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晚期痴呆患者的人工营养与水化

Artificial Nutrition and Hydration in People With Late-Stage Dementia.

作者信息

Smith Lenora, Ferguson Rita

机构信息

Lenora Smith, PhD, RN, is an Assistant Professor, College of Nursing, University of Alabama in Huntsville, Huntsville, Alabama. Rita Ferguson, PhD, RN, CHPN, CNE, is a Clinical Assistant Professor, College of Nursing, University of Alabama in Huntsville, Huntsville, Alabama.

出版信息

Home Healthc Now. 2017 Jun;35(6):321-325. doi: 10.1097/NHH.0000000000000550.

Abstract

The progressive nature of dementia marks this disease as a terminal illness in the advanced stage, and palliative care rather than curative treatment is indicated. The use of feeding tubes to deliver artificial nutrition and hydration at end of life is often part of the plan of care for people with dementia. Current evidence, however, suggests that tube feeding in advanced dementia is not beneficial and the burdens of the procedure and the feedings themselves outweigh any benefits. Evidence also reveals that healthcare providers may lack evidence-based knowledge about artificial nutrition and hydration to adequately inform families and surrogate decision makers. This article examines the evidence regarding use of artificial nutrition and hydration for patients with end-stage dementia and offers implications for home care clinicians.

摘要

痴呆症的渐进性使其在晚期被视为一种绝症,此时应采用姑息治疗而非治愈性治疗。在生命末期使用喂食管提供人工营养和水分补充通常是痴呆症患者护理计划的一部分。然而,目前的证据表明,晚期痴呆症患者使用管饲并无益处,而且该操作及喂养本身带来的负担超过了任何益处。证据还显示,医疗保健提供者可能缺乏关于人工营养和水分补充的循证知识,无法充分告知患者家属和替代决策者。本文探讨了晚期痴呆症患者使用人工营养和水分补充的相关证据,并为家庭护理临床医生提供了启示。

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