持续深度镇静直到癌症末期死亡:专业人员和亲属经验的词汇分析分析
Marie Locatelli1, Cécile Flahault2,3, Aurélien Proux4
1Université Paris Cité, Psychology Institut, Boulogne-Billancourt, France. marie.locatelli@etu.u-paris.fr.
概括
持续深度镇静 (CDS) 提供了缓解性缓解,但对亲属而言存在矛盾,对专业人士而言存在道德挑战. 开放的沟通和明确的指导方针对于在这种敏感的生命终端护理过程中管理患者的自主权和家庭参与至关重要.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 在生命末期的护理.
- 医学伦理 医学伦理
背景情况:
- 持续深度镇静 (CDS) 用于缓解难治的痛苦,特别是癌症患者的息性缓解.
- CDS为医疗保健专业人员和患者亲属创造了一个独特的体验环境.
- 了解这些不同的经验对于优化护理至关重要.
研究的目的:
- 从亲属和医疗保健专业人员的角度探索和比较持续深度镇静 (CDS) 的感知和经验.
- 确定影响所有相关方对CDS体验的关键因素.
主要方法:
- 一个多中心,前性,纵向研究 (APSY-SED),采用混合方法设计.
- 定性结果来自于在CDS启动时对亲属和医疗保健专业人员的采访的词汇分析.
- 这项研究包括27名亲属和22名医疗保健专业人员.
主要成果:
- 亲属经历了CDS的矛盾,将其视为患者的救济和个人情感负担,强调时间的最终性.
- 亲属强调了患者自主,沟通和对医疗保健提供者的信任的重要性.
- 医疗保健专业人员专注于患者护理,平衡道德和合法性,同时注意到程序性压力和家庭沟通的重要作用.
结论:
- CDS是一个复杂的过程,涉及亲属的矛盾和专业人士的伦理问题.
- 有效的沟通对于协调患者自主权,家庭参与和共享决策的观点至关重要.
- 更明确的法律/道德准则和对亲属的结构化教育可以改善CDS的体验,并减少专业人士的道德痛苦.
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