title: Qualitative Study on the Perceptions of Terminally Ill Cancer Patients and Their Family Members Regarding End-of-Life Experiences Focusing on Palliative Sedation.
abstract: Patients with terminal cancer experience refractory symptoms in the last days of life. Although palliative sedation (PS) is recommended for patients suffering unbearable symptoms with imminent death, it requires clear communication between physicians and patients/caregivers. Understanding the demands and perceptions of patients and caregivers in the end-of-life phase are needed for effective communication.
  
  
  
  To explore patient experiences regarding end-of-life status and PS.
  
  
  
  The study was performed between October and December, 2013 with eligible terminal cancer patients and their families in a non-religious, tertiary healthcare facility in Korea. Eligibility criteria were a hospitalized cancer patient with a life expectancy of less than three months and who had never experienced PS. Data were collected via face-to-face in-depth interviews and analyzed using the constant comparative method of qualitative analysis. Saturation was achieved after conducting interviews with 13 patients or care-giving family members.
  
  
  
  Enrolled patients raised the following issues: 1) simultaneously harboring the hope of prolonging life and wishing for a peaceful death, 2) experiencing difficulties in having honest conversations with caregivers regarding death, 3) possessing insufficient knowledge and information regarding PS, and 4) hoping for the decision on PS to be made before suffering becomes too great.
  
  
  
  Terminally ill cancer patients and their caregivers expressed conflicting desires in hoping to prolong life and simultaneously wishing to experience a peaceful death. Improvements in the communications that occur among physicians, patients, and caregivers on the issues of prognosis and PS are needed.
authors.affiliation: College of Nursing, Institute of Health Sciences, Gyeongsang National University, Korea.
authors.forename: Young
authors.initials: Y
authors.lastname: Eun
authors.affiliation: Department of Nursing, Gyeongnam Provincial Geochang College, Korea.
authors.forename: In-Wha
authors.initials: IW
authors.lastname: Hong
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
authors.affiliation: Department of Internal Medicine, School of Medicine, Institute of Health Sciences, Gyeongsang National University, Korea. Electronic address: newatp@naver.com.
authors.forename: Jung Hun
authors.initials: JH
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003657:Decision Making; D004644:Emotions; D005190:Family / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007297:Inpatients / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D036301:Qualitative Research; D056910:Republic of Korea; D013727:Terminal Care / Q000379:methods / Q000523:psychology; D019452:Terminally Ill / Q000523:psychology*
chemical_list: D006993:Hypnotics and Sedatives
keywords: Conscious sedation; caregivers; communication; qualitative research; terminal cancer