Skip to main content

Table 5 Summary of findings

From: The impact of the inpatient practice of continuous deep sedation until death on healthcare professionals’ emotional well-being: a systematic review

What is the effect of the inpatient practice of CDS on healthcare professionals’ emotional well-being?

Population: Healthcare professionals practicing CDS

Setting: Hospital, hospice, palliative care unit, cancer centre

Intervention: Continuous deep sedation until death for terminally ill adult patients (≥18 years age)

Outcome: Healthcare professionals’ emotional burden

Endpoints

Prevalence

Specific indicators

Effect of estimates (95% CI)

Participantsa (N, studies)

Confidence in estimatesb

Comments

CDS-related burden in physicians [37]

Emotional exhaustion [M, SD]:

- Physicians choosing CDS as treatment option for refractory dyspnoea: 20.8, 11.3

- Physicians not choosing CDS as treatment option for refractory dyspnoea: 17.6, 10.8

 

Comparison of physicians emotional exhaustion depending on treatment choice: p < 0.01

697, 1

++oo low

Physicians’ emotional exhaustion is an independent determinant for choosing CDS as treatment option for refractory dyspnoea:

OR = 1.02 (1.01;1.04) p = 0.14

  

9 concerns about CDS

[Agreement on 11 statements about CDS]

Range 1.6% concerns losing patients trust to 48% reporting difficulties to accurately determinate medical indications for CDS

  

Only descriptives, not assessed in multivariate models as independent determinants of physicians’ emotional burden.

CDS-related burden in nurses [38, 39]

Burden scorec [%, N(100)]: 14.2%, 2607

11 independent determinants

Strongest effect: Nurses’ personal values contradictory to CDS β = 0.27 (.24;.30)d

3203, 2

++oo low

 
 

Desire to leave work occasionally [%, N(100)]: 26%, 2607

11 independent determinants

Strongest effect: Nurse-perceived inadequate coping with own grief OR = 1.23 (1.14;1.32)e

   
 

Feeling uncomfortable working on the fine line between CDS and euthanasia n = 5

Clinical experience

-

  

N = 16

 

Feeling uncomfortable with the use of CDS for non-physical suffering n = 4

Clinical experience

-

  

N = 16

  1. Note. CDS = Continuous deep sedation; OR = Odds ratio; CI = Confidence interval
  2. aTotal number of participants analysed
  3. bGRADE Working Group grades of evidence. High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate
  4. cBurden score was calculated as mean score of four items, Cronbach’s α 0.86; the higher the score means the higher nurses burden
  5. dβ values for linear regression analyses using burden score as dependent variable. F = 76, p < .001, R2 = 0.24
  6. eOdds ratios for logistic regression analyses comparing the nurses who wanted to leave current work occasionally, often or always and others
Back to article page

BMC Palliative Care

ISSN: 1472-684X

Contact us