Preferences of Registered Dietitians and Nurses Recommending Artificial Nutrition and Hydration for Elderly Patients

Abstract Objective The study was designed to identify how the beliefs and perceptions of registered dietitians (RDs) affect their decisions to propose artificial nutrition and hydration (ANH) for elderly patients as compared with nurses. Design A questionnaire consisting of demographic information, 13 belief statements, and eight patient scenarios requiring ANH was mailed to RDs (n=1,500) and nurses (n=1,500) throughout Florida. Thirteen statements, rated on a 5-point Likert scale, addressed beliefs that influence ANH decisions. Eight scenarios of patients, without an advance directive or surrogate decision maker, were created with variations in age, cognition, and emotion. For each scenario, participants selected a treatment, ANH or hydration, and responded: recommend; not recommend; undecided; or recommend a trial period; if no improvement, stop treatment. Statistical Analyses Performed To establish reliability and validity, the instruments were pilot-tested with a group of RDs and nurses. Cross tabulations with χ2 tests compared the distribution of responses to the belief statements and scenarios. Statistical significance was P