Artificial Nutrition and Hydration in Terminally Ill Patients with Advanced Dementia: Opinions and Correlates among Italian Physicians and Nurses
To cite this article:Valentini Elisabetta, Giantin Valter, Voci Alberto, Iasevoli Mario, Zurlo Anna, Pengo Valentina, Maggi Stefania, Pegoraro Renzo, Catarini Massimo, Andrigo Margherita, Storti Matteo, and Manzato Enzo. Journal of Palliative Medicine. October 2014, 17(10): 1143-1149. doi:10.1089/jpm.2013.0616.
Published in Volume: 17 Issue 10: October 10, 2014
Author information
Elisabetta Valentini, PhD,1 Valter Giantin, MD,1 Alberto Voci, PhD,2 Mario Iasevoli, PhD,1 Anna Zurlo, MD,1 Valentina Pengo, MD,1 Stefania Maggi, PhD,3 Renzo Pegoraro, MD,4 Massimo Catarini, MD,5 Margherita Andrigo, IP,6 Matteo Storti, IP,7 and Enzo Manzato, MD1
1Geriatrics Division, University of Padova, Padova, Italy.
2Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy.
3Aging Section, Institute of Neurosciences, Italian Research Council, Padova, Italy.
4Lanza Foundation, Padova, Italy.
5Internal Medicine Division, Macerata Hospital, Macerata, Italy.
6Degree Course in Nursing, University of Padova, Padova, Italy.
7IPASVI Research Group, Vicenza, Italy.
Accepted May 14, 2014
ABSTRACT
Background:
Although their benefits are controversial, artificial nutrition and
hydration are often administered as a form of basic care to terminally
ill patients. An important reason for this may be that these treatments
have strong emotional and psychological meanings.
Aims: In the present article we investigated the opinions of Italian physicians and nurses on the administration of artificial nutrition and hydration to terminally ill patients with advanced dementia. We also investigated the antecedents of these opinions, considering feelings and thoughts related to death, ethical issues and training in palliative care.
Method: A questionnaire was administered to Italian physicians (n=288) and nurses (n=763). We analyzed the percentages of agreement with the administration of artificial nutrition and hydration and, using multivariate logistic regressions, the possible antecedents of these opinions.
Results: Agreement with the provision of artificial hydration was higher (73%) than for artificial nutrition (48%), suggesting that artificial hydration may be seen as a form of basic care. Agreement with their administration was generally lower among professionals in northern Italy working in geriatrics wards who had received training in palliative care. We also found that death-related feelings and thoughts and ethical issues played a different part for physicians and nurses.
Aims: In the present article we investigated the opinions of Italian physicians and nurses on the administration of artificial nutrition and hydration to terminally ill patients with advanced dementia. We also investigated the antecedents of these opinions, considering feelings and thoughts related to death, ethical issues and training in palliative care.
Method: A questionnaire was administered to Italian physicians (n=288) and nurses (n=763). We analyzed the percentages of agreement with the administration of artificial nutrition and hydration and, using multivariate logistic regressions, the possible antecedents of these opinions.
Results: Agreement with the provision of artificial hydration was higher (73%) than for artificial nutrition (48%), suggesting that artificial hydration may be seen as a form of basic care. Agreement with their administration was generally lower among professionals in northern Italy working in geriatrics wards who had received training in palliative care. We also found that death-related feelings and thoughts and ethical issues played a different part for physicians and nurses.
Conclusions:
Our findings suggest that opinions concerning artificial nutrition and
hydration not only derive from scientific background, but also relate to
cultural, ethical, and psychological issues. Our results also reveal
important differences between physicians' and nurses' opinions,
providing useful information for interpreting and overcoming obstacles
to the effective cooperation between these professionals.
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