Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-22T12:32:04.107Z Has data issue: false hasContentIssue false
  • English
  • Français

The perspective of the nursing staff on terminal sedation in pediatric onco-hematology: A phenomenologic-hermeneutic study

Published online by Cambridge University Press:  07 February 2013

Debora Tringali ,
Rosapia Lauro-Grotto  and
Massimo Papini
Debora Tringali
Affiliation:
LAPO ORGANIZZAZIONE NON LUCRATIVA DI UTILITÀ SOCIALE, Florence, Italy
Rosapia Lauro-Grotto*
Affiliation:
Department of Psychology, University of Florence, Florence, Italy
Massimo Papini
Affiliation:
LAPO ORGANIZZAZIONE NON LUCRATIVA DI UTILITÀ SOCIALE, Florence, Italy Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy
*
Address correspondence and reprint requests to: Rosapia Lauro-Grotto, Dipartimento di Psicologia, Università degli Studi di Firenze, Via San Salvi 12, Padiglione 26, 50135 Firenze, Italia. E-mail: rosapia.laurogrotto@unifi.it
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The study was designed to explore the subjective perspective on end-of-life practices in three different groups of pediatric onco-hematologic nurses.

Method:

In 2004–2005 each member of the nursing staff of the Pediatric Onco-Hematology Ward of the University of Padua, Italy, and the Oncology Ward and Home Assistance Module of the Giannetta Gaslini Hospital, Genoa, Italy was interviewed using a semistructured questionnaire with open questions on end-of-life procedures. The results were returned to the interviewees through group meetings. Here, we examine replies given regarding terminal sedation.

Results:

With regard to the nurses from Padua, common features came together in a consolidated practice. The amount of suffering and physical pain was considered an element in determining the use of sedation: “when there is atrocious suffering.” Another aspect was “painful awareness,” the difficulty in being able to bear the fact that the child is aware that death is imminent. The nurses from Genoa stated that the procedure was adopted mainly for three reasons: to sedate the pain, to calm the hunger for air, and to control the anguish caused by the realization that death was imminent or unavoidable. It was noted that the nursing staff of the Home Assistance Unit, Genoa found themselves in a privileged position regarding this procedure both because of the strong relationship established among child, parents, and nurse, and because of being able to take shared decisions after in-depth discussion.

Significance of results:

The results enlighten the critical role of the nursing staff with respect to this procedure, given the involvement with the families and their ability to understand the child's demands and intimate expectations.

Keywords

Phenomenologic-hermeneutic approachPediatric onco-hematologyterminal sedationHospital staff
Type
Original Articles
Information
Palliative & Supportive Care , Volume 11 , Issue 6 , December 2013 , pp. 465 - 472
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Altheide, D.L. & Johnson, J.M. (1994). Criteria for Assessing Intepretative Validity in Qualitative Research. In Handbook of Qualitative Research, Denzin, N.K. & Lincoln, Y.S. (eds.), Thousands Oaks, CA: Sage.Google Scholar
Beel, A.C., Hawranick, P.G., McClement, S., et al. (2006). Palliative sedation: nurses' perceptions. International Journal of Palliative Nursing, 12, 510–518.Google Scholar
Berde, C. & Wolfe, J. (2003). Pain, anxiety, distress and suffering: Interrelated but not interchangeable. Journal of Pediatrics, 142, 361–363.Google Scholar
Bichi, R. (2002). L'intervista biografica. Milano: Vita e Pensiero Università.Google Scholar
Bichi, R. (2007). La conduzione delle interviste nella ricerca sociale. Roma: Carocci.Google Scholar
Bion, W.R. (1962). Learning from the experience. London: Heinemann.Google Scholar
Bruce, A. & Boston, P. (2011). Relieving existential suffering through palliative sedation: Discussion of an uneasy practice. Journal of Advanced Nursing, 67, 2732–2740.Google Scholar
Carli, R. & Paniccia, M.R. (2003). Analisi della domanda. Bologna: Il Mulino.Google Scholar
Collins, J.J. (1996). Intractable pain in children with terminal cancer. Journal of Palliative Care, 12, 29–34.Google Scholar
Committee on Bioethics and Committee on Hospital Care (2000). Palliative care for children. Pediatrics, 106, 351–357.CrossRefGoogle Scholar
Correale, A. (2006). Area traumatica e campo istituzionale. Roma: Borla.Google Scholar
Dixon-Woods, M., Young, B. & Heney, D. (2005). Rethinking Experiences of Childhood Cancer: A Multidisciplinary Approach to Chronic Childhood Illness. London: Open University Press.Google Scholar
Elliot, R., Fischer, C.T. & Rennie, D.L. (1999). Evolving guidelines for pubblication of qualitative research studies in psychology and related fields. British Journal of Clinical Psychology, 38, 215–229.Google Scholar
Freyer, D.R. (2004). Care of the dying adolescent: Special considerations. Pediatrics, 113, 281–388.Google Scholar
Gadamer, H.G. (1960). Wahrheit und Methode. Tuebingen: Mohr.Google Scholar
Galletti, M. (2004). Le cure terminali: problemi etici nella prospettiva del personale sanitario. In Il pupazzo di garza. Papini, M. & Tringali, D. (eds.), pp. 247–255. Firenze: Firenze University Press.Google Scholar
Geert Pousset, M.A., Bilsen, J., Cohen, J., et al. (2011). Continuous deep sedation at the end of life of children in Flanders, Belgium. Journal of Pain and Symptom Management, 41, 449–455.Google Scholar
Houlahan, K.E., Branowicki, P.A., Mack, J.W., et al. (2006). Can end of life care for the pediatric patient suffering with escalating and intractable symptoms be improved? Journal of Pediatric Oncology Nursing, 23, 45–51.Google Scholar
Husserl, E. (1931). Die krisis der europaeishen wissenschaften und der transzendentale phaenomenologie. Nijhorff: Den Haag.Google Scholar
Jankovich, M., Conter, V., Ferrari, E., et al. (1998). Diffusione e classificazione dei tumori infantili. In Tutti bravi. Psicologia e clinica del bambino malato di tumore. Saccomanni, R. (ed.), pp. 492–493. Milano: Raffaello Cortina.Google Scholar
Kiman, R., Wuiloud Conti, A. & Requena, M.L. (2011). End of life care sedation for children. Current Opinion in Supportive and Palliative Care, 5, 285–290.Google Scholar
Kreitler, S. & Krivoy, E. (2004). Psychological intervenion with the dying children. In Psychosocial Aspects of Paediatric Oncology. Kreitler, S. & Weyl Ben Arush, M. (eds.), pp. 389–414. Southern Gate, Chichester: Wiley.Google Scholar
Lauro-Grotto, R., Tringali, D. & Papini, M. (2007). Close encounters with caregivers: The case of pediatric brain tumors. Psycho-onchology, 16, 264–265.Google Scholar
Lewin, K. (2005). La ricerca-azione. La sperimentazione nei contesti di vita reale. In La ricercazione. Teoria e metodi del lavoro sociologico. Minardi, E. & Cifiello, S. (eds.), pp. 71–83. Milano: Franco Angeli.Google Scholar
Mantovani, G. & Spagnolli, A. (2003). Metodi qualitativi in psicologia. Bologna: Il Mulino.Google Scholar
Montesperelli, P. (1998). L'intervista ermeneutica. Milano: Franco Angeli.Google Scholar
Morita, T., Miyashita, M., Rieko, K., et al. (2004). Emotional burden of nurses in palliative sedation therapy. Palliative Medicine, 18, 550–557.Google Scholar
Morita, T., Tsuneto, S. & Shima, Y. (2002). Definition of sedation for symptom relief: A systematic literature review and a proposal of operational criteria. Journal of Pain and Symptom Management, 24, 447–453.Google Scholar
Papini, M. & Tringali, D. (2004). Il pupazzo di garza. Firenze: Florence University Press.CrossRefGoogle Scholar
Papini, M. (2009). L'ultima cura: i vissuti degli operatori in due reparti di oncologia pediatrica. Firenze: Florence University Press.Google Scholar
Papini, M., Tringali, D. & Lauro-Grotto, R. (2011). La nostra era una vita normale. Millesimo (Savona): Sorbello Editore.Google Scholar
Postovsky, S. & Weyl Ben Arush, M. (2004a). Care of a child dying of cancer. In Psychosocial Aspects of Paediatric Oncology. Kreitler, S. & Weyl Ben Arush, M. (eds.), pp. 93–107. Southern Gate, Chichester: Wiley.Google Scholar
Postovsky, S. & Weyl Ben Arush, M. (2004b). Care of a child dying of cancer: The role of the palliative care team in pediatric oncology. Pediatric Hematology and Oncology, 21, 67–76.CrossRefGoogle ScholarPubMed
Spradley, J.P. (1980). Participant Observation. New York: Holt, Rinehart & Winston.Google Scholar
Solomon, M.Z., Sellers, D.E., Heller, K.S., et al. (2005). New and lingering controversies in pediatric end-of-life care. Pediatrics, 116, 872–883.Google Scholar
Swart, S.J., Brikkemper, T., Rietjens, J.A.C., et al. (2010). Physicians and nurses' experiences with continuous palliative sedation in the Netherlands. Archives of Internal Medicine, 170, 1271–1273.CrossRefGoogle ScholarPubMed
Swetenham, K., Hegarty, M., Breaden, K., et al. (2011). Refractory suffering: The impact of team dynamics on the interdisciplinary palliative care team. Palliative & Supportive Care, 9, 55–62.CrossRefGoogle ScholarPubMed
Vattimo, G. (1987). Ermeneutica come nuova koinè. Aut-aut, 3, 217–218.Google Scholar
White, K., Wilkes, L., Cooper, K., et al. (2004). The impact of unrelieved patient suffering on palliative care nurses. International Journal of Palliative Nursing, 10, 438–444.Google Scholar