Mar 30, 2021
This episode features Professor María Arantzamendi (Institute for Culture and Society-ATLANTES, Universidad de Navarra, Pamplona, Spain).
In the context of patients with incurable disease palliative
sedation is used for refractory symptom control. A minority of
articles measure the effect of palliative sedation and current
assessment of parameters of such effect is limited. The
literature about palliative sedation measurement has mainly focused
on medication use and level of sedation.
Discomfort Scale-dementia of Alzheimer Type (DS-DAT) and Patient
Comfort Score (PCS) are assessment instruments being used to
measure the effect of palliative sedation on patient comfort,
the latter being validated for palliative care context. There is
limited evidence on the timing of assessment, reported use ranges
from daily assessment to six times per day, with often hourly
measurements until adequate sedation is achieved. There is limited
data available on the training and preparation of the health
professional who has the responsibility for
assessing refractory symptoms and palliative sedation. There
is a lack of evidence, regarding measurement approaches or
instruments for assessment of existential and psychological
distress leading to palliative sedation; and also, for
measuring adverse events.
Measurement instruments adapted to palliative care context should
be used to assess palliative sedation, as these will facilitate
practice improvement and comparability of the study’s
results. Adding measurement instruments for comfort can
contribute to assessing palliative sedation effects. A more
standardized approach to assessing the effect of palliative
sedation and possible adverse events, paying special attention
to adequate training of health care professionals and timing of
measurements, is needed to improve the quality of palliative
sedation.