French Swiss physicians' attitude toward palliative sedation: Influence of prognosis and type of suffering.

Détails

ID Serval
serval:BIB_E448CE820F07
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
French Swiss physicians' attitude toward palliative sedation: Influence of prognosis and type of suffering.
Périodique
Palliative and Supportive Care
Auteur(s)
Beauverd M., Bernard M., Currat T., Ducret S., Foley R.A., Borasio G.D., Blondeau D., Dumont S.
ISSN
1478-9523 (Electronic)
ISSN-L
1478-9515
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
12
Numéro
5
Pages
345-350
Langue
anglais
Notes
Publication types: Journal Article
Résumé
OBJECTIVE: Palliative sedation is a last resort medical act aimed at relieving intolerable suffering induced by intractable symptoms in patients at the end-of-life. This act is generally accepted as being medically indicated under certain circumstances. A controversy remains in the literature as to its ethical validity. There is a certain vagueness in the literature regarding the legitimacy of palliative sedation in cases of non-physical refractory symptoms, especially "existential suffering." This pilot study aims to measure the influence of two independent variables (short/long prognosis and physical/existential suffering) on the physicians' attitudes toward palliative sedation (dependent variable).
METHODS: We used a 2 × 2 experimental design as described by Blondeau et al. Four clinical vignettes were developed (vignette 1: short prognosis/existential suffering; vignette 2: long prognosis/existential suffering; vignette 3: short prognosis/physical suffering; vignette 4: long prognosis/physical suffering). Each vignette presented a terminally ill patient with a summary description of his physical and psychological condition, medication, and family situation. The respondents' attitude towards sedation was assessed with a six-point Likert scale. A total of 240 vignettes were sent to selected Swiss physicians.
RESULTS: 74 vignettes were completed (36%). The means scores for attitudes were 2.62 ± 2.06 (v1), 1.88 ± 1.54 (v2), 4.54 ± 1.67 (v3), and 4.75 ± 1.71 (v4). General linear model analyses indicated that only the type of suffering had a significant impact on the attitude towards sedation (F = 33.92, df = 1, p = 0.000). Significance of the results: The French Swiss physicians' attitude toward palliative sedation is more favorable in case of physical suffering than in existential suffering. These results are in line with those found in the study of Blondeau et al. with Canadian physicians and will be discussed in light of the arguments given by physicians to explain their decisions.
Pubmed
Web of science
Création de la notice
07/01/2014 16:11
Dernière modification de la notice
03/03/2018 22:13
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