PDF(Pubmed)
Abstract：
UNASSIGNED: The European Association for Palliative Care (EAPC) acknowledges palliative sedation as an important, broadly accepted intervention for patients with life-limiting disease experiencing refractory symptoms. The EAPC therefore developed 2009 a framework on palliative sedation. A revision was needed due to new evidence from literature, ongoing debate and criticism of methodology, terminology and applicability.
UNASSIGNED: To provide evidence- and consensus-based guidance on palliative sedation for healthcare professionals involved in end-of-life care, for medical associations and health policy decision-makers.
UNASSIGNED: Revision between June 2020 and September 2022 of the 2009 framework using a literature update and a Delphi procedure.
UNASSIGNED: European.
UNASSIGNED: International experts on palliative sedation (identified through literature search and nomination by national palliative care associations) and a European patient organisation.
UNASSIGNED: A framework with 42 statements for which high or very high level of consensus was reached. Terminology is defined more precisely with the terms suffering used to encompass distressing physical and psychological symptoms as well as existential suffering and refractory to describe the untreatable (healthcare professionals) and intolerable (patient) nature of the suffering. The principle of proportionality is introduced in the definition of palliative sedation. No specific period of remaining life expectancy is defined, based on the principles of refractoriness of suffering, proportionality and independent decision-making for hydration. Patient autonomy is emphasised. A stepwise pharmacological approach and a guidance on hydration decision-making are provided.
UNASSIGNED: This is the first framework on palliative sedation using a strict consensus methodology. It should serve as comprehensive and soundly developed information for healthcare professionals.
UNASSIGNED: To provide evidence- and consensus-based guidance on palliative sedation for healthcare professionals involved in end-of-life care, for medical associations and health policy decision-makers.
UNASSIGNED: Revision between June 2020 and September 2022 of the 2009 framework using a literature update and a Delphi procedure.
UNASSIGNED: European.
UNASSIGNED: International experts on palliative sedation (identified through literature search and nomination by national palliative care associations) and a European patient organisation.
UNASSIGNED: A framework with 42 statements for which high or very high level of consensus was reached. Terminology is defined more precisely with the terms suffering used to encompass distressing physical and psychological symptoms as well as existential suffering and refractory to describe the untreatable (healthcare professionals) and intolerable (patient) nature of the suffering. The principle of proportionality is introduced in the definition of palliative sedation. No specific period of remaining life expectancy is defined, based on the principles of refractoriness of suffering, proportionality and independent decision-making for hydration. Patient autonomy is emphasised. A stepwise pharmacological approach and a guidance on hydration decision-making are provided.
UNASSIGNED: This is the first framework on palliative sedation using a strict consensus methodology. It should serve as comprehensive and soundly developed information for healthcare professionals.
摘要：
■欧洲姑息治疗协会（EAPC）承认姑息镇静是重要的，对出现难治性症状的生命限制性疾病患者进行广泛接受的干预。因此，EAPC在2009年制定了姑息镇静框架。由于文献中的新证据，需要进行修订，对方法论的持续辩论和批评，术语和适用性。
■为参与临终关怀的医疗保健专业人员提供基于证据和共识的姑息镇静指导，医疗协会和卫生政策决策者。
■使用文献更新和Delphi程序在2020年6月至2022年9月之间对2009年框架进行了修订。
■欧洲。
■国际姑息镇静专家（通过国家姑息治疗协会的文献检索和提名确定）和欧洲患者组织。
■一个包含42个声明的框架，达成了很高或非常高的共识。术语更准确地定义了术语“痛苦”，用于涵盖令人痛苦的身体和心理症状以及存在的痛苦和难治，以描述痛苦的不可治愈（医疗保健专业人员）和无法忍受的（患者）性质。在姑息镇静的定义中引入了相称性原则。没有定义剩余预期寿命的特定时期，基于苦难的折射原则，水合的比例性和独立决策。强调患者的自主性。提供了逐步的药理学方法和水合决策指导。
■这是第一个使用严格共识方法的姑息镇静框架。它应该为医疗保健专业人员提供全面和完善的信息。
■为参与临终关怀的医疗保健专业人员提供基于证据和共识的姑息镇静指导，医疗协会和卫生政策决策者。
■使用文献更新和Delphi程序在2020年6月至2022年9月之间对2009年框架进行了修订。
■欧洲。
■国际姑息镇静专家（通过国家姑息治疗协会的文献检索和提名确定）和欧洲患者组织。
■一个包含42个声明的框架，达成了很高或非常高的共识。术语更准确地定义了术语“痛苦”，用于涵盖令人痛苦的身体和心理症状以及存在的痛苦和难治，以描述痛苦的不可治愈（医疗保健专业人员）和无法忍受的（患者）性质。在姑息镇静的定义中引入了相称性原则。没有定义剩余预期寿命的特定时期，基于苦难的折射原则，水合的比例性和独立决策。强调患者的自主性。提供了逐步的药理学方法和水合决策指导。
■这是第一个使用严格共识方法的姑息镇静框架。它应该为医疗保健专业人员提供全面和完善的信息。
