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J Adv Nurs. 2019 Oct 29. doi: 10.1111/jan.14249. [Epub ahead of print]

Long-term care nurses´ attitudes and the incidence of voluntary stopping of eating and drinking: A cross-sectional study.

Author information

1
Witten/Herdecke University, Faculty of Health, Department of Nursing Science, Witten.
2
Zurich University of Applied Sciences, School of Health Professions, Institute of Nursing , Technikumstrasse 81, Winterthur.
3
Cantonal Hospital St.Gallen, , Palliative Centre St.Gallen, St. Gallen.

Abstract

AIMS:

To assess the incidence of voluntary stopping of eating and drinking in long-term care and to gain insights into the attitudes of long-term care nurses about the voluntary stopping of eating and drinking.

DESIGN:

A cross-sectional study.

METHODS:

Heads of Swiss nursing homes (535; 34%) answered the Online-Survey between June and October 2017, which was evaluated using descriptive data analysis.

RESULTS:

The incidence of patients who died in Swiss nursing homes by voluntarily stopping eating and drinking is 1.7% and 67.5% of participants consider this phenomenon highly relevant in their daily work. Most participants (64.2%) rate voluntary stopping of eating and drinking as a natural death accompanied by health professionals and patients are also granted the right to care (91.9%). This phenomenon is expected by the participants less at a young age and more in old age.

CONCLUSION:

Participants' overall views on the voluntary stopping of eating and drinking are very positive, whereas it is assumed that voluntary stopping of eating and drinking is a phenomenon of old age. Professionals still lack sufficient knowledge about this phenomenon, which could be clarified through training. International Registered Report Identifier (IRRID): DERR1-10.2196/10358.

IMPACT:

Voluntary stopping of eating and drinking is much discussed interprofessional, but there is a lack of knowledge on how this is perceived in the context of long-term care and about the incidence of the phenomenon. Voluntary stopping of eating and drinking is rare but noticeable end-of-life practises that is considered by professionals to be mainly dignified and peaceful, although moral concerns make it difficult to accompany. These findings call on long-term care institutions to discuss voluntary stopping of eating and drinking as an end-of-life practice. Positioning on the issue provides clarity for staff and patients and promotes to develop standardized care.

KEYWORDS:

VSED; advance nursing practice; attitudes; decision at the end-of-life; end-of-life practice; food refusal; long-term care; nurse; nursing home; self-determination

PMID:
31659779
DOI:
10.1111/jan.14249

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