Cognition of Palliative Care and Experience of Palliative Sedation in Chinese Anesthesiologists: A National Cross-sectional Survey

Objective This study aimed to investigate the understanding of palliative care and experience of palliative sedation for end-stage patients in Chinese anesthesiologists. Methods From October to December 2021, a national cross-sectional survey was conducted among anesthesiologists in China distributed by the Chinese Society of Anesthesiology, Chinese Medical Association with convenient sampling. The questionnaire in this study included general information, working experience, familiarity with palliative care, feelings with end-stage cases, experience in sedation for critical/end-stage patients and choice of medication. Results A total of 2536 anesthesiologists from 29 provinces in China completed valid questionnaires. 572 (22.6%, 572/2536) reported that they were familiar with palliative medicine. Anesthesiologists who had experience in critical/end-stage patients care, pain management, and whose hospitals set up with institutional palliative care team reported more familiarity with palliative care. Over 40% of anesthesiologists felt powerless, helpless, and undecisive when facing end-stage patients. Anesthesiologists with knowledge of palliative care were more likely to show confidence in their management of critical/end-stage patients (9.8% vs 4.4%, P = 0.001). 734 anesthesiologists had experience of conducting sedation in end-stage patients, among whom 151 anesthesiologists (20.6%, 151/734) improperly used opioids as the only medication in sedation protocol. Conclusion The understanding of palliative care and palliative sedation medication choice among anesthesiologists in China was still very limited. Development of palliative care team, education and training on palliative care may help to build the confidence of anesthesiologists when facing critical/end-stage patients and to improve the quality of care in end-stage patients.