“We don’t want to sedate him” - A qualitative interview study on intentions when administering sedative drugs at the end of life in nursing homes and hospitals
Abstract Background Previous data indicate major differences between countries and settings regarding the intention when administering sedative drugs at the end of life and the perception, which drugs are sedating. Therefore, we aimed to explore the concept of ‘sedative drugs’ and the intentions of...
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-021-00832-0 |
| _version_ | 1818589038352793600 |
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| author | Sophie Meesters Bettina Grüne Claudia Bausewein Eva Schildmann |
| author_facet | Sophie Meesters Bettina Grüne Claudia Bausewein Eva Schildmann |
| author_sort | Sophie Meesters |
| collection | DOAJ |
| description | Abstract Background Previous data indicate major differences between countries and settings regarding the intention when administering sedative drugs at the end of life and the perception, which drugs are sedating. Therefore, we aimed to explore the concept of ‘sedative drugs’ and the intentions of German healthcare professionals in general palliative care when administering sedative drugs at the end of life. Methods Semi-structured qualitative interviews with physicians and nurses (n = 49). Recruitment took place via contact persons in five hospital departments (haematology/oncology (n = 2), neurology, geriatrics, gynaecology) and five nursing homes. We thematically analysed the transcripts by the Framework approach, using MAXQDA version 2018.2. Results Most interviewees referred to benzodiazepines, opioids, and antipsychotics. Some subsumed all into sedative drugs, others differentiated between sedative drugs, anxiolytics, and analgesics. In explaining their intention, interviewees particularly emphasized what they want to avoid when administering sedative drugs. We identified three main themes regarding (excluded) intentions: (1) use of sedative drugs to relieve the patient’s suffering with reduction of consciousness as side effect, (2) use of sedative drugs to relieve the situation for the team and/or the family, (3) distinction between intention and expectation regarding hastening death. Interviewees often equated the term ‘sedation’ with inducing a state of unconsciousness, which should be avoided. Conclusion German healthcare professionals in general palliative care seem to negatively connote the term ‘sedation’. Moreover, they see themselves in a more passive role by accepting a side effect rather than performing an intentional act. Critical reflection of indications and intentions in accordance with respective guidelines is needed. |
| first_indexed | 2024-12-16T09:34:17Z |
| format | Article |
| id | doaj.art-4824bd0923134dd3a12f44f2d32a7f4e |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-12-16T09:34:17Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-4824bd0923134dd3a12f44f2d32a7f4e2022-12-21T22:36:26ZengBMCBMC Palliative Care1472-684X2021-09-012011810.1186/s12904-021-00832-0“We don’t want to sedate him” - A qualitative interview study on intentions when administering sedative drugs at the end of life in nursing homes and hospitalsSophie Meesters0Bettina Grüne1Claudia Bausewein2Eva Schildmann3Department of Palliative Medicine, University Hospital, LMU MunichDepartment of Palliative Medicine, University Hospital, LMU MunichDepartment of Palliative Medicine, University Hospital, LMU MunichDepartment of Palliative Medicine, University Hospital, LMU MunichAbstract Background Previous data indicate major differences between countries and settings regarding the intention when administering sedative drugs at the end of life and the perception, which drugs are sedating. Therefore, we aimed to explore the concept of ‘sedative drugs’ and the intentions of German healthcare professionals in general palliative care when administering sedative drugs at the end of life. Methods Semi-structured qualitative interviews with physicians and nurses (n = 49). Recruitment took place via contact persons in five hospital departments (haematology/oncology (n = 2), neurology, geriatrics, gynaecology) and five nursing homes. We thematically analysed the transcripts by the Framework approach, using MAXQDA version 2018.2. Results Most interviewees referred to benzodiazepines, opioids, and antipsychotics. Some subsumed all into sedative drugs, others differentiated between sedative drugs, anxiolytics, and analgesics. In explaining their intention, interviewees particularly emphasized what they want to avoid when administering sedative drugs. We identified three main themes regarding (excluded) intentions: (1) use of sedative drugs to relieve the patient’s suffering with reduction of consciousness as side effect, (2) use of sedative drugs to relieve the situation for the team and/or the family, (3) distinction between intention and expectation regarding hastening death. Interviewees often equated the term ‘sedation’ with inducing a state of unconsciousness, which should be avoided. Conclusion German healthcare professionals in general palliative care seem to negatively connote the term ‘sedation’. Moreover, they see themselves in a more passive role by accepting a side effect rather than performing an intentional act. Critical reflection of indications and intentions in accordance with respective guidelines is needed.https://doi.org/10.1186/s12904-021-00832-0Hospitals; Nursing homes; Palliative Care; Hypnotics and Sedatives; Opioid; Intention; Qualitative research; Deep sedation |
| spellingShingle | Sophie Meesters Bettina Grüne Claudia Bausewein Eva Schildmann “We don’t want to sedate him” - A qualitative interview study on intentions when administering sedative drugs at the end of life in nursing homes and hospitals BMC Palliative Care Hospitals; Nursing homes; Palliative Care; Hypnotics and Sedatives; Opioid; Intention; Qualitative research; Deep sedation |
| title | “We don’t want to sedate him” - A qualitative interview study on intentions when administering sedative drugs at the end of life in nursing homes and hospitals |
| title_full | “We don’t want to sedate him” - A qualitative interview study on intentions when administering sedative drugs at the end of life in nursing homes and hospitals |
| title_fullStr | “We don’t want to sedate him” - A qualitative interview study on intentions when administering sedative drugs at the end of life in nursing homes and hospitals |
| title_full_unstemmed | “We don’t want to sedate him” - A qualitative interview study on intentions when administering sedative drugs at the end of life in nursing homes and hospitals |
| title_short | “We don’t want to sedate him” - A qualitative interview study on intentions when administering sedative drugs at the end of life in nursing homes and hospitals |
| title_sort | we don t want to sedate him a qualitative interview study on intentions when administering sedative drugs at the end of life in nursing homes and hospitals |
| topic | Hospitals; Nursing homes; Palliative Care; Hypnotics and Sedatives; Opioid; Intention; Qualitative research; Deep sedation |
| url | https://doi.org/10.1186/s12904-021-00832-0 |
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