Qualitative Study on the Perceptions of Terminally Ill Cancer Patients and Their Family Members Regarding End-of-Life Experiences Focusing on Palliative Sedation.
CONTEXT
Patients with terminal cancer experience refractory symptoms in the last days of life. Although palliative sedation (PS) is recommended for patients suffering unbearable symptoms with imminent death, it requires clear communication between physicians and patients/caregivers. Understanding the demands and perceptions of patients and caregivers in the end-of-life phase are needed for effective communication.


OBJECTIVE
To explore patient experiences regarding end-of-life status and PS.


METHODS
The study was performed between October and December, 2013 with eligible terminal cancer patients and their families in a non-religious, tertiary healthcare facility in Korea. Eligibility criteria were a hospitalized cancer patient with a life expectancy of less than three months and who had never experienced PS. Data were collected via face-to-face in-depth interviews and analyzed using the constant comparative method of qualitative analysis. Saturation was achieved after conducting interviews with 13 patients or care-giving family members.


RESULTS
Enrolled patients raised the following issues: 1) simultaneously harboring the hope of prolonging life and wishing for a peaceful death, 2) experiencing difficulties in having honest conversations with caregivers regarding death, 3) possessing insufficient knowledge and information regarding PS, and 4) hoping for the decision on PS to be made before suffering becomes too great.


CONCLUSION
Terminally ill cancer patients and their caregivers expressed conflicting desires in hoping to prolong life and simultaneously wishing to experience a peaceful death. Improvements in the communications that occur among physicians, patients, and caregivers on the issues of prognosis and PS are needed.
['Eun|Young|Y|', 'Hong|In-Wha|IW|', 'Bruera|Eduardo|E|', 'Kang|Jung Hun|JH|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D003142:Communication D003657:Decision Making D004644:Emotions D005190:Family D005260:Female D007722:Health Knowledge, Attitudes, Practice D006801:Humans D006993:Hypnotics and Sedatives D007297:Inpatients D008297:Male D008875:Middle Aged D009369:Neoplasms D010166:Palliative Care D036301:Qualitative Research D056910:Republic of Korea D013727:Terminal Care D019452:Terminally Ill
terminal cancer communication caregivers Conscious sedation qualitative research