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儿科病房中在身体约束下进行鼻胃管喂养:关于这种挽救生命干预措施的伦理、法律和实际考量

Nasogastric tube feeding under physical restraint on paediatric wards: ethical, legal and practical considerations regarding this lifesaving intervention.

作者信息

Fuller Sarah J, Chapman Simon, Cave Emma, Druce-Perkins James, Daniels Poppy, Tan Jacinta

机构信息

Advanced Specialist Eating Disorders Dietitian, East London NHS Foundation Trust and Child; and Child and Adolescent Mental Health Department, Imperial College London, UK.

Consultant in Paediatric and Adolescent Medicine, Department of Paediatrics, King's College London, UK.

出版信息

BJPsych Bull. 2023 Apr;47(2):105-110. doi: 10.1192/bjb.2022.11.

DOI:10.1192/bjb.2022.11
PMID:35249576
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10063984/
Abstract

Eating disorders have the highest mortality rate of any psychiatric condition. Since the COVID-19 pandemic, the number of patients who have required medical stabilisation on paediatric wards has increased significantly. Likewise, the number of patients who have required medical stabilisation against their will as a lifesaving intervention has increased. This paper highlights a fictional case study aiming to explore the legal, ethical and practical considerations a trainee should be aware of. By the end of this article, readers will be more aware of this complex issue and how it might be managed, as well as the impact it can have on the patient, their family and ward staff.

摘要

饮食失调在所有精神疾病中死亡率最高。自新冠疫情以来,需要在儿科病房进行医学稳定治疗的患者数量显著增加。同样,作为一种挽救生命的干预措施,违背患者意愿进行医学稳定治疗的患者数量也有所增加。本文重点介绍了一个虚构的案例研究,旨在探讨实习医生应了解的法律、伦理和实际考量因素。在本文结尾,读者将更清楚地了解这个复杂问题及其可能的处理方式,以及它对患者、其家人和病房工作人员可能产生的影响。

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Nasogastric tube feeding under physical restraint on paediatric wards: ethical, legal and practical considerations regarding this lifesaving intervention.儿科病房中在身体约束下进行鼻胃管喂养:关于这种挽救生命干预措施的伦理、法律和实际考量
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本文引用的文献

1
Nasogastric tube feeding in line with new dietetic guidelines for the treatment of anorexia nervosa in a specialist children and adolescent inpatient unit: a case series.在儿童和青少年专科住院病房中,根据治疗神经性厌食症的新饮食指南进行鼻胃管喂养:病例系列研究。
J Hum Nutr Diet. 2021 Feb;34(1):33-41. doi: 10.1111/jhn.12765. Epub 2020 May 12.
2
The development of consensus-based guidelines for dietetic practice in nasogastric tube feeding under restraint for patients with anorexia nervosa using a modified Delphi process.使用改良 Delphi 法为神经性厌食症约束下经鼻胃管喂养的患者制定基于共识的饮食实践指南。
J Hum Nutr Diet. 2020 Jun;33(3):287-294. doi: 10.1111/jhn.12731. Epub 2020 Feb 5.
3
Nasogastric Tube Feeding for Individuals With Anorexia Nervosa: An Integrative Review.神经性厌食症患者的鼻饲管喂养:一项综合综述。
J Am Psychiatr Nurses Assoc. 2016 Nov;22(6):449-468. doi: 10.1177/1078390316657872. Epub 2016 Aug 12.
4
A systematic review of the frequency, duration, type and effect of involuntary treatment for people with anorexia nervosa, and an analysis of patient characteristics.对神经性厌食症患者非自愿治疗的频率、持续时间、类型和效果进行系统回顾,并分析患者特征。
J Eat Disord. 2014 Nov 11;2(1):29. doi: 10.1186/s40337-014-0029-8. eCollection 2014.
5
Attitudes of patients with anorexia nervosa to compulsory treatment and coercion.厌食症患者对强制治疗和强制手段的态度。
Int J Law Psychiatry. 2010 Jan-Feb;33(1):13-19. doi: 10.1016/j.ijlp.2009.10.003. Epub 2009 Nov 18.
6
Refeeding syndrome: what it is, and how to prevent and treat it.再喂养综合征:是什么,以及如何预防和治疗。
BMJ. 2008 Jun 28;336(7659):1495-8. doi: 10.1136/bmj.a301.
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Gillick v West Norfolk and Wisbech Area Health Authority.吉利克诉西诺福克和威斯贝奇地区健康管理局案
All Engl Law Rep. 1984;1985(1):533-59.
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Nasogastric feeding in children and adolescents with eating disorders: toward good practice.患有饮食失调症的儿童和青少年的鼻饲:迈向良好实践
Int J Eat Disord. 2001 May;29(4):441-8. doi: 10.1002/eat.1040.