1 Department of Dietetics and Nutrition, Taipei City Hospital , Taipei, Taiwan .
2 Department of Dietetics, National Taiwan University Hospital , Taipei, Taiwan .
J Palliat Med. 2019 Apr;22(4):370-376. doi: 10.1089/jpm.2018.0133. Epub 2018 Nov 9.
Even though no evidence suggests tube feeding is beneficial for individuals with advanced dementia, many are still tube fed.
To assess perceptions of hospital staff regarding reducing tube feeding (RTF) of patients with advanced dementia.
Cross-sectional survey.
A regional teaching hospital in Taipei, Taiwan.
Hospital staff (n = 624), including physicians, nurses, dieticians, paramedical personnel, social workers, volunteers, attendants, and administrators.
Anonymous questionnaires.
The overall awareness of RTF for advanced dementia patients averaged 10.2 ± 3.74 points (maximum, 19 points) among all respondents. Among the different hospital professions, dieticians scored the highest, whereas nurses and attendants/volunteers had relatively low scores. Over half of respondents (57%) agreed tube feeding is the best choice for advanced dementia with dysphagia. Physicians of different specialties had significantly different responses toward RTF with regard to the belief that tube feeding reduces the risk of aspiration pneumonia, referring patients who refuse tube feeding to other health care team members, and the belief that family members would be able to accept the patient's death along with insufficient food/fluid intake. Only 35.1% of respondents believed they were able to implement comfort feeding.
The present survey shows a persistent knowledge gap among various health care professions regarding tube feeding of patients with advanced dementia. Also, there is insufficient awareness about this subject, indicating that promotion of comfort feeding by enhanced training and communication within medical teams is essential to achieving better person-centered care and preventing unnecessary suffering.
尽管没有证据表明管饲对晚期痴呆症患者有益，但仍有许多患者被管饲。
评估医院工作人员对减少晚期痴呆症患者管饲（RTF）的看法。
横断面调查。
中国台湾省台北市的一家地区教学医院。
医院工作人员（n=624），包括医生、护士、营养师、辅助医疗人员、社会工作者、志愿者、护理员和管理人员。
匿名问卷。
所有受访者对晚期痴呆症患者 RTF 的总体认识平均为 10.2±3.74 分（满分 19 分）。在不同的医院职业中，营养师得分最高，而护士和护理员/志愿者得分相对较低。超过一半的受访者（57%）认为管饲是吞咽困难的晚期痴呆症患者的最佳选择。不同专业的医生在管饲是否能降低吸入性肺炎风险、是否将拒绝管饲的患者转介给其他医疗团队成员，以及患者家属是否能够接受患者因摄入不足而死亡等方面的态度存在显著差异。只有 35.1%的受访者认为他们能够实施舒适喂养。
本次调查显示，不同医疗保健专业人员对晚期痴呆症患者管饲存在持续的知识差距。此外，对这一主题的认识不足，这表明通过在医疗团队内部加强培训和沟通来推广舒适喂养，对于实现更好的以患者为中心的护理和预防不必要的痛苦至关重要。
