Research Article
Caregivers Perception of Palliative Sedation: A French Opinion and Survey
Serresse L*, Perigault F, Chenivesse C, Crozier S, Salachas and Varin FDDepartment of Palliative Care, Hospital: Universitary hospital Pitié-Salpetrière, UMASP, Paris, France
- *Corresponding Author:
- Laure Serresse
MD, Department of Palliative Care
Hospital: Universitary hospital Pitié-Salpetrière
UMASP, 47-83 Boulevard de l'Hôpital
75013, Paris, France
Tel: +33619258838
E-mail: laure.serresse@psl.aphp.fr
Received date: June 05, 2015 Accepted date: September 02, 2015 Published date: September 05, 2015
Citation: Serresse L, Perigault F, Chenivesse C, Crozier S, Salachas, et al. (2015) Caregiver’s Perception of Palliative Sedation: A French Opinion and Survey. J Palliat Care Med 5:233. doi:10.4172/2165-7386.1000233
Copyright: © 2015 Serresse L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: In end-of-life palliative care, appropriate medications may be ineffective in relieving symptoms. When this condition leads to intolerable suffering, palliative sedation (PS) must be considered. Although guidelines have been developed in France, ethical controversies and inappropriate requests appear to exist in clinical practice. We hypothesize that this situation is due to caregivers’ inadequate knowledge. Objective: We aimed at investigated caregivers’ knowledge, experience and feelings related to PS. Methods: We conducted a survey in a French University hospital. Caregivers from departments including dedicated palliative-care beds were asked to fill in a questionnaire composed of 6 items concerning PS definition, experience and emotional impact. Results: 160 questionnaires were completed by nurses (39%), physicians (37%) and nursing assistants (18%). Of them, 38% had been involved more than ten times in PS. 23% knew the consensual definition of PS and 50% made a clear difference between PS and euthanasia. 24% of caregivers felt unsettled by PS practice. Crossing data showed that less caregivers were destabilized when they made a clear difference between PS and euthanasia than when they did not (18% vs. 36%, p<0.025). There was no statistical relationship between the experience in practice of PS and its emotional impact. Thinking that “the goal of PS is patient’s relief” rather than “a decrease in consciousness” was associated with a better distinction between PS and euthanasia (73% vs. 55%, p<0.05). Discussion: The present study showed that PS definition, indication and purpose were unclear in a raised awareness population. These results support the idea that PS remains a complex concept. This may lead to heterogeneous practices of PS and ambiguous perception of PS ethics including a deleterious confusion with euthanasia.
