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护士对养老院中患有晚期痴呆症的居民喂养决策的看法。

Nurses' perspectives on feeding decisions for nursing home residents with advanced dementia.

机构信息

MGH Institute of Health Professions School of Nursing, Boston, MA 02129-4557, USA.

出版信息

J Clin Nurs. 2010 Mar;19(5-6):632-8. doi: 10.1111/j.1365-2702.2009.03108.x.

Abstract

AIM

To develop a broad understanding of nursing beliefs, knowledge and roles in feeding decisions for nursing home residents with advanced dementia.

BACKGROUND

Concern is growing about the common use of feeding tubes in nursing home residents with advanced dementia. Nurses can play an important role in providing information and guiding family members through difficult feeding decisions. Little is known about nurses' perspectives on feeding decisions.

DESIGN

Qualitative descriptive.

METHODS

In-depth semi-structured interviews of 11 licensed nurses who were experienced in caring for nursing home residents with dementia.

RESULTS

Analysis of the interview transcripts revealed three themes: insufficient empirical information, ambiguous role in feeding decisions and uncertainty about moral agency in decisions about the placement of feeding tubes.

CONCLUSIONS

Despite views that family members would benefit from guidance in decisions regarding the placement of feeding tubes, nurses were, nevertheless, reluctant to become involved in these difficult decisions.

RELEVANCE TO CLINICAL PRACTICE

If nurses are to guide family members in decisions about the use of feeding tubes, they need more education about evidence-based practice as well as support in exercising their nursing responsibilities.

摘要

目的

深入了解护理人员在为患有晚期痴呆症的养老院居民提供喂养决策方面的信念、知识和角色。

背景

人们越来越关注在患有晚期痴呆症的养老院居民中普遍使用饲管的问题。护士在为患者提供信息和指导家属做出艰难的喂养决策方面可以发挥重要作用。然而,对于护士在喂养决策方面的观点知之甚少。

设计

定性描述。

方法

对 11 名有经验的执业护士进行深入的半结构化访谈,这些护士在照顾患有痴呆症的养老院居民方面经验丰富。

结果

对访谈记录的分析揭示了三个主题:经验证据信息不足、在喂养决策中的角色模糊以及在决定是否放置饲管方面的道德代理问题上存在不确定性。

结论

尽管有观点认为,家属在决定是否放置饲管方面会受益于指导,但护士仍然不愿意参与这些困难的决策。

对临床实践的意义

如果护士要在使用饲管的决策中指导家属,他们需要更多关于循证实践的教育,并在履行护理职责方面得到支持。

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