Araújo Carlos Álvaro, de Melo Rauany Fiuza Braga Pires, Sant Anna Geisa, Amorim Fábio Ferreira
Graduation Program in Health Sciences, University of Brasília (UnB), Brasília, Brazil.
Intensive Care Unit, Hospital Sírio Libanês Brasília, Brasília, Brazil.
Medicine (Baltimore). 2025 Jul 18;104(29):e43381. doi: 10.1097/MD.0000000000043381.
Food consumption is not only driven by a desire for nutrients and satiety but also a fundamental element of human interaction. This study aimed to comprehensively analyze bibliometric characteristics, collaboration networks, points of interest, and research trends, providing insights into the current landscape of publications on nutrition in palliative care at the end of life (PC-EOL).
The Web Wof Science Core Collection database was screened for studies addressing PC-EOL, published until December 2024. From the search results, we performed statistical descriptions of the year of publication, study type, authors, country, institution, keywords, scientific journal, citations, and disciplinary (Web of Science category). VOSviewer 1.6.19 (visualization of similarities), Microsoft Office Excel 16.78 for Mac, BibExcel, and the Bibliometrix R package, along with the Biblioshiny tool, were used for data analysis.
Three hundred fourteen articles from 48 countries were included. Annual publications increased from 4 in 1994 to a peak of 35 in 2022 but declined over the past 2 years, reaching 16 in 2024. Most articles were from the United States, but the United Kingdom had the highest influence on the network. Keywords were stratified into 9 clusters: "Comprehensive End of Life Care," "Ethics and Decision-Making in End-of-Life," "Eating Disorders and Assisted Dying," "Palliative and Long-Term Care," "Palliative and Long-Term Care," "Advanced Nutritional Support," "Critical Care," "Family and Pediatric Care," "Advanced Cancer Management," and "Gastrointestinal Obstruction." Trend topic analysis suggests an increase in terms related to patients' refusal of nutrition/artificial nutrition, ethics, family, bereavement, and eating disorders, shifting from prior main themes, such as withdrawal/withholding life-sustaining therapy in advanced cancer/dementia. Among the top 20 cited articles, although all addressed nutrition in PC-EOL, it was the core element in only 9.
The number of articles published annually remains limited, with low levels of collaboration among countries and authors. Few studies have examined the symbolic and relational meanings of food in terminal illness from the perspectives of patients and their families, dimensions crucial to truly person-centered care. Future research should prioritize the lived experiences, cultural contexts, and ethical concerns of those directly affected.
食物消费不仅受对营养和饱腹感的需求驱动，也是人际互动的基本要素。本研究旨在全面分析文献计量特征、合作网络、关注点和研究趋势，以洞察临终姑息治疗（PC-EOL）中营养领域出版物的当前格局。
在Web of Science核心合集数据库中筛选截至2024年12月发表的关于PC-EOL的研究。从搜索结果中，我们对发表年份、研究类型、作者、国家、机构、关键词、科学期刊、引用次数和学科（Web of Science类别）进行了统计描述。使用VOSviewer 1.6.19（相似性可视化）、适用于Mac的Microsoft Office Excel 16.78、BibExcel以及Bibliometrix R包和Biblioshiny工具进行数据分析。
纳入了来自48个国家的314篇文章。年发表量从1994年的4篇增加到2022年的峰值35篇，但在过去两年有所下降，2024年降至16篇。大多数文章来自美国，但英国对该网络的影响最大。关键词分为9个聚类：“临终综合护理”、“临终伦理与决策”、“饮食失调与安乐死”、“姑息与长期护理”、“姑息与长期护理”、“高级营养支持”、“重症护理”、“家庭与儿科护理”、“晚期癌症管理”和“胃肠道梗阻”。趋势主题分析表明，与患者拒绝营养/人工营养、伦理、家庭、丧亲之痛和饮食失调相关的术语有所增加，从先前的主要主题，如晚期癌症/痴呆症中撤除/停止维持生命治疗转变而来。在被引用次数最多的20篇文章中，尽管所有文章都涉及PC-EOL中的营养，但营养只是其中9篇的核心要素。
每年发表的文章数量仍然有限，国家和作者之间的合作水平较低。很少有研究从患者及其家人的角度审视食物在绝症中的象征意义和关系意义，而这些维度对于真正以患者为中心的护理至关重要。未来的研究应优先关注直接受影响者的生活经历、文化背景和伦理问题。
