Supervisors info:
Βασίλειος Κουλουλίας, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Κυριακή Μυστακίδου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Στυλιανός Κατσαραγάκης, Επίκουρος Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Summary:
Introduction
The use of Palliative Sedation (P.S.) is applied to reduce the uncontrolled symptoms experienced by cancer patients at the end of their lives. However, this process of sedation is also experienced by relatives who support and care for the patient.
Purpose
The present work focuses on the complete bibliographic review of the experiences of end-of-life relatives of cancer patients receiving P.S.
Methodology
The methodology used for this task is based on the PRISMA guidelines. The databases used for this study are PUBMED, COCHRANE LIBRARY and WILEY ONLINE LIBRARY. The search lasted from 1/5 / 2019-10 / 7/2019.
The keywords used are: palliative sedation, experiences, cancer, relatives, caregivers, end of life, perceptions, continuous deep sedation, family and all possible combinations of them.
Results
The results are that the majority of relatives appear to be satisfied with the use of P.S., however, they state that they need more information, they need health professionals who act with empathy. Relatives are positive for participating in decision making about the use of P.S., usually this decision is made by the attending physicians with the consent of the relatives. In addition, relatives consider the use of P.S. as moral solution, however, some worry that it may hasten death and confuse it with euthanasia. Reasons for starting P.S. is delirium / anxiety, pain and shortness of breath. The average duration of the use of P.S. varies among 21h-86h. The longer the duration, the greater the stress of relatives. The medicines used are midazolam, benzodiazepines, antipsychotics and opioids. Also, the use of sedation does not seem to affect relatives during the period of mourning, on the contrary, it prepares them for the coming loss. Finally, the opportunity to say goodbye seems to have a positive effect on mourning management of the relatives.
Conclusions
In general, relatives are satisfied with P.S. They need to be informed and involved in the care of their loved one. There is still, confusion about the euthanasia or the view that P.S. is accelerating death, so it needs to be clarified from the health providers its purpose and to keep relatives informed.
Keywords:
Palliative, Sedation, End of life, Cancer, Relatives, Care-givers, Experiences, Opinions
