Deep sedation; emotional adjustment; healthcare providers; palliative care; relatives; Humans; Male; Female; Middle Aged; Longitudinal Studies; Prospective Studies; Adult; Terminal Care/psychology; Aged; Surveys and Questionnaires; Anxiety/psychology; Depression/psychology; Neoplasms/psychology; Neoplasms/therapy; Job Satisfaction; Palliative Care/psychology; Health Personnel/psychology; Family/psychology; Deep Sedation/psychology; Adaptation, Psychological; Emotional Adjustment; Anxiety; Depression; Family; Health Personnel; Neoplasms; Terminal Care; Nursing (all); Neurology (clinical); Anesthesiology and Pain Medicine
Abstract :
[en] [en] INTRODUCTION: Deep and continuous sedation addresses the refractory suffering of patients expected to die in the short term. This practice creates a distinctive experience for both healthcare professionals and relatives. The objective of this study was to describe their psychological adjustment after caring for cancer patients for whom deep sedation was implemented.
METHODS: APSY-SED is a multicenter, prospective, longitudinal study using mixed methods. This report focuses on quantitative data collected during the initial (T1) phase, at the onset of sedation. Relatives completed questionnaires assessing attachment style (RSQ), anxiety and depression (STAI-S, BDI-II), and satisfaction with end-of-life care (CANHELP). Healthcare professionals completed a job satisfaction questionnaire (Karasek questionnaire).
RESULTS: The sample included 52 relatives and 46 healthcare professionals from five French hospitals. Satisfaction with needs negatively predicted depression (β = -2.68, P = 0.007). Anxiety was predicted by total CanHelp (β = 4.13, P = 0.004), but reduced by satisfaction with involvement (β = -1.84, P = 0.035) and relationship with doctors and nurses (β = -1.77, P = 0.008). ANOVA showed higher satisfaction when sedation was patient-initiated (P = 0.015). Among professionals, 19.6% reported job strain; job latitude was high (M = 76.83, SD = 7.57).
DISCUSSION: These findings underscore the need for targeted emotional support for anxious relatives and highlight the protective role of satisfactory end-of-life care in mitigating depressive symptoms. Clear protocols and communication may help preserve high job satisfaction among healthcare professionals. Further longitudinal and qualitative research is necessary to clarify how these factors evolve over time within continuous deep sedation contexts.
Disciplines :
Treatment & clinical psychology
Author, co-author :
Locatelli, Marie ; Laboratory of Psychopathology and Health Processes (LPPS, UR 4057) (M.L., C.F., L.F.), Université Paris Cité - Institut of Psychology, Boulogne-Billancourt, France. Electronic address: marie.locatelli@etu.u-paris.fr
Flahault, Cécile; Laboratory of Psychopathology and Health Processes (LPPS, UR 4057) (M.L., C.F., L.F.), Université Paris Cité - Institut of Psychology, Boulogne-Billancourt, France, Psycho-Oncology Unit (C.F., J.B.P., L.F.), Gustave Roussy Cancer Campus, Villejuif, France
Joffin, Ingrid; Palliative Care Department (I.J.), Groupe Hospitalier Diaconesses Croix Saint-Simon (GH DCSS), Paris, France
Proux, Aurélien ; Department of Supportive and Palliative Care (A.P.), Institut Paoli-Calmettes, Marseille, France
Vander Haegen, Marie ; Université de Liège - ULiège > Département de Psychologie > Psychologie de la santé
Mateus, Christine; Palliative Care Department (C.M.), Gustave Roussy Cancer Campus, Villejuif, France
Le Provost, Jean Bernard; Psycho-Oncology Unit (C.F., J.B.P., L.F.), Gustave Roussy Cancer Campus, Villejuif, France
Prod'homme, Chloé; Palliative Care Unit, Lille University Hospital (CHRU de Lille) (C.P.), Lille, France
Adrien, Evin; Palliative and Supportive Care Unit (A.E.), Nantes University Hospital (CHU de Nantes), Nantes, France
Fasse, Léonor; Laboratory of Psychopathology and Health Processes (LPPS, UR 4057) (M.L., C.F., L.F.), Université Paris Cité - Institut of Psychology, Boulogne-Billancourt, France, Psycho-Oncology Unit (C.F., J.B.P., L.F.), Gustave Roussy Cancer Campus, Villejuif, France
Language :
English
Title :
Relatives and Healthcare Providers' Psychological Adjustment at Continuous Deep Sedation Initiation.
The authors declare no conflicts of interest. This study is funded by the French National Cancer Institute (INCa SHS 2020) and has undergone peer-review by this funding body. It is also supported by The Faculty \u201CSoci\u00E9t\u00E9s et Humanit\u00E9s\u201D of the University Paris Cit\u00E9.
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