Article (Scientific journals)
Attitudes of professional caregivers and family members regarding the use of monitoring devices to improve assessments of pain and discomfort during continuous sedation until death.
Six, Stefaan; Van Overmeire, Roel; Bilsen, Johan et al.
2020In Journal of Pain and Symptom Management
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Keywords :
palliative sedation; monitoring technology; qualitative research
Abstract :
[en] Context Assessing consciousness and pain during continuous sedation until death (CSD) by behaviorbased observational scales alone has recently been put into question. Instead, the use of monitoring technology has been suggested to make more objective and reliable assessments. Insights into which factors influence attitudes towards using these monitoring devices in a context of CSD is a first step in formulating recommendations to inform future practice. Objectives The aim of this study was to find out what influences professional caregivers’ and family members’ attitudes regarding the use of monitors during CSD. Methods We conducted semi-structured face-to-face interviews with 20 professional caregivers and 15 family members, who cared for a patient or had a family member respectively who took part in a study using monitoring devices. Recruitment took place in an academic hospital, a locoregional hospital and 2 nursing homes, all located in Belgium. Two researchers independently analysed the data, using grounded theory to inductively develop a model that represents the emerging attitude towards use of monitors during CSD. Results Our model shows that the emerging attitudes towards using monitors during CSD is determined by view on CSD, desire for peace of mind, emotional valence attached to using monitors and the realization that the sole use of behavior-based observational measures could be unreliable in a CSD context. We identified several facilitators and barriers to inform future implementation strategies. Conclusion Most participants had no objections and all participants found the use of monitoring devices during CSD feasible and acceptable. We identified a number of facilitators and barriers and suggested that being aware that care can be improved, good communication, shared decision making and continuing professional education can overcome the identified barriers. We suggest future research would focus on developing implementation strategies and guidelines for introducing objective monitoring devices in diverse palliative care settings. Key Message Our study shows attitude towards using monitors during CSD is determined by the view on CSD, desire for peace of mind, emotional valence attached to using monitors and realizing the sole use of behavior-based observational measures could be unreliable. The use of monitoring devices was acceptable to all participants.
Research center :
CHU de Liège-Centre du Cerveau² - ULiège
Disciplines :
Public health, health care sciences & services
Author, co-author :
Six, Stefaan ;  Université de Liège - ULiège > GIGA
Van Overmeire, Roel;  Vrije Universiteit Brussel - VUB > Public Health > Mental Health and Wellbeing Research Group
Bilsen, Johan;  Vrije Universiteit Brussel - VUB > Public Health > Mental Health and Wellbeing Research Group
Laureys, Steven  ;  Université de Liège - ULiège > GIGA Consciousness-Coma Science Group
Poelaert, Jan;  Vrije Universiteit Brussel - VUB > Anesthesiology & Perioperative Medicine
Theuns, Peter;  Vrije Universiteit Brussel - VUB > Experimental and Applied Psychology
Deschepper, Reginald;  Vrije Universiteit Brussel - VUB > Public Health > Mental Health and Wellbeing Group
Language :
English
Title :
Attitudes of professional caregivers and family members regarding the use of monitoring devices to improve assessments of pain and discomfort during continuous sedation until death.
Publication date :
2020
Journal title :
Journal of Pain and Symptom Management
ISSN :
0885-3924
eISSN :
1873-6513
Publisher :
Elsevier, New York, United States - New York
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 26 February 2020

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