title: The process of palliative sedation as viewed by physicians and nurses working in palliative care in Brazil.
abstract: OBJECTIVE
  Our aim was to describe the process of palliative sedation from the point of view of physicians and nurses working in palliative care in Brazil.
  
  
  METHODS
  Ours was a descriptive study conducted between May and December of 2011, with purposeful snowball sampling of 32 physicians and 29 nurses working in facilities in Brazil that have adopted the practice of palliative care.
  
  
  RESULTS
  The symptoms prioritized for an indication of palliative sedation were dyspnea, delirium, and pain. Some 65.6% of respondents believed that the survival time of a patient in the final phase was not a determining factor for the indication of this measure, and that the patient, family, and healthcare team should participate in the decision-making process. For 42.6% of these professionals, the opinion of the family was the main barrier to an indication of this therapy.
  
  
  CONCLUSIONS
  The opinion of the physicians and nurses who participated in this study converged with the principal national and international guidelines on palliative sedation. However, even though it is a therapy that has been adopted in palliative care, it remains a controversial practice.
authors.affiliation: Paulista School of Nursing, Federal University of São Paulo,São Paulo,São Paulo,Brazil.
authors.forename: Vívian Marina Calixto Damasceno
authors.initials: VM
authors.lastname: Spineli
authors.affiliation: Fundação Antônio Prudente,A.C. Camargo Cancer Center,São Paulo,São Paulo,Brazil.
authors.forename: Andrea Yamaguchi
authors.initials: AY
authors.lastname: Kurashima
authors.affiliation: Paulista School of Nursing, Federal University of São Paulo,São Paulo,São Paulo,Brazil.
authors.forename: Maria Gaby Rivero
authors.initials: MG
authors.lastname: De Gutiérrez
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001938:Brazil; D054810:Deep Sedation / Q000379:methods / Q000592:standards*; D003693:Delirium / Q000188:drug therapy; D004417:Dyspnea / Q000188:drug therapy; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000592:standards*; D008297:Male; D059408:Pain Management / Q000379:methods / Q000592:standards; D010166:Palliative Care / Q000379:methods / Q000592:standards*; D013727:Terminal Care / Q000379:methods / Q000592:standards*
chemical_list: D006993:Hypnotics and Sedatives
keywords: Deep sedation; End of life; Palliative care; Palliative sedation; Terminal sedation