{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:25:28Z","timestamp":1777929928472,"version":"3.51.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliative Medicine Reports"],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Palliative sedation (PS) is a therapeutic intervention employed to manage severe and refractory symptoms in terminally ill patients at end of life. Inconsistencies in PS practice guidelines coupled with clinician ambiguity have resulted in confusion about how PS is best integrated into practice. Understanding the perspectives, experiences, and practices relating to this modality will provide insight into its clinical application and challenges within the palliative care landscape.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The aim is to explore the perspectives of palliative care physicians administering PS, including how practitioners define PS, factors influencing decision making about the use of PS, and possible reasons for changes in practice patterns over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A survey (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200937) and semistructured interviews (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200923) were conducted with palliative care physicians throughout Ontario. Codes were determined collaboratively and applied line-by-line by two independent investigators. Survey responses were analyzed alongside interview transcripts and noted to be concordant. Themes were generated through reflexive thematic analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Five key themes were identified: (1) lack of standardization, (2) differing definitions, (3) logistical challenges, (4) perceived \u201cback-up\u201d to Medical Assistance in Dying, and (5) tool of the most responsible physician.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There was significant variability in how participants defined PS and in frequency of use of PS. Physicians described greater ease implementing PS when practicing in palliative care units, with significant barriers faced by individuals providing home-based palliative care or working as consultants on inpatient units. Educational efforts are required about the intent and practice of PS, particularly among inpatient interprofessional teams.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/pmr.2023.0081","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T11:33:25Z","timestamp":1707910405000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Practices of and Perspectives on Palliative Sedation Among Palliative Care Physicians in Ontario, Canada: A Mixed-Methods Study"],"prefix":"10.1177","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2804-131X","authenticated-orcid":false,"given":"Amy","family":"Nolen","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine and University of Toronto, Toronto, Ontario, Canada."},{"name":"Division of Palliative Care and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debbie","family":"Selby","sequence":"additional","affiliation":[{"name":"Division of Palliative Care and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada."},{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahad","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine and University of Toronto, Toronto, Ontario, Canada."},{"name":"Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anneliese","family":"Mills","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine and University of Toronto, Toronto, Ontario, Canada."},{"name":"Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,2,13]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0000000000000224"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/082585979401000207"},{"key":"e_1_3_5_4_2","first-page":"1","article-title":"Reflections on palliative sedation","volume":"12","author":"Twycross R.","year":"2019","unstructured":"Twycross R. Reflections on palliative sedation. Palliat Care, 2019; 12:1\u201316; doi: 10.1177\/1178224218823511","journal-title":"Palliat Care"},{"key":"e_1_3_5_5_2","article-title":"Clinical Practice Guidelines on Palliative Sedation Around the World: A systematic review","volume":"825859722113867","author":"Tomczyk M","year":"2022","unstructured":"Tomczyk M, , Jaques C, , Jox RJ. Clinical Practice Guidelines on Palliative Sedation Around the World: A systematic review. J Palliat Care, 2022; 8258597221138674; doi: 10.1177\/08258597221138674","journal-title":"J Palliat Care"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2016-001159"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2011.0498"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2018.0372"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/10499091211030443"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39504.531505.25"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1705630"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951523000706"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.4018\/978-1-4666-7409-7.ch007"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.4135\/9781452218403.n25"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39602.690162.47"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1628806"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1080\/14780887.2014.955224"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049732316665344"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.04.019"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.08.012"},{"issue":"1","key":"e_1_3_5_22_2","first-page":"CD010206","article-title":"Palliative pharmacological sedation for terminally ill adults","volume":"1","author":"Beller EM","year":"2015","unstructured":"Beller EM, , van Driel ML, , McGregor L, et al. Palliative pharmacological sedation for terminally ill adults. 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Refractory Symptoms and Palliative Sedation. New Westminster BC; 2017. Available from: 17-RefractorySymptomsAndPalliativeSedationGreyscalePrint.pdf(bc-cpc.ca) [Last accessed: 11\/12\/2023]."},{"key":"e_1_3_5_35_2","unstructured":"McMaster University Division of Palliative Care Dept. of Family Medicine. Continuous Palliative Sedation Therapy (CPSGT) Guidelines: Hamilton ON; 2020. Available from: McMaster-Palliative-Sedation-Guidelines-2020-31March2020.pdf(hfam.ca) [Last accessed: 11\/12\/2023]."},{"key":"e_1_3_5_36_2","unstructured":"Champlain Hospice Palliative Care Program Guideline Review Committee. The Champlain Region Palliative Sedation Therapy Clinical Practice and Medication Guidelines: Champlain ON; 2018. Available from: Microsoft Word\u2014PST Guidelines Regional 2018_ENG (champlainpalliative.ca) [Last accessed: December 11 2023]."},{"key":"e_1_3_5_37_2","unstructured":"Sunnybrook Health Sciences Centre. Continuous Palliative Sedation Therapy Policy: Toronto ON; 2019. 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[Last accessed: December 11 2023]."},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909114533002"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-684X-13-17"}],"container-title":["Palliative Medicine Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/pmr.2023.0081","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/pmr.2023.0081","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/pmr.2023.0081","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:58:09Z","timestamp":1777679889000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/pmr.2023.0081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,1]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1,1]]}},"alternative-id":["10.1089\/pmr.2023.0081"],"URL":"https:\/\/doi.org\/10.1089\/pmr.2023.0081","relation":{},"ISSN":["2689-2820","2689-2820"],"issn-type":[{"value":"2689-2820","type":"print"},{"value":"2689-2820","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,1]]},"article-number":"pmr.2023.0081"}}