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

(2014) SUPPORTIVE CARE IN CANCER. 22(12). p.3243-3252
Author
Organization
Abstract
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. 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. 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. 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.
Keywords
End-of-life care, Relatives, Continuous sedation, Qualitative study, Interviews, CONTINUOUS DEEP SEDATION, PATIENTS NEARING DEATH, PALLIATIVE SEDATION, UNTIL DEATH, TERMINAL SEDATION, DECISION-MAKING, FAMILY-MEMBERS, NETHERLANDS, EUTHANASIA, PHYSICIANS

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Citation

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MLA
Bruinsma, SM, J Brown, A van der Heide, et al. “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 (2014): 3243–3252. Print.
APA
Bruinsma, S., Brown, J., van der Heide, A., Deliens, L., Anquinet, L., Payne, S., Seymour, J., et al. (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.
Chicago author-date
Bruinsma, SM, J Brown, A van der Heide, Luc Deliens, Livia Anquinet, SA Payne, JE Seymour, and JAC Rietjens. 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.
Chicago author-date (all authors)
Bruinsma, SM, J Brown, A van der Heide, Luc Deliens, Livia Anquinet, SA Payne, JE Seymour, and JAC Rietjens. 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.
Vancouver
1.
Bruinsma S, Brown J, van der Heide A, Deliens L, Anquinet L, Payne S, et al. 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. 2014;22(12):3243–52.
IEEE
[1]
S. Bruinsma et al., “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, vol. 22, no. 12, pp. 3243–3252, 2014.
@article{5803612,
  abstract     = {{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. 
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. 
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. 
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.}},
  author       = {{Bruinsma, SM and Brown, J and van der Heide, A and Deliens, Luc and Anquinet, Livia and Payne, SA and Seymour, JE and Rietjens, JAC}},
  issn         = {{0941-4355}},
  journal      = {{SUPPORTIVE CARE IN CANCER}},
  keywords     = {{End-of-life care,Relatives,Continuous sedation,Qualitative study,Interviews,CONTINUOUS DEEP SEDATION,PATIENTS NEARING DEATH,PALLIATIVE SEDATION,UNTIL DEATH,TERMINAL SEDATION,DECISION-MAKING,FAMILY-MEMBERS,NETHERLANDS,EUTHANASIA,PHYSICIANS}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{3243--3252}},
  title        = {{Making sense of continuous sedation in end-of-life care for cancer patients: an interview study with bereaved relatives in three European countries}},
  url          = {{http://dx.doi.org/10.1007/s00520-014-2344-7}},
  volume       = {{22}},
  year         = {{2014}},
}

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