Palliative sedation in patients with advanced cancer in a specialized unit in a middle-income country: A retrospective cohort study.

OBJECTIVE: To describe the 5-year practice on palliative sedation in a specialized palliative care unit in a deprived region in Brazil, and to compare survival of patients with advanced cancer who were and were not sedated during their end-of-life care. METHOD: Retrospective cohort study in a tertiary teaching hospital. We described the practice of palliative sedation and compared the survival time between patients who were and were not sedated in their last days of life. RESULTS: We included 906 patients who were admitted to the palliative care unit during the study period, of whom, 92 (10.2%) received palliative sedation. Patients who were sedated were younger, presented with higher rates of delirium, and reported more pain, suffering, and dyspnea than those who were not sedated. Median hospital survival of patients who received palliative sedation was 9.30 (CI 95%, 7.51-11.81) days and of patients who were not sedated was 8.2 (CI 95%, 7.3-9.0) days (P = 0.31). Adjusted for age and sex, palliative sedation was not significantly associated with hospital survival (hazard ratio = 0.93; CI 95%, 0.74-1.15). SIGNIFICANCE OF RESULTS: Palliative sedation can be accomplished even in a deprived area. Delirium, dyspnea, and pain were more common in patients who were sedated. Median survival was not reduced in patients who were sedated.

[The main caregiver of oncologic terminally ill patient, repercussions of this task]. / Cuidador principal de paciente oncológico fora de possibilidade de cura, repercussões deste encargo.

OBJECTIVES: to identify the profile of the caregivers of terminally ill patient, to inquire the activities, changes and difficulties. The researchers applied a questionnaire. From all the 53 caregivers, 48 were female. 92% of the caregivers were relative to the patient. Despite of the financial problems, their relationship between caregiver and patient improved. The hygiene cares, feeding, medication were responsibility of the caregiver. The activities developed increased their amount of job, negative physical and psychical repercussions appeared. 60% of the caregivers answered that the most convenient place of the patient's death was the hospital, 40% chose home. There is a distinction between the routine of care and the death of the patient; the caregivers in fact take care of life.

[Ethical aspects of scientific research]. / Aspectos éticos da pesquisa científica.

The professed importance of ethical relations in the development of researches in human beings has been observed in many standards. This text approaches the complexity of procedures, guidelines, risk and benefit analyses, and innumerable contributions, given the significance of pertinent and up-to-date consideration on the matter.