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Attitudes and practices of hospice physicians regarding palliative sedation: a cross-sectional descriptive study
Mengmeng Chen1, Zhigang Li1, Jiejie Niu1
1Department of Pain Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Objective:
The primary aim of this study was to assess the attitudes and practices of Chinese hospice physicians involved in palliative sedation, with an additional focus on exploring factors associated with the experience of palliative sedation.
Design:
A cross-sectional study using a web-based structured questionnaire.
Setting And Participants:
With the support of the Hospice Committee of the Chinese Anti-Cancer Association, this study employed a convenience sampling method to survey hospice physicians nationwide. Subsequently, a total of 550 questionnaires were distributed via email.
Outcome Measures:
Physicians' attitudes and practices regarding palliative sedation.
Results:
The statistical analysis was based on 449 valid responses. Among them, 252 had no experience with palliative sedation, while only 197 had experience in this area. Notably, the study of relevant guidelines (OR=8.01, 95% CI (5.19 to 12.38), p<0.001) and participation in training programmes (OR=5.45, 95% CI (3.62 to 8.2), p<0.001) were significantly associated with experience in palliative sedation. Among these experienced physicians, 108 physicians (54.8%) administered palliative sedation to between 1 and 5 patients, with only 21 physicians (10.7%) treating more than 20 patients over the last year. Additionally, 96 physicians (48.7%) reported feeling stressed during the administration of palliative sedation. Regarding perspectives on palliative sedation, 31 physicians (15.7%) believed it is intended to hasten death, and 60 physicians (30.5%) considered that it may shorten a patient's lifespan. Furthermore, five physicians (2.5%) perceived no difference between palliative sedation and euthanasia.
Conclusions:
The findings indicate a relative scarcity of hospice physicians in China with experience in palliative sedation, with many encountering significant stress during its implementation. There is an urgent need to enhance professional training and establish guidelines for palliative sedation in China, which will provide a solid foundation for its application and foster the development of hospice care.
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