Table 1 Study characteristics
First Author, Year | Country | Study Design | Data collection | Setting | Respondents | N enrolled/N analyzed | Patient Diagnosis | Definition of CDS | Burden-related Measurement | Related Case of CDS |
|---|---|---|---|---|---|---|---|---|---|---|
Morita T, 2002 [37] | Japan | Quantitative study, nationwide, cross-sectional, retrospective | Questionnaire | Cancer center/Hospital Hospice/PCU | Oncologistsa (80%) PC Physiciansb (13%) | 1436/697 | 100% Cancer | “The continuous administration of sedatives to the point where the patient almost (completely) loses consciousness for symptom relief with the primary aim that the patient does not experience suffering. For example, the continuous 24-h administration of 1A (10 mg) of midazolam (Dormicum®) increased to levels such that the patient is almost unconscious” | Maslach Burnout Inventory: Personal feelings and attitudes on 22 items [0 never experiencing; 6 every day] Three subscales: Emotional exhaustion, 9 items [0–54] Personal accomplishment, 8 items [0–48] Depersonalization, 5 items [0–30] | 1) Actual clinical experiences of sedation for cancer patients whose survival was estimated to be 6 months or less 2) Physicians treatment choice for four vignettes [1 unthinkable; 4 strong possibility] |
Morita T, 2004 [38] | Japan | Quantitative study, national wide, cross-sectional, retrospective | Questionnaire | Cancer center Hospital PCU | Oncology Nursesc (72%) PC Nursesc (17%) | 4210/3187 | 100% Cancer | “Continuous use of sedative medications to relieve intolerable and refractory distress by achieving almost or complete unconsciousness until death.” | One Statement: “Wish to leave the current work situation due to sedation-related burden” [never, seldom, occasionally, often, always] Four statements: “Intensity of negative feelings about sedation practice” [1 strongly disagree; 7 strongly agree] Overall burden score: Mean score of the four statements about negative feelings | Overall emotional burden, not patient-specific |
Rietjens JAC, 2007 [39] | Netherlands | Qualitative study, retrospective | Semi-structured Interview | PCU MICU | PC Nursesc (62.5%) MICU Nursesc (37.5%) | 110/16 | 75% Cancer 12.5% ALS 6.25% Chronic disease 6.25% Attempted suicide | “The use of continuous iv. benzodiazepines, barbiturates or other medications to bring an imminently dying patient into a state of unresponsiveness to alleviate suffering from symptoms that cannot be controlled with conventional therapies.” | Semi-structured Interview: “Feeling uncomfortable with the use of palliative sedation” | A memorable case: A case that stuck with you, that made a lasting impression on you, one that you still remember |