Palliative sedation in the treatment of existential suffering in end-of-life patients: protocol for an integrative review

Abstract

Background and aim

Existential suffering is among the main symptoms refractory to treatment in people at the end of life. There is evidence in the literature on the use of palliative sedation, the controlled administration of sedative medication with the purpose of inducing a state of reduced consciousness or unconsciousness to relieve unbearable suffering experienced by people with terminal illnesses, to control existential suffering. This article presents the protocol for an integrative review which aims to analyze the evidence available in the literature on the use of palliative sedation to manage existential suffering in people with serious end-of-life illnesses.

Methods

This is an integrative review protocol based on the steps described by Whittemore and Knalf, and reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). A comprehensive search strategy including carefully selected terms corresponding to the domains of interest (palliative sedation and existential suffering) will be used to search for the relevant literature in the PubMed, Scopus, Web of Science, CINAHL, Cochrane Library, and EMBASE databases. The Endnote and Rayyan softwares will be used for data management.

Discussion

This integrative review aims to identify existing gaps and contribute to the presentation of information that may contribute to settling the controversy regarding the use of palliative sedation to manage refractory existential suffering at the end of life.

Registration

Open Science Framework (https://osf.io/qrpbf/).

Keywords:

• Deep sedation
• Palliative sedation
• Demoralization
• Existential suffering
• Systematic review

Acknowledgements

Not applicable.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Funding The author(s) reported there is no funding associated with the work featured in this article.

Additional information

Notes on contributors

Geovanna Maria Isidoro

Geovanna Maria Isidoro: Nurse, master student.

Eliza Mara das Chagas Paiva

Eliza M. das C. Paiva: Nurse, acupuncturist, doctoral student. Researches the effects of auriculotherapy on symptom control in people with cancer.

Fábio de Souza Terra

Fábio de Souza Terra: Associate Professor of Nursing at the Federal University of Alfenas. Master's and PhD advisor, researcher in the area of Workers' Health and Mental Health with an emphasis on chronic diseases.

Ana Cláudia Mesquita Garcia

Ana Cláudia M. Garcia: Palliative care nurse, Professor – Her work is focused on hospice and palliative care, integrative and complementary practices (emphasis on mindfulness), spirituality and health, and on the therapeutic potential of psychedelics in the control of symptoms of people with serious illnesses.