Perceptions of Nurses Involved in Patient Decision-making regarding Palliative Sedation

ABSTRACT

This study aimed to reveal the perceptions of nurses involved in patient decision-making regarding palliative sedation. Semi-structured interviews were conducted with six nurses working at hospices, and the data were qualitatively and descriptively analyzed. Nurses’ perception regarding “difficulties involved in the decision-making process,” “stance of placing emphasis on patients’ preferences,” and “coping behaviors for participating in the decision-making process” were identified. The nurses had difficulties associated with concerns about making patients conscious of death and carried a heavy burden, and it was suggested that they find it difficult to explain sedation or confirm patients’ preferences. On the other hand, the nurses relied on their moral principles to make judgments, showing that they try to emphasize patients’ preferences. Multidisciplinary discussions are needed to provide psychological support for nurses involved in patient decision-making on palliative sedation. In terms of the educational aspect, the need for experiences was cited, suggesting that it is necessary to educate nurses through hands-on activities such as role-playing exercises concerning making decisions about sedation.