Factors associated with the decision-making process in palliative sedation therapy. The experience of an Italian hospice struggling with balancing various individual autonomies

Autor: Endrizzi Cristina, Senore Carlo, D’Amico Gabriella, Palella Mirella
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Cogent Medicine, Vol 4, Iss 1 (2017)
Druh dokumentu: article
ISSN: 2331-205X
2331205X
DOI: 10.1080/2331205X.2017.1290307
Popis: In this observational and retrospective study, the authors aimed to evaluate how the practice of palliative terminal sedation therapy (PST) in a hospice setting has changed in a given period of clinical activity and which psychosocial factors have influenced it. We considered the prevalence of palliative/terminal sedation therapy (PST) and the prevalence of some factors associated with the decision-making process in PST (awareness of death, impairment of cognitive function, discussion of sedation with physicians, etc.). Despite a downward trend in patients without awareness of death, the interlocutor of the decision-making process is always the caregiver (44 vs. 28% for the patient). Furthermore, the probability that conscious sedation preceded deep sedation was significantly reduced when the principal interlocutor in the decision-making process was the caregiver. The weight of the decision-making of the patient seems to be relative to an awareness of the death process and the families’ responsibility is a relevant aspect in advanced care planning.
Databáze: Directory of Open Access Journals
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