scholarly journals Continuous Deep Sedation to Terminally Ill Cancer Patients in the General Ward Who Were Referred to Palliative Care Team: A Retrospective Analysis

2017 ◽  
Vol 12 (4) ◽  
pp. 317-320
Author(s):  
Seitetsu Kanemura ◽  
Norio Hashimoto ◽  
Kazuko Fujiwara ◽  
Mari Haratake ◽  
Marie Iwai ◽  
...  
Keyword(s):  
Palliative Care ◽  
Retrospective Analysis ◽  
Cancer Patients ◽  
Deep Sedation ◽  
Terminally Ill ◽  
General Ward ◽  
Palliative Care Team ◽  
Care Team ◽  
Terminally Ill Cancer Patients ◽  
Continuous Deep Sedation

Effectiveness of multidisciplinary team conference on decision-making surrounding the application of continuous deep sedation for terminally ill cancer patients

2013 ◽  
Vol 13 (2) ◽  
pp. 157-164 ◽  
Author(s):  
Kazuhiko Koike ◽  
Takeshi Terui ◽  
Yuji Takahashi ◽  
Yasuo Hirayama ◽  
Naomi Mizukami ◽  
...  
Keyword(s):  
Decision Making ◽  
Retrospective Analysis ◽  
Cancer Patients ◽  
Multidisciplinary Team ◽  
Deep Sedation ◽  
Conscious Experience ◽  
Terminally Ill ◽  
Care Providers ◽  
Terminally Ill Cancer Patients ◽  
Continuous Deep Sedation

AbstractObjective:Continuous deep sedation (CDS) is a way to reduce conscious experience of symptoms of severe suffering in terminally ill cancer patients. However, there is wide variation in the frequency of its reported. So we conducted a retrospective analysis to assess the prevalence and features of CDS in our palliative care unit (PCU).Methods:We performed a systemic retrospective analysis of the medical and nursing records of all 1581 cancer patients who died at the PCU at Higashi Sapporo Hospital between April 2005 and August 2011. Continuous deep sedation can only be administered safely and appropriately when a multidisciplinary team is involved in the decision-making process. Prior to administration of CDS, a multidisciplinary team conference (MDTC) was held with respect to all the patients considered for CDS by an attending physician. The main outcome measures were the frequency and characteristics of CDS (patient background, all target symptoms, medications used for sedation, duration, family's satisfaction, and distress). We mailed anonymous questionnaires to bereaved families in August 2011.Results:Of 1581 deceased patients, 22 (1.39%) had received CDS. Physical exhaustion 8 (36.4%), dyspnea 7 (31.8%), and pain 5 (22.7%) were the most frequently mentioned indications. Continuous deep sedation had a duration of less than 1 week in 17 (77.3%). Six patients (0.38%) did not meet the appropriate criteria for CDS according to the MDTC and so did not receive it. Although bereaved families were generally comfortable with the practice of CDS, some expressed a high level of emotional distress.Significance of results:Our results indicate that the prevalence of CDS will be decreased when it is carried out solely for appropriate indications. Continuity of teamwork, good coordination, exchange of information, and communication between the various care providers are essential. A lack of any of these may lead to inadequate assessment, information discrepancies, and unrest.

Association between continuous deep sedation and survival time in terminally ill cancer patients

2020 ◽  
Vol 29 (1) ◽  
pp. 525-531
Author(s):  
So-Jung Park ◽  
Hee Kyung Ahn ◽  
Hong Yup Ahn ◽  
Kyu-Tae Han ◽  
In Cheol Hwang
Keyword(s):  
Survival Time ◽  
Cancer Patients ◽  
Deep Sedation ◽  
Terminally Ill ◽  
Terminally Ill Cancer Patients ◽  
Continuous Deep Sedation

Practices and Attitudes of Japanese Oncologists and Palliative Care Physicians Concerning Terminal Sedation: A Nationwide Survey

2002 ◽  
Vol 20 (3) ◽  
pp. 758-764 ◽  
Author(s):  
Tatsuya Morita ◽  
Tatsuo Akechi ◽  
Yuriko Sugawara ◽  
Satoshi Chihara ◽  
Yosuke Uchitomi
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Psychiatric Treatment ◽  
Deep Sedation ◽  
Terminally Ill ◽  
Palliative Sedation ◽  
Professional Burnout ◽  
Palliative Sedation Therapy ◽  
Continuous Deep Sedation ◽  
Psychologic Distress

PURPOSE: To clarify the frequency of practice of sedation therapy for terminally ill cancer patients and to identify physicians’ attitudes toward sedation. METHODS: Questionnaires were mailed to 1,436 Japanese oncologists and palliative care physicians with a request to report their practice of and attitudes toward palliative sedation therapy. RESULTS: A total of 697 physicians returned questionnaires (response rate, 49.6%). Use of mild, intermittent-deep, or continuous-deep sedation for physical and psychologic distress was reported by 89% and 64%, 70% and 46%, and 66% and 38%, respectively. In vignettes in which physicians were asked whether they would use sedation for a patient with refractory dyspnea or with existential distress, 14% and 15%, respectively, chose continuous-deep sedation as a strong possibility. Those physicians less confident with psychologic care and with higher levels of professional burnout were more likely to choose continuous-deep sedation. In vignettes in which they were asked whether they use sedation for a patient with depression or delirium, 39% and 31%, respectively, considered psychiatric treatment to be a strong possibility, and 42% and 50% regarded continuous-deep sedation as a potential treatment option. Physicians less involved in caring for the terminally ill and less specialized in palliative medicine were significantly less likely to choose psychiatric treatment. CONCLUSION: Sedation is frequently used for severe physical and psychologic distress of cancer patients. Physicians’ clinical experiences with the terminally ill and their levels of professional burnout influence the decisions. Training and education for physicians in regard to end-of-life care and valid clinical guidelines for palliative sedation therapy are necessary.

scholarly journals Participation of the Nurses Who Are Certified Aromatherapist in Palliative Care Team and Their Offering Aromatherapy Massage to Cancer Patients in the General Ward

2017 ◽  
Vol 12 (2) ◽  
pp. 923-927
Author(s):  
Yumi Kamei ◽  
Yayoi Kitamura ◽  
Mari Haratake ◽  
Kazuko Fujiwara ◽  
Hiromi Okamura ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
General Ward ◽  
Palliative Care Team ◽  
Care Team

Japanese physicians’ experiences of terminally ill patients voluntarily stopping eating and drinking: a national survey

2017 ◽  
Vol 9 (2) ◽  
pp. 143-145 ◽  
Author(s):  
Takuya Shinjo ◽  
Tatsuya Morita ◽  
Daisuke Kiuchi ◽  
Masayuki Ikenaga ◽  
Hirofumi Abo ◽  
...  
Keyword(s):  
Palliative Care ◽  
National Survey ◽  
Clinical Setting ◽  
Deep Sedation ◽  
Terminally Ill ◽  
Treatment Decision ◽  
Mail Questionnaire ◽  
Terminally Ill Patients ◽  
Continuous Deep Sedation

ObjectivesVoluntarily stopping eating and drinking (VSED) could be regarded as a patients’ own non-treatment decision that hastens death, which involves patients voluntarily forgoing food and liquid until death. The aims of this study were to investigate the experience of home hospice physicians and palliative care specialists who care for patients during VSED in Japan, and their opinions on continuous deep sedation (CDS) as a means to relieve patient symptoms during VSED.Methods219 home hospice physicians and 695 palliative care specialists across Japan were surveyed by mail questionnaire in 2016.ResultsA total of 571 (62%) responses were analysed. A total of 185 (32%) had experience of patients who selected VSED. In response to questions about CDS to provide relief to patients during VSED, the number of physicians who replied that CDS was acceptable was 88 (15%).ConclusionsIn Japan, 32% of physicians surveyed replied that they had experience of caring for patients during VSED in a clinical setting and 15% considered CDS acceptable.

Verbalized desire for death or euthanasia in advanced cancer patients receiving palliative care

2014 ◽  
Vol 13 (2) ◽  
pp. 295-303 ◽  
Author(s):  
Ernest Güell ◽  
Adelaida Ramos ◽  
Tania Zertuche ◽  
Antonio Pascual
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Terminally Ill ◽  
Well Being ◽  
Semistructured Interview ◽  
Advanced Cancer Patients ◽  
Terminally Ill Cancer Patients ◽  
Symptom Intensity ◽  
Edmonton Symptom Assessment Scale ◽  
Desire To Die

AbstractObjective:We aimed to address the prevalence of desire-to-die statements (DDSs) among terminally ill cancer patients in an acute palliative care unit. We also intended to compare the underlying differences between those patients who make desire-to-die comments (DDCs) and those who make desire-for-euthanasia comments (EUCs).Method:We conducted a one-year cross-sectional prospective study in all patients receiving palliative care who had made a DDC or EUC. At inclusion, we evaluated symptom intensity, anxiety and depression, and conducted a semistructured interview regarding the reasons for these comments.Results:Of the 701 patients attended to during the study period, 69 (9.8%; IC95% 7.7–12.3) made a DDS: 51 (7.3%) a DDC, and 18 (2.5%) an EUC. Using Edmonton Symptom Assessment Scale (ESAS) DDC group showed higher percentage of moderate-severe symptoms (ESAS > 4) for well-being (91 vs. 25%; p = 0.001), depression (67 vs. 25%; p = 0.055), and anxiety (52 vs. 13%; p = 0.060) than EUC group. EUC patients also considered themselves less spiritual (44 vs. 84%; p = 0.034). The single most common reason for a DDS was pain or physical suffering, though most of the reasons given were nonphysical.Significance of results:Almost 10% of the population receiving specific oncological palliative care made a DDC (7.3%) or EUC (2.5%). The worst well-being score was lower in the EUC group. The reasons for both a DDC and EUC were mainly nonphysical. We find that emotional and spiritual issues should be identified and effectively addressed when responding to a DDS in terminally ill cancer patients.

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