Nutrition and hydration in dying patients: the perceptions of acute care nurses.

Higgins, Isabel, van der Riet, Pamela, Sneesby, Ludmilla and Good, Phillip (2013) Nutrition and hydration in dying patients: the perceptions of acute care nurses.. Journal of Clinical Nursing, 23 17-18: 2609-2617. doi:10.1111/jocn.12478


Author Higgins, Isabel
van der Riet, Pamela
Sneesby, Ludmilla
Good, Phillip
Title Nutrition and hydration in dying patients: the perceptions of acute care nurses.
Journal name Journal of Clinical Nursing   Check publisher's open access policy
ISSN 0962-1067
1365-2702
Publication date 2013-12-20
Year available 2013
Sub-type Article (original research)
DOI 10.1111/jocn.12478
Open Access Status
Volume 23
Issue 17-18
Start page 2609
End page 2617
Total pages 9
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell
Collection year 2014
Language eng
Formatted abstract
Aims and objectives: To explore the perceptions of nurses regarding the provision and nonprovision of medical nutrition and hydration during the end stage of life when death is imminent in the acute care setting.

Background: When people are dying, they often experience a loss of appetite and desire for drinking which are natural processes at this time. The cessation of eating and drinking challenges both family members and clinical staff. This article builds on previous studies that describe the perceptions of medical doctors and palliative care nurses regarding medical nutrition and hydration during the end stage of life when death is imminent.

Design: Qualitative descriptive design.

Methods: This study included three focus group meetings with ten nurses in an acute care setting in medical, oncology and haematology units. An interview schedule was used to guide the discussions.

Results: The main theme to emerge from this study was 'finding a comfort space/ambiguous spaces of unrest' that included four subthemes: (1) limited involvement in decision-making, (2) comfort vs. discomfort, (3) uncertainty and (4) the comfort of withdrawing treatment. Finding a comfort space captures the challenges nurses faced when speaking about the concerns of patients and family. In this space, there were ambiguities that created unease and unrest: a reluctance to talk about death; a reluctance to engage with the patient and the family.

Conclusions: Acute care nurses need to be more cognisant of the palliative approach to care and become more engaged with decision-making during the end stage of life when death is imminent. Relevance to clinical practice: Nurses in acute care settings need to be involved in decision-making and advocate for patients and family during the dying phase. Nurses in acute care need better understanding about the palliative approach to care and nutrition and hydration for people who are dying.  
Keyword Acute care
Dying
End of life care
Hydration
Nurses
Nutrition
Qualitative research
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
Official 2014 Collection
School of Medicine Publications
 
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Created: Thu, 24 Apr 2014, 14:11:51 EST by Dominique Rossouw on behalf of Examinations