{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:02:25Z","timestamp":1791468145521,"version":"4.3.4"},"reference-count":31,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T00:00:00Z","timestamp":1472688000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T00:00:00Z","timestamp":1472688000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T00:00:00Z","timestamp":1578873600000},"content-version":"vor","delay-in-days":1229,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"name":"De Zorggroep"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jpsmjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pain and Symptom Management"],"published-print":{"date-parts":[[2016,9]]},"DOI":"10.1016\/j.jpainsymman.2016.05.008","type":"journal-article","created":{"date-parts":[[2016,7,4]],"date-time":"2016-07-04T12:20:27Z","timestamp":1467634827000},"page":"361-369","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":23,"title":["Level of Discomfort Decreases After the Administration of Continuous Palliative Sedation: A Prospective Multicenter Study in Hospices and Palliative Care Units"],"prefix":"10.1016","volume":"52","author":[{"given":"Rogier H.P.D.","family":"van Deijck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen G.J.","family":"Hasselaar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stans C.A.H.H.V.M.","family":"Verhagen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris C.P.","family":"Vissers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond T.C.M.","family":"Koopmans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jpainsymman.2016.05.008_bib1","series-title":"Guideline for palliative sedation","year":"2009"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib2","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1177\/0269216309107024","article-title":"European Association for Palliative Care (EAPC) recommended framework for the use of sedation in palliative care","volume":"23","author":"Cherny","year":"2009","journal-title":"Palliat Med"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib3","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1089\/jpm.2011.0498","article-title":"Framework for continuous palliative sedation therapy in Canada","volume":"15","author":"Dean","year":"2012","journal-title":"J\u00a0Palliat Med"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib4","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1089\/jpm.2006.0139","article-title":"Palliative sedation therapy in the last weeks of life: a literature review and recommendations for standards","volume":"10","author":"de Graeff","year":"2007","journal-title":"J\u00a0Palliat Med"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib5","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1016\/j.pain.2013.04.038","article-title":"Palliative sedation: why we should be more concerned about the risks that patients experience an uncomfortable death","volume":"154","author":"Deschepper","year":"2013","journal-title":"Pain"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib6","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1086\/JCE201425305","article-title":"The ethical and clinical importance of measuring consciousness in continuously sedated patients","volume":"25","author":"Raus","year":"2014","journal-title":"J\u00a0Clin Ethics"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib7","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1016\/j.jpainsymman.2011.11.010","article-title":"Palliative sedation: reliability and validity of sedation scales","volume":"44","author":"Arevalo","year":"2012","journal-title":"J\u00a0Pain Symptom Manage"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib8","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1177\/0269216311425421","article-title":"The use of observational scales to monitor symptom control and depth of sedation in patients requiring palliative sedation: a systematic review","volume":"27","author":"Brinkkemper","year":"2013","journal-title":"Palliat Med"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib9","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.jpainsymman.2014.08.013","article-title":"Medication and monitoring in palliative sedation therapy: a systematic review and quality assessment of published guidelines","volume":"49","author":"Schildmann","year":"2015","journal-title":"J\u00a0Pain Symptom Manage"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib10","first-page":"CD010206","article-title":"Palliative pharmacological sedation for terminally ill adults","author":"Beller","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib11","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/SPC.0b013e3283260628","article-title":"When cancer symptoms cannot be controlled: the role of palliative sedation","volume":"3","author":"Hasselaar","year":"2009","journal-title":"Curr Opin Support Palliat Care"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib12","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/j.jpainsymman.2010.07.013","article-title":"Palliative sedation in patients with advanced cancer followed at home: a systematic review","volume":"41","author":"Mercadante","year":"2011","journal-title":"J\u00a0Pain Symptom Manage"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib13","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1164\/rccm.2107138","article-title":"The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients","volume":"166","author":"Sessler","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib14","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.jpainsymman.2005.03.017","article-title":"Efficacy and safety of palliative sedation therapy: a multicenter, prospective, observational study conducted on specialized palliative care units in Japan","volume":"30","author":"Morita","year":"2005","journal-title":"J\u00a0Pain Symptom Manage"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib15","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1002\/nur.4770150506","article-title":"Assessment of discomfort in advanced Alzheimer patients","volume":"15","author":"Hurley","year":"1992","journal-title":"Res Nurs Health"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib16","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1089\/jpm.2005.8.716","article-title":"Development of a clinical guideline for palliative sedation therapy using the Delphi method","volume":"8","author":"Morita","year":"2005","journal-title":"J\u00a0Palliat Med"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib17","unstructured":"International Classification of Diseases (ICD). World Health Organization. 1992. Available at: http:\/\/www.who.int\/classifications\/icd\/en\/. Accessed November 25,\u00a02014."},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib18","series-title":"Diagnostic and statistical manual of mental disorders","year":"2000"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib19","doi-asserted-by":"crossref","unstructured":"Volicer L, van der Steen JT. Outcome measures for dementia in the advanced stage and at the end of life Adv Geriatr Available at http:\/\/www.hindawi.com\/journals\/ager\/2014\/346485\/. Accessed Aug 20, 2015.","DOI":"10.1155\/2014\/346485"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib20","first-page":"117","article-title":"The role of observer for the reliability of Dutch version of the Discomfort Scale-Dementia of Alzheimer Type (DS-DAT)","volume":"32","author":"Hoogendoorn","year":"2001","journal-title":"Tijdschr Gerontol Geriatr"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib21","first-page":"257","article-title":"Measuring discomfort in patients with dementia. Validity of a Dutch version of the Discomfort Scale\u2013dementia of Alzheimer type (DS-DAT)","volume":"33","author":"van der Steen","year":"2002","journal-title":"Tijdschr Gerontol Geriatr"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib22","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/01376517-199606000-00005","article-title":"The assessment of discomfort in elderly confused patients: a preliminary study","volume":"28","author":"Miller","year":"1996","journal-title":"J\u00a0Neurosci Nurs"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib23","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/00012272-199309000-00004","article-title":"Palliative fever management in Alzheimer patients. Quality plus fiscal responsibility","volume":"16","author":"Hurley","year":"1993","journal-title":"ANS Adv Nurs Sci"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib24","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1002\/(SICI)1098-240X(199902)22:1<27::AID-NUR4>3.0.CO;2-T","article-title":"Development and testing of the Resistiveness to Care Scale","volume":"22","author":"Mahoney","year":"1999","journal-title":"Res Nurs Health"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib25","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1093\/annonc\/mdi121","article-title":"Association between hydration volume and symptoms in terminally ill cancer patients with abdominal malignancies","volume":"16","author":"Morita","year":"2005","journal-title":"Ann Oncol"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib26","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jpainsymman.2013.03.011","article-title":"Prevalence, impact, and treatment of death rattle: a systematic review","volume":"47","author":"Lokker","year":"2014","journal-title":"J\u00a0Pain Symptom Manage"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib27","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1111\/j.1532-5415.2010.03014.x","article-title":"The practice of continuous palliative sedation in elderly patients: a nationwide explorative study among Dutch nursing home physicians","volume":"58","author":"Van Deijck","year":"2010","journal-title":"J\u00a0Am Geriatr Soc"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib28","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1001\/archinte.167.11.1166","article-title":"Improving prescription in palliative sedation: compliance with dutch guidelines","volume":"167","author":"Hasselaar","year":"2007","journal-title":"Arch Intern Med"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib29","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1001\/archinternmed.2008.613","article-title":"Changed patterns in Dutch palliative sedation practices after the introduction of a national guideline","volume":"169","author":"Hasselaar","year":"2009","journal-title":"Arch Intern Med"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib30","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.jpainsymman.2007.10.014","article-title":"Palliative sedation in a specialized unit for acute palliative care in a cancer hospital: comparing patients dying with and without palliative sedation","volume":"36","author":"Rietjens","year":"2008","journal-title":"J\u00a0Pain Symptom Manage"},{"key":"10.1016\/j.jpainsymman.2016.05.008_bib31","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1136\/bmjspcare-2011-000063","article-title":"Continuous palliative sedation until death: practice after introduction of the Dutch national guideline","volume":"2","author":"Swart","year":"2012","journal-title":"BMJ Support Palliat Care"}],"container-title":["Journal of Pain and Symptom Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0885392416301634?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0885392416301634?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:15:55Z","timestamp":1760130955000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0885392416301634"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9]]},"references-count":31,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2016,9]]}},"alternative-id":["S0885392416301634"],"URL":"https:\/\/doi.org\/10.1016\/j.jpainsymman.2016.05.008","relation":{},"ISSN":["0885-3924"],"issn-type":[{"value":"0885-3924","type":"print"}],"subject":[],"published":{"date-parts":[[2016,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Level of Discomfort Decreases After the Administration of Continuous Palliative Sedation: A Prospective Multicenter Study in Hospices and Palliative Care Units","name":"articletitle","label":"Article Title"},{"value":"Journal of Pain and Symptom Management","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jpainsymman.2016.05.008","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}