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医疗保健专业人员对为晚期癌症患者提供人工营养和水分补充的知识、态度及实践

Healthcare Professionals' Knowledge, Attitudes and Practices Toward Providing Artificial Nutrition and Hydration for Patients With Terminal Cancer.

作者信息

Coetzee Beatri, Nel Daan G, Visser Janicke

机构信息

Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa.

Centre for Statistical Consultation, Stellenbosch University, Cape Town, Western Cape, South Africa.

出版信息

J Hum Nutr Diet. 2025 Jun;38(3):e70060. doi: 10.1111/jhn.70060.

Abstract

BACKGROUND

Decisions related to artificial nutrition and hydration (ANH) provision for patients with terminal cancer are a complex topic that can affect the patients' quality of life (QoL). This study aimed to investigate the knowledge, attitudes and practices of healthcare professionals (HCPs) in South Africa concerning the provision of ANH for patients with terminal cancer.

METHODS

This descriptive, cross-sectional study with an analytical component, involved doctors, nurses and dietitians experienced in caring for patients with terminal cancer. Data were collected via an electronic platform (n = 151), utilising a validated questionnaire with close-ended questions. Statistical analysis was performed using Statistica Version 14.0, with p < 0.05 indicating statistical significance.

RESULTS

Notable disparities were observed in HCPs' knowledge, attitudes and practices related to ANH provision. Participants demonstrated a high level of knowledge about palliative care (PC) (92%) but scored lower for ANH provision (56%). Most participants were aware of the burdens associated with ANH provision (mean score: 4.1 ± 0.7 [5-point Likert scale]), yet optimism emerged regarding its perceived psychological benefits. Factors such as patient autonomy (4.5 ± 0.8) and communication between the medical team and patients (4.4 ± 1.0) appeared to influence HCPs' practices. Furthermore, a notable difference was observed in knowledge scores and attitudes based on certain socio-demographic variables.

CONCLUSION

This study suggests that HCPs have inadequate knowledge about, and contradictory attitudes toward, ANH provision in patients with terminal cancer. The study highlights the need for targeted education on terminal care, thereby informing efforts to improve the overall quality of care of these patients.

摘要

背景

为晚期癌症患者提供人工营养与水化(ANH)相关的决策是一个复杂的话题,会影响患者的生活质量(QoL)。本研究旨在调查南非医疗保健专业人员(HCPs)在为晚期癌症患者提供ANH方面的知识、态度和实践。

方法

这项具有分析成分的描述性横断面研究涉及在照顾晚期癌症患者方面有经验的医生、护士和营养师。通过电子平台(n = 151)收集数据,使用经过验证的封闭式问题问卷。使用Statistica 14.0版本进行统计分析,p < 0.05表示具有统计学意义。

结果

在HCPs与ANH提供相关的知识、态度和实践方面观察到显著差异。参与者对姑息治疗(PC)表现出较高的知识水平(92%),但在ANH提供方面得分较低(56%)。大多数参与者意识到与ANH提供相关的负担(平均得分:4.1±0.7[5点李克特量表]),然而对其感知的心理益处表现出乐观态度。患者自主权(4.5±0.8)和医疗团队与患者之间的沟通(4.4±1.0)等因素似乎影响了HCPs的实践。此外,基于某些社会人口统计学变量,在知识得分和态度方面观察到显著差异。

结论

本研究表明,HCPs在为晚期癌症患者提供ANH方面知识不足且态度矛盾。该研究强调了对临终关怀进行有针对性教育的必要性,从而为改善这些患者的整体护理质量的努力提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/120f/12053246/8051c1cb64fa/JHN-38-0-g001.jpg

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