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Table 8 Multivariate analysis of factors contributing to CDS-related burden in healthcare professionals

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

First Author, Year

 

Covariate

Measure of Association

p Value

Morita T, 2002 [37]

Logistic Regressiona

Physicians’ decision to choose CDS as treatment option

OR (95% CI)

 
  

1) For refractory dyspnoea

  
   

Physicians' preference for their own end-of-life care

1.53 (1.07, 2.20)

0.021

   

Emotional exhaustion

1.02 (1.01, 1.04)

0.014

  

2) For existential suffering

  
   

Emotional exhaustion

1.02 (1.00, 1.04)

0.060

Morita T, 2004 [38]

Logistic Regressionb

Nurses’ desire to leave current work (N = 369)

OR (95% CI)

 
   

Clinical experience (years)

0.98 (0.96,0.99)

<.001

   

Insufficient timec

1.17 (1.10, 1.25)

<.001

   

Lack of common understanding of sedation between physicians and nursesc

1.17 (1.09, 1.26)

<.001

   

Team conference unavailablec

1.09 (1.01, 1.18)

0.021

   

Frequent experience of conflicting wishes between patient and familyc

1.11 (1.02, 1.22)

0.014

   

Nurse-perceived inadequate interpersonal skillsc

-

ns

   

Belief that it is difficult to diagnose refractory symptomsc

1.11 (1.03, 1.20)

<.001

   

Belief that sedation would hasten deathc

-

ns

   

Belief that sedation is indistinguishable from euthanasiac

1.15 (1.07, 1.23)

<.001

   

Nurses-perceived inadequate coping with own griefc

1.23 (1.14, 1.32)

<.001

   

Nurses' personal values contradictory to sedationc

1.14 (1.06, 1.23)

<.001

 

Linear Regressiond

Nurses’ overall burden (N = 369)

Beta (95% CI)

 
   

Clinical experience (years)

-0.062 (-0.011,-0.002)

0.009

   

Insufficient timec

0.029 (0.005, 0.053)

0.019

   

Lack of common understanding of sedation between physicians and nursesc

-

ns

   

Team conference unavailablec

0.066 (0.035, 0.097)

<.001

   

Frequent experience of conflicting wishes between patient and familyc

0.051 (0.017, 0.085)

0.003

   

Nurse-perceived inadequate interpersonal skillsc

0.060 (0.026, 0.093)

<.001

   

Belief that it is difficult to diagnose refractory symptomsc

0.073 (0.041, 0.11)

<.001

   

Belief that sedation would hasten deathc

0.057 (0.028, 0.085)

<.001

   

Belief that sedation is indistinguishable from euthanasiac

0.054 (0.023, 0.085)

<.001

   

Nurses-perceived inadequate coping with own grief c

0.075 (0.043, 0.11)

<.001

   

Nurses' personal values contradictory to sedationc

0.27 (0.24, 0.30)

<.001

  1. Note. CDS Continuous deep sedation; OR Odds ratio; CI Confidence interval; n.s. not significant
  2. aMultiple logistic regression analysis comparing physicians who chose CDS as strong possibility with others. Physicians’ preference for symptomatic treatment was assessed using 3 items, score range of 1 to 5 (higher preference); emotional exhaustion was assessed using a subscale of Maslach Burnout Inventory, Cronbach's alpha range 0.6 to 0.88, score range of 0 to 54 (high exhaustion)
  3. bLogistic regression comparing nurses who wished to leave the current work occasionally, often, or always and others
  4. cRated as the degree of agreement on each statement from 1 (strongly disagree) to 7 (strongly agree)
  5. dMultiple linear regression only included nurses with high-level emotional burden, F = 76, p < .001, R2 = 0.24; Burden score was calculated as the mean score of four items about CDS-related negative feelings, Cronbach's alpha coefficient 0.86; the higher score means the higher nurses burden
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BMC Palliative Care

ISSN: 1472-684X

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