UK-Netherlands-Belgium International Sedation Study

UNBIASED: UK-Netherlands-Belgium International Sedation Study

The UNBIASED study
To better understand the practices of professional caregivers and to optimize care for the vulnerable group of suffering dying patients and their relatives, more insight is necessary in the experiences of physicians, nurses and relatives with palliative sedation. In this context, the UNBIASED study started in 2009. The UNBIASED study is conducted in the UK (University of Nottingham, Lancaster University, Southampton University and University of London), Belgium (Vrije Universiteit Brussel and Ghent University) and the Netherlands (Erasmus MC and VUmc).

Themes that will be addressed in the UNBIASED study are: views on the concept of sedation in end of life care, clinical characteristics of the application of continuous sedation until death, the decision-making process and communication surrounding the application of continuous sedation until death, the contribution made by continuous sedation to the quality of dying, the use of guidelines and protocols, and ethical and legal aspects of sedation. The themes will be explored by means of semi-structured interviews. Per country we will identify 30 deceased patients for whom palliative sedation was used. Per case, the most involved physician, nurse and relative will be interviewed after the patient’s death (90 interviews per country; 270 in 3 countries together). This study will be conducted in three sites: the community, a hospital and a hospice.

The Dutch UNBIASED study
Besides the common goal of the international study, each country also has its own focus. In the Netherlands the focus lies on the effect of the use continuous sedation until death on the wellbeing of the relatives of the patient. What is the effect of the use of palliative sedation on the wellbeing of the relatives? And which elements of palliative sedation are associated with the wellbeing of relatives during sedation and after patient’s death? These issues will be discussed in the interviews with the relatives. In preparation for the interviews, three focus groups were held with relatives of patients who were sedated prior to their death. Also a questionnaire study will be conducted among relatives of sedated and non-sedated patients.

More information: S.M. (Sophie) Bruinsma