Medical staff perception of palliative sedation and its implications for clinical practice in a high complexity hospital Sedación paliativa percepción del personal médico e implicaciones en la práctica clínica en un hospital de alta complejidad

Abstract

Introduction: palliative care is geared to symptoms control and quality of life improvement among patients with advanced, progressive, or non-curative diseases. It plays a fundamental role on refractory symptoms and lack of teaching on this matter, at all medical training levels, leads to unawareness and misunderstanding or fear to administer it. Materials and methods:  a descriptive, cross-sectional study conducted to define knowledge, and personal and professional perception of palliative sedation (PS), using a survey applied to 201 participants selected from last year medical students, general practitioners, residents, and different specialists at a high complexity university hospital in Cali, Colombia in 2021.  Results: 57.2% were men, 3.98% worked mostly in operating rooms, 25.4% in the outpatient clinic, 57.2% in the hospitalization ward and 13.4% in the emergency room. Regarding training in palliative care 19.9% considered they had not received any training, 67.7% little and 12.4% a lot, 16.4% did not know the definition of terminal illness and 25.4% did not know the definition of PS. 90        % would not distinguish between the purpose of palliative sedation and euthanasia, although 94.5% recognized that preventing patient suffering was important and that sedation was a therapeutic option. Discussion and conclusions: palliative sedation is an important intervention in patients with refractory symptoms. Knowledge gaps limiting its clinical administration show the need of strengthening education on PS, at all levels of medical training.