持续深度镇静的经验和感知:在荷兰患者和亲属中进行的一项采访研究
Louise Annemoon Jonker1,2, Madelon T Heijltjes1, Judith A C Rietjens3,4
1Department of Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
持续深度镇静 (CDS) 越来越多地使用,患者和亲属将其视为正常的息治疗选择. 他们希望更多地参与决策,以避免痛苦,并在生命结束时保持控制权.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 生命终端决策 - - 生命终端决策
- 患者体验 患者体验
背景情况:
- 持续深度镇静 (CDS) 的发生率在荷兰增加了一倍多.
- 这种增加的原因尚未完全理解,但患者和相对参与是关键.
- 假设:增加的CDS实践与患者在决策中的演变和相对角色有关.
研究的目的:
- 描述患者和相对患者对CDS的看法和经验.
- 为专业人士和政策制定者提供关于不断变化的CDS实践的见解.
主要方法:
- 与患者和亲属进行的定性采访.
- 参与者对CDS有个人经验,或者自己考虑使用CDS.
主要成果:
- 大多数受访者都认为CDS是一种息护理选择,没有任何反对意见.
- 患者和家属在很大程度上认为CDS是他们的选择,优先考虑避免痛苦.
- 负面经验源于因沟通不良或护理连续性而失去代理权.
- 对CDS与其他生命终结决定 (如安乐死) 的理解有所不同;有些人认为CDS是加速死亡.
结论:
- 患者和亲属认为CDS是一种常规的息选择,而不是最后的手段.
- 他们希望在决策过程中发挥重要作用,因为他们希望避免痛苦并控制他们的生命末期.
- 在指南中调和患者,亲属和医疗保健提供者之间的不同观点至关重要.
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