Erfahrungen mit Vigilanzminderung in der Palliativmedizin - Konzepte zur Steigerung der Lebensqualität

The primary objective of palliative medicine is to improve the patients quality of life. If patients are compromised in their vigilance,their ability to communicate about things which could increase their well-being is restricted. The aim of this dissertation was to investigate how palliative care can succeed in cases of reduced vigilance. For the qualitative study, different points of view on the impact of therapeutic interventions on patients with reduced vigilance were assembled to identify similarities and to draw conclusions. Patients of a cancer rehabilitation centre were asked about their experiences with sedation, one patient of a palliative care unit was asked to talk about his experiences after a short period of reduced vigilance,doctors of German palliative care units were asked in a questionnaire about their view on therapeutic interventions on patients with different levels of consciousness and members of various professions were performed to get an impression about their experiences and methods in working with patients with disturbances of consciousness. The interviews were interpreted according to the method of "grounded theory" to develop concepts to improve quality of life. These different concepts can be called "familiarity", "social surrounding", "meaning for the self and other individuals", "acoustic feedback" and "recognizability". All those concepts seem to be adequate to reduce patients´anxiety and to improve their well-being by considering the different concepts leading to "reduction of fear", "support of well-being", "consolidation of identity", "addressing positive emotions" and "support of orientation".