Miles Anna, Watt Tanya, Wong Wei-Yuen, McHutchison Louise, Friary Philippa
The University of Auckland, New Zealand.
Hutt Valley District Health Board, Lower Hutt, New Zealand.
Gerontol Geriatr Med. 2016 Aug 22;2:2333721416665523. doi: 10.1177/2333721416665523. eCollection 2016 Jan-Dec.
Where swallowing difficulties are chronic or progressive, or a patient is palliative, tube feeding is often not deemed appropriate. Instead, patients continue to eat and drink despite the risks of pneumonia and death. There is currently little evidence to guide clinical practice in this field often termed "risk feeding." This qualitative study investigated staff, patient, and family member perceptions of risk feeding practices in one New Zealand hospital. Twenty-nine staff members and six patients and/or their family were interviewed. Thematic analysis revealed four global themes: supporting practice, communication, complexity of feeding decisions, and patient and family-centered care. Staff described limited education and organizational policy around risk feeding decisions. Communication was considered a major factor in the success. Feeding decisions are complex in the hospital environment. The themes identified in this study provide a foundation for hospital guideline development and implementation.
当吞咽困难是慢性的或进行性的，或者患者是姑息治疗时，管饲通常被认为不合适。相反，尽管有肺炎和死亡风险，患者仍继续进食和饮水。目前几乎没有证据可指导这个通常被称为“风险喂养”领域的临床实践。这项定性研究调查了新西兰一家医院的工作人员、患者及其家属对风险喂养做法的看法。采访了29名工作人员以及6名患者和/或他们的家属。主题分析揭示了四个总体主题：支持实践、沟通、喂养决策的复杂性以及以患者和家庭为中心的护理。工作人员表示围绕风险喂养决策的教育和组织政策有限。沟通被认为是成功的一个主要因素。在医院环境中，喂养决策很复杂。本研究中确定的主题为医院指南的制定和实施奠定了基础。
