatives as described in a vignette of a patient with untreatable pain and a life expectancy of <1 week who received sedatives to alleviate his suffering. This percentage was somewhat lower for a patient with a life expectancy of <1 month (74%, P = 0.007) and comparable in the case where the physician gave sedatives with the aim of ending the patient's life (79%, P = 0.54). Most of the general public accept the use of Palliative Sedation at the end of life, regardless of a potential life-shortening effect. However, confusion exists about what Palliative Sedation represents. This should be taken into account by healthcare professionals when communicating with patients and their relatives on end-of-life care options.
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opinions of the dutch public on Palliative Sedation a mixed methods approach
British Journal of General Practice, 2013Co-Authors: Hilde T H Van Der Kallen, Johannes J M Van Delden, Judith A.c. Rietjens, Herman J Bueving, Natasja J H Raijmakers, Alex A. Van Der Male, Agnes Van Der HeideAbstract:Background: Palliative Sedation is defined as deliberately lowering a patient’s consciousness, to relieve intolerable suffering from refractory symptoms at the end of life. Palliative Sedation is considered a last resort intervention in end-of-life care that should not be confused with euthanasia. Aim: To inform healthcare professionals about attitudes of the general public regarding Palliative Sedation. Design and setting: A cross-sectional survey among members of the Dutch general public followed by qualitative interviews. Method: One thousand nine hundred and sixty members of the general public completed the questionnaire, which included a vignette describing Palliative Sedation (response rate 78%); 16 participants were interviewed. Results: In total, 22% of the responders indicated knowing the term ‘Palliative Sedation’. Qualitative data showed a variety of interpretations of the term. Eighty-one per cent of the responders agreed with the provision of sedatives as described in a vignette of a patient with untreatable pain and a life expectancy of <1 week who received sedatives to alleviate his suffering. This percentage was somewhat lower for a patient with a life expectancy of <1 month (74%, P = 0.007) and comparable in the case where the physician gave sedatives with the aim of ending the patient’s life (79%, P = 0.54). Conclusion: Most of the general public accept the use of Palliative Sedation at the end of life, regardless of a potential life-shortening effect. However, confusion exists about what Palliative Sedation represents. This should be taken into account by healthcare professionals when communicating with patients and their relatives on end-of-life care options. (aut. ref.)
Alexander De Graeff - One of the best experts on this subject based on the ideXlab platform.
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Improving Prescription in Palliative Sedation
2017Co-Authors: Jeroen Hasselaar, Alexander De Graeff, Stans Verhagen, Kris Vissers, Rob Reuzel, Ben J. P. CrulAbstract:Background: Two guidelines addressing Palliative Sedation have been published in the Netherlands in 2002 and 2003. The objective of the present study is to determine adherence to the guidelines for Palliative Sedation with regard to prescription. The study is restricted to the practice of continuous deep Palliative Sedation. Methods:A structured retrospective questionnaire was administeredto1464physiciansconcerningtheirlastcase of deep Sedation during the past 12 months. Physicians included Dutch hospital specialists, general practitioners, and nursing home physicians. Results:Theresponseratewas36%.Atotalof43%(95% confidence interval [CI], 37%-49%) of the responding physicians did not adhere to the guidelines. Sources of deviation were the use of basic medication other than a benzodiazepine (30%), which mostly involved morphine,andomissionsinadjuvantmedication(13%).Nonsignificant positive association was found for consultationofaPalliativecareexpert(oddsratio[OR],3.86;95% CI,0.92-8.87).Significantpositiveassociationwasfound for the physician being a Palliative care expert himself or herself (OR, 4.42; 95% CI, 1.42-13.75) and the use of guidelines (OR, 1.74; 95% CI, 1.02-2.98). Treatment of pain symptoms (OR, 2.21; 95% CI, 1.28-3.82), anxiety (OR, 2.32; 95% CI, 1.33-4.06), vomiting (OR, 6.52; 95% CI, 1.08-39.50), and loss of dignity (OR, 3.93; 95% CI, 1.80-8.58) also correlated positively. Treatment of deliriumcorrelatednegativelywithadherencetotheguidelines (OR, 0.22; 95% CI,0.11-0.44). Conclusions: The rate of 43% noncompliance to the guidelines was mostly owing to the omission of continued antipsychotic treatment for delirium and the use of morphine as the single therapy for the purpose of deep Sedation. Future efforts, like better use and knowledge of the guidelines and a larger involvement of consultation teams, should increase adherence to the guidelines.
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A national guideline for Palliative Sedation in the Netherlands
Journal of pain and symptom management, 2007Co-Authors: Marian Verkerk, Eric Van Wijlick, Johan Legemaate, Alexander De GraeffAbstract:The first national guideline on Palliative Sedation in The Netherlands has been adopted by the General Board of the Royal Dutch Medical Association. By law, the physician is obliged to take this guideline into consideration. In this paper, we present the main principles of the guideline. Palliative Sedation is defined as the intentional lowering of consciousness of a patient in the last phase of his or her life. The aim of Palliative Sedation is to relieve suffering, and lowering consciousness is a means to achieve this. The indication for Palliative Sedation is the presence of one or more refractory symptoms that lead to unbearable suffering for the patient. Palliative Sedation is given to improve patient comfort. It is the degree of symptom control, not the level to which consciousness is lowered, which determines the dose and the combinations of the sedatives used and duration of treatment. Palliative Sedation is normal medical practice and must be clearly distinguished from the termination of life.
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Palliative Sedation in the Netherlands: starting-points and contents of a national guideline
European journal of health law, 2007Co-Authors: Johan Legemaate, Marian Verkerk, Eric Van Wijlick, Alexander De GraeffAbstract:In December 2005 the first national guideline for Palliative Sedation in the Netherlands was published. This guideline was developed by a committee of the Royal Dutch Medical Association, at the request of the Dutch government. The guideline defines Palliative Sedation as 'the intentional lowering of consciousness of a patient in the last phase of his or her life'. According to the guideline the objective of Palliative Sedation is to relieve suffering, and lowering consciousness is a means to achieve this. It is very important that Palliative Sedation is given for the right indication, proportionally, and adequately. It is the degree of symptom control, not the level to which consciousness is lowered, which determines the dose and combinations of the sedatives used and duration of treatment. The assessment and decision-making processes must focus on adequate relief of the patient's suffering, so that a peaceful and acceptable situation is created. Palliative Sedation is given in the last phase of life, in the imminently dying patient. Palliative Sedation raises several legal questions. In this article we describe the structure and contents of the guideline, with special attention for the main legal issues involved, like the distinction between Palliative Sedation and euthanasia and the process of informed consent
Siebe J. Swart - One of the best experts on this subject based on the ideXlab platform.
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Palliative Sedation and moral distress: A qualitative study of nurses.
Applied nursing research : ANR, 2018Co-Authors: Martine E. Lokker, Siebe J. Swart, J.a.c. Rietjens, L. Van Zuylen, R.s.g.m. Perez, A. Van Der HeideAbstract:Abstract Background Clinical nursing practice may involve moral distress, which has been reported to occur frequently when nurses care for dying patients. Palliative Sedation is a practice that is used to alleviate unbearable and refractory suffering in the last phase of life and has been linked to distress in nurses. Aim The aim of this study was to explore nurses' reports on the practice of Palliative Sedation focusing on their experiences with pressure, dilemmas and morally distressing situations. Methods In-depth interviews with 36 nurses working in hospital, nursing home or primary care. Results Several nurses described situations in which they felt that administration of Palliative Sedation was in the patient's best interest, but where they were constrained from taking action. Nurses also reported on situations where they experienced pressure to be actively involved in the provision of Palliative Sedation, while they felt this was not in the patient's best interest. The latter situation related to (1) starting Palliative Sedation when the nurse felt not all options to relieve suffering had been explored yet; (2) family requesting an increase of the Sedation level where the nurse felt that this may involve unjustified hastening of death; (3) a decision by the physician to start Palliative Sedation where the patient had previously expressed an explicit wish for euthanasia. Conclusions Nurses experienced moral distress in situations where they were not able to act in what they believed is the patient's best interest. Situations involving moral distress require nurses to be well informed and able to adequately communicate with suffering patients, distressed family and physicians.
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Continuous Palliative Sedation: not only a response to physical suffering.
Journal of palliative medicine, 2014Co-Authors: Siebe J. Swart, Johannes J M Van Delden, Agnes Van Der Heide, Lia Van Zuylen, Wouter W.a. Zuurmond, Roberto S. G. M. Perez, Paul J. Van Der Maas, Judith A.c. RietjensAbstract:Abstract Background: Palliative Sedation is a medical intervention aimed at relieving symptoms that can no longer be controlled by conventional treatment. Ample knowledge is available regarding the nature of such symptoms, but there is no in-depth information regarding how health care workers decide about Palliative Sedation. Objective: The study objective was to investigate considerations concerning the indications for continuous Palliative Sedation (CPS) and issues that influence these considerations. Design: The study consisted of qualitative interviews regarding patients who had recently received CPS. Setting/subjects: The study involved physicians and nurses working in general practice, nursing homes, and hospitals. Measurement: Analyses by a multidisciplinary research team used the constant comparative method. Results: Together with physical symptoms, psychological and existential suffering may combine to produce a refractory state for which other treatment options than CPS were not available or con...
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Consultation with specialist Palliative care services in Palliative Sedation: considerations of Dutch physicians.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2013Co-Authors: Ian Koper, Rien Janssens, Agnes Van Der Heide, Roberto S. G. M. Perez, Siebe J. Swart, Judith A.c. RietjensAbstract:Purpose Palliative Sedation is considered a normal medical practice by the Royal Dutch Medical Association. Therefore, consultation of an expert is not considered mandatory. The European Association of Palliative Care (EAPC) framework for Palliative Sedation, however, is more stringent: it considers the use of Palliative Sedation without consulting an expert as injudicious and insists on input from a multi-professional Palliative care team. This study investigates the considerations of Dutch physicians concerning consultation about Palliative Sedation with specialist Palliative care services.
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The practice of Palliative Sedation in the Netherlands after the launch of the national guideline
2013Co-Authors: Siebe J. SwartAbstract:textabstractPalliative Sedation is a medical intervention aimed at relieving intractable suff ering by inducing decreased awareness of symptoms. It is typically considered a Palliative option for patients suff ering unbearably in the last days of life. The estimated frequency of Palliative Sedation varies considerably in scientifi c literature, partly due to diff erences in defi nition and research setting and diff erences in terminology. Whereas in the English medical scientifi c literature the fi rst descriptions of Palliative Sedation referred to ‘terminal Sedation’, in Dutch medical literature Palliative Sedation was fi rst described as ‘deep Sedation in the dying phase’. Although terminology still varies – e.g. continuous deep Sedation6, continuous Sedation until death, continuous deep Sedation until death, continuous Sedation at the end of life, Palliative Sedation at the end of life, Palliative Sedation therapy, Palliative Sedation to unconsciousness, terminal Sedation, continuous Palliative Sedation – the most frequently used general term for this treatment in the literature nowadays is Palliative Sedation.
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Day-to-day care in Palliative Sedation: Survey of nurses' experiences with decision-making and performance
International journal of nursing studies, 2012Co-Authors: Jimmy J. Arevalo, Judith A.c. Rietjens, Roberto S. G. M. Perez, Siebe J. Swart, Agnes Van Der HeideAbstract:Abstract Context Continuous Palliative Sedation has been the focus of extensive international debates in the field of end-of-life decision making. Although nurses may be important participants in the performance of continuous Palliative Sedation, research has focused primarily on the role and experience of physicians. Nurses' experiences differ from that of physicians; they more often describe that continuous Palliative Sedation is used with the intention of hastening death and to have experienced serious emotional burden. Therefore, it is important to understand the experience of nurses in continuous Palliative Sedation. Objective To describe nurses' experiences with the decision-making and performance of continuous Palliative Sedation in terminally ill patients. Methods Cross-sectional study. In 2008, a structured questionnaire was sent to 576 nurses in six professional home care organizations, ten units for Palliative care in nursing homes and in-patient hospices and seven hospitals in the western region of the Netherlands. Respondents provided information about the last patient receiving continuous Palliative Sedation whom they had cared for. Results Two-hundred seventy-seven questionnaires were returned and 199 (71.84%) reported a case of continuous Palliative Sedation. Nurses felt involved in the decision to use Sedation in 84% of cases, albeit to a lesser extent in home care (68.75%, p =0.002). They agreed with the performance of continuous Palliative Sedation in 95.97% of cases and they proposed the use of continuous Palliative Sedation in 16.16%. Nurses were present at the start of Sedation in 81.40% of cases and reported physicians to be present in 45.22%. In 72.77%, arrangements had been made among caregivers about the coordination of health care regarding the Sedation. Conclusion Nurses seem to play an important role in the use of continuous Sedation. This role is mainly supportive toward physicians and patients during the decision-making process, but shifts to an active performance of Sedation, particularly in settings where they explicitly participate as members of a team. Nurses could develop the practice of Palliative Sedation by anticipating procedural obstacles in the performance of continuous Palliative Sedation. We recommend them to become more active participants in the decision-making to improve the care of patients receiving continuous Palliative Sedation.
Johannes J M Van Delden - One of the best experts on this subject based on the ideXlab platform.
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Palliative Sedation: The end of heated debate?
Palliative medicine, 2018Co-Authors: Judith A.c. Rietjens, Johannes J M Van Delden, Agnes Van Der HeideAbstract:After more than 15 years of engagement in research on Palliative Sedation, we dare to pose that it is among the most challenging topics in end-of-life care. The first publications on Palliative Sedation appeared in this journal as early as 20 years ago. Chater et al.1 stressed the need for proper terminology and proposed to abandon the term “terminal Sedation.” While Palliative Sedation has remained the most commonly used term ever since, it has also become clear that simply using a common term does not guarantee the use of a common concept, leave alone common practices. [...]
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Continuous Palliative Sedation: not only a response to physical suffering.
Journal of palliative medicine, 2014Co-Authors: Siebe J. Swart, Johannes J M Van Delden, Agnes Van Der Heide, Lia Van Zuylen, Wouter W.a. Zuurmond, Roberto S. G. M. Perez, Paul J. Van Der Maas, Judith A.c. RietjensAbstract:Abstract Background: Palliative Sedation is a medical intervention aimed at relieving symptoms that can no longer be controlled by conventional treatment. Ample knowledge is available regarding the nature of such symptoms, but there is no in-depth information regarding how health care workers decide about Palliative Sedation. Objective: The study objective was to investigate considerations concerning the indications for continuous Palliative Sedation (CPS) and issues that influence these considerations. Design: The study consisted of qualitative interviews regarding patients who had recently received CPS. Setting/subjects: The study involved physicians and nurses working in general practice, nursing homes, and hospitals. Measurement: Analyses by a multidisciplinary research team used the constant comparative method. Results: Together with physical symptoms, psychological and existential suffering may combine to produce a refractory state for which other treatment options than CPS were not available or con...
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Opinions of the Dutch public on Palliative Sedation: a mixed-methods approach
British Journal of General Practice, 2013Co-Authors: Hilde T H Van Der Kallen, Johannes J M Van Delden, Judith A.c. Rietjens, Herman J Bueving, Natasja J H Raijmakers, Alex A. Van Der Male, Agnes Van Der HeideAbstract:Background: Palliative Sedation is defined as deliberately lowering a patient’s consciousness, to relieve intolerable suffering from refractory symptoms at the end of life. Palliative Sedation is considered a last resort intervention in end-of-life care that should not be confused with euthanasia. Aim: To inform healthcare professionals about attitudes of the general public regarding Palliative Sedation. Design and setting: A cross-sectional survey among members of the Dutch general public followed by qualitative interviews. Method: One thousand nine hundred and sixty members of the general public completed the questionnaire, which included a vignette describing Palliative Sedation (response rate 78%); 16 participants were interviewed. Results: In total, 22% of the responders indicated knowing the term ‘Palliative Sedation’. Qualitative data showed a variety of interpretations of the term. Eighty-one per cent of the responders agreed with the provision of sedatives as described in a vignette of a patient with untreatable pain and a life expectancy of
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Opinions of the Dutch public on Palliative Sedation: a mixed-methods approach.
The British journal of general practice : the journal of the Royal College of General Practitioners, 2013Co-Authors: Hilde T H Van Der Kallen, Johannes J M Van Delden, Judith A.c. Rietjens, Herman J Bueving, Natasja J H Raijmakers, Alex A. Van Der Male, Agnes Van Der HeideAbstract:Palliative Sedation is defined as deliberately lowering a patient's consciousness, to relieve intolerable suffering from refractory symptoms at the end of life. Palliative Sedation is considered a last resort intervention in end-of-life care that should not be confused with euthanasia. To inform healthcare professionals about attitudes of the general public regarding Palliative Sedation. design and setting: A cross-sectional survey among members of the Dutch general public followed by qualitative interviews. One thousand nine hundred and sixty members of the general public completed the questionnaire, which included a vignette describing Palliative Sedation (response rate 78%); 16 participants were interviewed. In total, 22% of the responders indicated knowing the term 'Palliative Sedation'. Qualitative data showed a variety of interpretations of the term. Eighty-one per cent of the responders agreed with the provision of sedatives as described in a vignette of a patient with untreatable pain and a life expectancy of <1 week who received sedatives to alleviate his suffering. This percentage was somewhat lower for a patient with a life expectancy of <1 month (74%, P = 0.007) and comparable in the case where the physician gave sedatives with the aim of ending the patient's life (79%, P = 0.54). Most of the general public accept the use of Palliative Sedation at the end of life, regardless of a potential life-shortening effect. However, confusion exists about what Palliative Sedation represents. This should be taken into account by healthcare professionals when communicating with patients and their relatives on end-of-life care options.
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opinions of the dutch public on Palliative Sedation a mixed methods approach
British Journal of General Practice, 2013Co-Authors: Hilde T H Van Der Kallen, Johannes J M Van Delden, Judith A.c. Rietjens, Herman J Bueving, Natasja J H Raijmakers, Alex A. Van Der Male, Agnes Van Der HeideAbstract:Background: Palliative Sedation is defined as deliberately lowering a patient’s consciousness, to relieve intolerable suffering from refractory symptoms at the end of life. Palliative Sedation is considered a last resort intervention in end-of-life care that should not be confused with euthanasia. Aim: To inform healthcare professionals about attitudes of the general public regarding Palliative Sedation. Design and setting: A cross-sectional survey among members of the Dutch general public followed by qualitative interviews. Method: One thousand nine hundred and sixty members of the general public completed the questionnaire, which included a vignette describing Palliative Sedation (response rate 78%); 16 participants were interviewed. Results: In total, 22% of the responders indicated knowing the term ‘Palliative Sedation’. Qualitative data showed a variety of interpretations of the term. Eighty-one per cent of the responders agreed with the provision of sedatives as described in a vignette of a patient with untreatable pain and a life expectancy of <1 week who received sedatives to alleviate his suffering. This percentage was somewhat lower for a patient with a life expectancy of <1 month (74%, P = 0.007) and comparable in the case where the physician gave sedatives with the aim of ending the patient’s life (79%, P = 0.54). Conclusion: Most of the general public accept the use of Palliative Sedation at the end of life, regardless of a potential life-shortening effect. However, confusion exists about what Palliative Sedation represents. This should be taken into account by healthcare professionals when communicating with patients and their relatives on end-of-life care options. (aut. ref.)