Making sense of continuous sedation in end-of-life care for cancer patients: an interview study with bereaved relatives in three European countries

Bruinsma, S. M., Brown, J., van der Heide, A., Deliens, L., Anquinet, L., Payne, S.A., Seymour, J. E. and Rietjens, J. A. C. (2014) Making sense of continuous sedation in end-of-life care for cancer patients: an interview study with bereaved relatives in three European countries. Supportive Care in Cancer, 22 12: 3243-3252. doi:10.1007/s00520-014-2344-7

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Author Bruinsma, S. M.
Brown, J.
van der Heide, A.
Deliens, L.
Anquinet, L.
Payne, S.A.
Seymour, J. E.
Rietjens, J. A. C.
Title Making sense of continuous sedation in end-of-life care for cancer patients: an interview study with bereaved relatives in three European countries
Journal name Supportive Care in Cancer   Check publisher's open access policy
ISSN 0941-4355
1433-7339
Publication date 2014-12-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1007/s00520-014-2344-7
Volume 22
Issue 12
Start page 3243
End page 3252
Total pages 10
Place of publication Heidelberg, Germany
Publisher Springer
Collection year 2015
Language eng
Formatted abstract
Purpose The purpose of the study was to explore relatives’ descriptions and experiences of continuous sedation in end-of-life care for cancer patients and to identify and explain differences between respondents from the Netherlands, Belgium, and the UK.

Methods In-depth interviews were held between January 2011 and May 2012 with 38 relatives of 32 cancer patients who received continuous sedation until death in hospitals, the community, and hospices/palliative care units.

Results Relatives’ descriptions of the practice referred to the outcome, to practical aspects, and to the goals of sedation. While most relatives believed sedation had contributed to a ‘good death’ for the patient, yet many expressed concerns. These related to anxieties about the patient’s wellbeing, their own wellbeing, and questions about whether continuous sedation had shortened the patient’s life (mostly UK), or whether an alternative approach would have been better. Such concerns seemed to have been prompted by relatives witnessing unexpected events such as the patient coming to awareness during sedation. In the Netherlands and in Belgium, several relatives reported that the start of the sedation allowed for a planned moment of ‘saying goodbye’. In contrast, UK relatives discerned neither an explicit point at which sedation was started nor a specific moment of farewell.

Conclusions Relatives believed that sedation contributed to the patient having a good death. Nevertheless, they also expressed concerns that may have been provoked by unexpected events for which they were unprepared. There seems to exist differences in the process of saying goodbye between the NL/BE and the UK.
Keyword Continuous sedation
End-of-life care
Relatives
Qualitative study
Interviews
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2015 Collection
School of Nursing, Midwifery and Social Work Publications
 
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Created: Thu, 26 Feb 2015, 22:58:21 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work