The practices and attitudes of nurses regarding palliative sedation: A scoping review

Heino, Linda; Stolt, Minna; Haavisto, Elina

doi:10.1016/j.ijnurstu.2020.103859

Cited by 13 publications

(19 citation statements)

References 65 publications

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“…The same context was reported in a study indicating that family members feel pain when they cannot interact with the patient when sedatives are administered. 33 As nurses administer palliative sedation and have valuable information about the needs and wishes of patients and their family members, 16 they can help family members interact with patients in deep sleep. Unlike the study 34 in which South Korean healthcare workers (doctors, nurses, and medical technicians) recognized death as a phenomenon derived from medical failure, the present study suggests that palliative care nurses understood humans holistically, especially when providing palliative sedation care.…”

Section: Discussionmentioning

confidence: 99%

“…15 Such dilemmas are related to the decision to use sedatives, depth of sedative administration, likelihood of shortening the patient's life, and loss of social interactions. 16 They further occur when the patient's family demands an increase of the sedation level for the patient. 17,18 Nurses were able to alleviate their ethical dilemmas when they provided care that helped patients experience a peaceful death, 19 or when they received support from colleagues and supervisors.…”

Section: Introductionmentioning

confidence: 99%

“…17,18 Nurses were able to alleviate their ethical dilemmas when they provided care that helped patients experience a peaceful death, 19 or when they received support from colleagues and supervisors. 16 However, in most of the studies conducted on the experiences of nurses who care for palliative sedation patients, 16,[18][19][20] they had serious burdens or ethical difficulties with palliative sedation, and sometimes had conflicting thoughts that it was not the most beneficial step for the patients. Few studies have focused on nurses' practices, attitudes toward, and experiences in palliative sedation nursing care.…”

Section: Introductionmentioning

confidence: 99%

“…Few studies have focused on nurses' practices, attitudes toward, and experiences in palliative sedation nursing care. 16,19 Furthermore, no study has investigated how nurses who experience ethical dilemmas, deal with such problems.…”

Section: Introductionmentioning

confidence: 99%

“…15 Such dilemmas are related to the decision to use sedatives, depth of sedative administration, likelihood of shortening the patient’s life, and loss of social interactions. 16 They further occur when the patient’s family demands an increase of the sedation level for the patient. 17,18…”

Section: Introductionmentioning

confidence: 99%

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Ethical dilemmas and care actions in nurses providing palliative sedation

2022

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Background Recently, palliative care is increasingly important, with an emphasis on the process of dying with dignity. However, nurses who care for such patients experience the associated ethical dilemmas. Objective To explore the meaning of nurses’ experiences in dealing with ethical dilemmas in relation to palliative sedation. Research design A qualitative research design was employed with a thematic analysis approach. Participants and research context Using purposive sampling, 15 nurses, working at palliative care units for at least 1 year, were recruited as participants. Data were collected using unstructured in-depth interviews, and data collection and analysis was performed simultaneously. Ethical considerations Ethical approval was obtained from the authors’ institutional review board. All participants provided informed consent. For the face-to-face interview, the South Korean standard COVID-19 quarantine guidelines, such as mandatory masking and social distancing, were followed. Results Dilemmas raised by patients, were related to concerns about appropriate drug dose; dilemmas raised by nurses, were related to passive care, sense of guilt for failure to predict death, and colleague’s disrespectful attitudes toward patients; dilemmas from patients’ families were related to demands for palliative sedation and reversal of those demands. Care actions to deal with ethical dilemmas comprised evidence-based care, person-centered thinking, reflecting on the death situation, compassion, providing explanation and help to family members. Conclusion Nurses’ ethical dilemmas were pre-dominantly influenced by themselves, rather than by the patients or their families, especially if they felt they could not do their best for patients. The core concept of care actions to deal with the ethical dilemmas, was person-centered care and compassion. Then, how patients and their family members perceive person-centered care and compassion, should be further explored to improve palliative sedation.

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Section: Discussionmentioning

confidence: 99%