PDF(Pubmed)
Abstract：
BACKGROUND: The involvement of patients in decision making about their healthcare plans is being emphasized. In the context of palliative sedation, it is unclear how these decisions are made and who are involved in. The aim of the study is to understand how this decision-making is taken.
METHODS: Information from a systematic review on clinical aspects of palliative sedation prospective studies were included. PubMed, CINAHL, Cochrane, MEDLINE, and EMBASE were searched (January 2014-December 2019). Data extraction and analysis regarded: (a) When and by whom the decision-making process is initiated; (b) patient involvement; (c) family involvement and (d) healthcare involvement.
RESULTS: Data about decision making were reported in 8/10 included articles. Palliative sedation was reported in 1137 patients (only 16 of them were non-cancer). Palliative sedation was introduced by the palliative care team during the disease process, at admission, or when patients experienced refractory symptoms. Only two studies explicitly mentioned the involvement of patients in decision making. Co-decision between families and the regular health care professionals was usual, and the health care professionals involved had been working in palliative care services.
CONCLUSIONS: Patient participation in decision making appeared to be compromised by limited physical or cognitive capacity and family participation is described. The possibility of palliative sedation should be discussed earlier in the disease process.
METHODS: Information from a systematic review on clinical aspects of palliative sedation prospective studies were included. PubMed, CINAHL, Cochrane, MEDLINE, and EMBASE were searched (January 2014-December 2019). Data extraction and analysis regarded: (a) When and by whom the decision-making process is initiated; (b) patient involvement; (c) family involvement and (d) healthcare involvement.
RESULTS: Data about decision making were reported in 8/10 included articles. Palliative sedation was reported in 1137 patients (only 16 of them were non-cancer). Palliative sedation was introduced by the palliative care team during the disease process, at admission, or when patients experienced refractory symptoms. Only two studies explicitly mentioned the involvement of patients in decision making. Co-decision between families and the regular health care professionals was usual, and the health care professionals involved had been working in palliative care services.
CONCLUSIONS: Patient participation in decision making appeared to be compromised by limited physical or cognitive capacity and family participation is described. The possibility of palliative sedation should be discussed earlier in the disease process.
摘要：
背景：强调患者参与医疗计划的决策。在姑息镇静的背景下，目前还不清楚这些决定是如何做出的，以及谁参与了这些决定。这项研究的目的是了解如何做出这种决策。
方法：纳入了姑息性镇静前瞻性研究临床方面的系统综述。PubMed,CINAHL,科克伦,MEDLINE,和EMBASE进行了搜索（2014年1月至2019年12月）。数据提取和分析考虑：（a）何时以及由谁启动决策过程；（b）患者参与；（c）家庭参与和（d）医疗保健参与。
结果：有关决策的数据在8/10的文章中报告。1137例患者报告姑息镇静（其中只有16例非癌症）。姑息治疗团队在疾病过程中引入了姑息镇静，在入院时,或者当患者出现难治性症状时。只有两项研究明确提到患者参与决策。家庭和普通医疗保健专业人员之间的共同决定是很常见的，参与的卫生保健专业人员一直在姑息治疗服务中工作。
结论：患者参与决策似乎受到身体或认知能力和家庭参与的影响。姑息性镇静的可能性应在疾病过程的早期讨论。
方法：纳入了姑息性镇静前瞻性研究临床方面的系统综述。PubMed,CINAHL,科克伦,MEDLINE,和EMBASE进行了搜索（2014年1月至2019年12月）。数据提取和分析考虑：（a）何时以及由谁启动决策过程；（b）患者参与；（c）家庭参与和（d）医疗保健参与。
结果：有关决策的数据在8/10的文章中报告。1137例患者报告姑息镇静（其中只有16例非癌症）。姑息治疗团队在疾病过程中引入了姑息镇静，在入院时,或者当患者出现难治性症状时。只有两项研究明确提到患者参与决策。家庭和普通医疗保健专业人员之间的共同决定是很常见的，参与的卫生保健专业人员一直在姑息治疗服务中工作。
结论：患者参与决策似乎受到身体或认知能力和家庭参与的影响。姑息性镇静的可能性应在疾病过程的早期讨论。
