YU Jiawen, LIU Hongju, XU Yingying, BAO Yanping, SHI Jie, LIU Zhimin, ZHANG Yuelun, NING Xiaohong, HUANG Yuguang. Cognition of Palliative Care and Experience of Palliative Sedation in Chinese Anesthesiologists: A National Cross-sectional Survey[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(1): 77-83. DOI: 10.12290/xhyxzz.2023-0158
Citation: YU Jiawen, LIU Hongju, XU Yingying, BAO Yanping, SHI Jie, LIU Zhimin, ZHANG Yuelun, NING Xiaohong, HUANG Yuguang. Cognition of Palliative Care and Experience of Palliative Sedation in Chinese Anesthesiologists: A National Cross-sectional Survey[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(1): 77-83. DOI: 10.12290/xhyxzz.2023-0158

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

More Information
  • Corresponding author:

    LIU Hongju, E-mail: liuhongju@pumch.cn

    NING Xiaohong, E-mail: ningxh1973@foxmail.com

  • Received Date: March 27, 2023
  • Accepted Date: June 01, 2023
  • Available Online: July 12, 2023
  • Issue Publish Date: January 29, 2024
  •   Objective  This study aimed to investigate Chinese anesthesiologists' comprehension of palliative care and their experiences with palliative sedation for patients in the end-stage of life.
      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 survey questionnaire encompassed general information, professional experience, familiarity with palliative care, emotional responses to end-stage cases, experience with sedation for critically ill or end-stage patients, and preferences for sedation medication.
      Results  A total of 2536 anesthesiologists from 29 provinces in China completed valid questionnaires. Among them, 572 anesthesiologists(22.6%, 572/2536) reported familiarity with palliative medicine. Male anesthesiologists, as well as those with prior experience in caring for critically ill or end-stage patients, involved in pain management and practicing in hospitals with established institutional palliative care teams, demonstrated greater familiarity with palliative care concepts(all P<0.05). Over 40% of respondents felt powerless, helpless, and indecisive when confronted with end-stage patients. Anesthesiologists knowledgeable about palliative care exhibited greater confidence in managing critically ill or end-stage patients(9.8% vs. 4.4%, P=0.001). Among the anesthesiologists surveyed, 734 had administered sedation to end-stage patients, with 151 of them(20.6%, 151/734) inappropriately relying solely on opioids for sedation.
      Conclusions  The understanding of palliative care and palliative sedation medication choice among anesthesiologists in China is still very limited. The establishment of palliative care teams, provision of education and training in palliative care, and enhancement of familiarity with palliative principles may bolster anesthesiologists' confidence when encountering critically ill or end-stage patients and subsequently enhance the quality of care for patients in the terminal stages of life.
  • [1]
    Dans M, Kutner J S, Agarwal R, et al. NCCN guidelines® insights: palliative care, version 2.2021[J]. J Natl Compr Canc Netw, 2021, 19(7): 780-788. DOI: 10.6004/jnccn.2021.0033
    [2]
    Cherny N I. ESMO clinical practice guidelines for the management of refractory symptoms at the end of life and the use of palliative sedation[J]. Ann Oncol, 2014, 25(Suppl 3): iii143-iii152.
    [3]
    Dumanovsky T, Augustin R, Rogers M, et al. The growth of palliative care in U.S. hospitals: a status report[J]. J Palliat Med, 2016, 19(1): 8-15. DOI: 10.1089/jpm.2015.0351
    [4]
    Kettler D, Nauck F. Palliative care and involvement of anaesthesiology: current discussions[J]. Curr Opin Anaesthesiol, 2010, 23(2): 173-176. DOI: 10.1097/ACO.0b013e328337331d
    [5]
    Won Y W, Chun H S, Seo M, et al. Clinical patterns of continuous and intermittent palliative sedation in patients with terminal cancer: a descriptive, observational study[J]. J Pain Symptom Manage, 2019, 58(1): 65-71. DOI: 10.1016/j.jpainsymman.2019.04.019
    [6]
    Maltoni M, Scarpi E, Rosati M, et al. Palliative sedation in end-of-life care and survival: a systematic review[J]. J Clin Oncol, 2012, 30(12): 1378-1383. DOI: 10.1200/JCO.2011.37.3795
    [7]
    Patel C, Kleinig P, Bakker M, et al. Palliative sedation: a safety net for the relief of refractory and intolerable symptoms at the end of life[J]. Aust J Gen Pract, 2019, 48(12): 838-845. DOI: 10.31128/AJGP-05-19-4938
    [8]
    Zhang C S, Wang S S, Li H G, et al. Anaesthesiology in China: a cross-sectional survey of the current status of anaesthesiology departments[J]. Lancet Reg Health West Pac, 2021, 12: 100166. DOI: 10.1016/j.lanwpc.2021.100166
    [9]
    杜铁宽, 宁晓红, 朱华栋, 等. 三级医院急诊医师对缓和医疗的认知和能力[J]. 中国医学科学院学报, 2021, 43(4): 563-570.

    Du T K, Ning X H, Zhu H D, et al. Cognition and ability of emergency physicians for palliative care in tertiary hospitals[J]. Acta Acad Med Sinic, 2021, 43(4): 563-570.
    [10]
    宁晓红, 董祈, 曲璇, 等. 高年资内科医师对安宁缓和医疗的认知及需求[J]. 中国临床保健杂志, 2020, 23(3): 321-324. DOI: 10.3969/J.issn.1672-6790.2020.03.009

    Ning X H, Dong Q, Qu X, et al. Cognition, attitude and demand of senior physicians for hospice and palliative care[J]. Chin J Clin Health, 2020, 23(3): 321-324. DOI: 10.3969/J.issn.1672-6790.2020.03.009
    [11]
    Storarri A C M, De Castro G D, Castiglioni L, et al. Confidence in palliative care issues by medical students and internal medicine residents[J]. BMJ Support Palliat Care, 2019, 9(1): e1. DOI: 10.1136/bmjspcare-2017-001341
    [12]
    Wiese C H R, Felber S, Lassen C L, et al. Anesthesiology and palliative medicine. Structured results of a prospective questionnaire-based survey in German hospitals[J]. Schmerz, 2011, 25(5): 522-533. DOI: 10.1007/s00482-011-1090-8
    [13]
    Cortegiani A, Russotto V, Raineri S M, et al. Attitudes towards end-of-life issues in intensive care unit among Italian anesthesiologists: a nation-wide survey[J]. Support Care Cancer, 2018, 26(6): 1773-1780. DOI: 10.1007/s00520-017-4014-z
    [14]
    Cherny N I, Radbruch L, Board of the European Association for Palliative Care. European Association for Palliative Care (EAPC) recommended framework for the use of sedation in palliative care[J]. Palliat Med, 2009, 23(7): 581-593. DOI: 10.1177/0269216309107024
    [15]
    Kuragaichi T, Kurozumi Y, Ohishi S, et al. Nationwide survey of palliative care for patients with heart failure in Japan[J]. Circ J, 2018, 82(5): 1336-1343. DOI: 10.1253/circj.CJ-17-1305
    [16]
    Verkerk M, Van Wijlick E, Legemaate J, et al. A national guideline for palliative sedation in the Netherlands[J]. J Pain Symptom Manage, 2007, 34(6): 666-670. DOI: 10.1016/j.jpainsymman.2007.01.005
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