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,...
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| Veröffentlicht in: | Journal of the American Dietetic Association 2007-03, Vol.107 (3), p.416-421 |
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| description | 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 |
| doi_str_mv | 10.1016/j.jada.2006.12.008 |
| format | Article |
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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 <0.05. Results Responses to the belief statement, “when in doubt, feed” differed significantly ( P <0.001) between RDs and nurses, all other belief statements were not significantly different. In all eight scenarios, significantly more ( P <0.001) RDs recommended ANH than did nurses. Conclusions RDs clearly endorsed feeding when in doubt; therefore, they recommended ANH more than nurses. Nurses, who hesitated to feed when in doubt, were more diverse with their recommendations, either recommending a trial or not recommending ANH. A philosophical difference related to feeding was apparent between RDs and nurses and may affect consistent and quality care in patients without an advance directive or surrogate decision maker.</description><identifier>ISSN: 0002-8223</identifier><identifier>ISSN: 2212-2672</identifier><identifier>EISSN: 1878-3570</identifier><identifier>EISSN: 2212-2680</identifier><identifier>DOI: 10.1016/j.jada.2006.12.008</identifier><identifier>PMID: 17324659</identifier><identifier>CODEN: JADAAE</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Advance Directives ; Aged, 80 and over ; artificial hydration ; artificial nutrition ; Biological and medical sciences ; Chi-Square Distribution ; clinical nutrition ; Comparative studies ; Decision Making ; dehydration (animal physiology) ; diet counseling ; dietary recommendations ; Dietetics ; Dietitians ; elderly ; elderly nutrition ; Enteral nutrition ; Female ; Florida ; Fluid Therapy - standards ; food beliefs ; Gastroenterology and Hepatology ; Health Knowledge, Attitudes, Practice ; Health Services for the Aged - standards ; Humans ; imitation foods ; Internal Medicine ; Male ; Medical sciences ; Metabolic diseases ; Middle Aged ; Nurse's Role ; Nurses ; nutritional intervention ; Nutritional Support - standards ; Older people ; Parenteral nutrition ; patient care ; patients ; Perceptions ; perceptions (cognitive) ; Quality of Health Care ; Surveys and Questionnaires</subject><ispartof>Journal of the American Dietetic Association, 2007-03, Vol.107 (3), p.416-421</ispartof><rights>American Dietetic Association</rights><rights>2007 American Dietetic Association</rights><rights>2007 INIST-CNRS</rights><rights>Copyright American Dietetic Association Mar 2007</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490t-d34c2964af9a82a992942daae70b5c2a7fe3bdd1c99b0f261407b85f62c79253</citedby><cites>FETCH-LOGICAL-c490t-d34c2964af9a82a992942daae70b5c2a7fe3bdd1c99b0f261407b85f62c79253</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jada.2006.12.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3541,27915,27916,45986</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18556813$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17324659$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Enrione, Evelyn B., PhD, RD</creatorcontrib><creatorcontrib>Chutkan, Sophia, MS, RD</creatorcontrib><title>Preferences of Registered Dietitians and Nurses Recommending Artificial Nutrition and Hydration for Elderly Patients</title><title>Journal of the American Dietetic Association</title><addtitle>J Am Diet Assoc</addtitle><description>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 <0.05. Results Responses to the belief statement, “when in doubt, feed” differed significantly ( P <0.001) between RDs and nurses, all other belief statements were not significantly different. In all eight scenarios, significantly more ( P <0.001) RDs recommended ANH than did nurses. Conclusions RDs clearly endorsed feeding when in doubt; therefore, they recommended ANH more than nurses. Nurses, who hesitated to feed when in doubt, were more diverse with their recommendations, either recommending a trial or not recommending ANH. A philosophical difference related to feeding was apparent between RDs and nurses and may affect consistent and quality care in patients without an advance directive or surrogate decision maker.</description><subject>Adult</subject><subject>Advance Directives</subject><subject>Aged, 80 and over</subject><subject>artificial hydration</subject><subject>artificial nutrition</subject><subject>Biological and medical sciences</subject><subject>Chi-Square Distribution</subject><subject>clinical nutrition</subject><subject>Comparative studies</subject><subject>Decision Making</subject><subject>dehydration (animal physiology)</subject><subject>diet counseling</subject><subject>dietary recommendations</subject><subject>Dietetics</subject><subject>Dietitians</subject><subject>elderly</subject><subject>elderly nutrition</subject><subject>Enteral nutrition</subject><subject>Female</subject><subject>Florida</subject><subject>Fluid Therapy - standards</subject><subject>food beliefs</subject><subject>Gastroenterology and Hepatology</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Health Services for the Aged - standards</subject><subject>Humans</subject><subject>imitation foods</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Middle Aged</subject><subject>Nurse's Role</subject><subject>Nurses</subject><subject>nutritional intervention</subject><subject>Nutritional Support - standards</subject><subject>Older people</subject><subject>Parenteral nutrition</subject><subject>patient care</subject><subject>patients</subject><subject>Perceptions</subject><subject>perceptions (cognitive)</subject><subject>Quality of Health Care</subject><subject>Surveys and Questionnaires</subject><issn>0002-8223</issn><issn>2212-2672</issn><issn>1878-3570</issn><issn>2212-2680</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9klFrFDEQxxdR7Fn9Aj7oIujbnZPJZrMLRSi1WqFoaetzyCaTI-tetiZ7wn17s73DQh98CjP5_WeG-U9RvGawYsDqj_2q11avEKBeMVwBNE-KBWtks-RCwtNiAQC4bBD5UfEipT6HIBg8L46Y5FjVol0U01UkR5GCoVSOrrymtU9TTtjys6fJT16HVOpgy-_bmDJzTWbcbChYH9blaZy888brIX9PMdNjuIcvdjbq-8iNsTwfLMVhV17lFIUpvSyeOT0kenV4j4vbL-e3ZxfLyx9fv52dXi5N1cK0tLwy2NaVdq1uULctthVarUlCJwxq6Yh31jLTth04rFkFsmuEq9HIFgU_Lj7sy97F8feW0qQ2PhkaBh1o3CYlARlHiRl89wjsx20MeTSFrKmgrrDKEO4hE8eU8tbUXfQbHXeKgZr9UL2a_VCzH4qhyn5k0ZtD5W23IfsgORiQgfcHQCejBxd1MD49cI0QdcN45t7uOadHpdcxMz9vEBgHkIKjmFud7AnKG_3jKapk_Oyr9ZHMpOzo_z_pp0dyM_jg80y_aEfp30KYSlmgbubbmk8LasBaCsn_AjSxx1E</recordid><startdate>20070301</startdate><enddate>20070301</enddate><creator>Enrione, Evelyn B., PhD, RD</creator><creator>Chutkan, Sophia, MS, RD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20070301</creationdate><title>Preferences of Registered Dietitians and Nurses Recommending Artificial Nutrition and Hydration for Elderly Patients</title><author>Enrione, Evelyn B., PhD, RD ; Chutkan, Sophia, MS, RD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c490t-d34c2964af9a82a992942daae70b5c2a7fe3bdd1c99b0f261407b85f62c79253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Advance Directives</topic><topic>Aged, 80 and over</topic><topic>artificial hydration</topic><topic>artificial nutrition</topic><topic>Biological and medical sciences</topic><topic>Chi-Square Distribution</topic><topic>clinical nutrition</topic><topic>Comparative studies</topic><topic>Decision Making</topic><topic>dehydration (animal physiology)</topic><topic>diet counseling</topic><topic>dietary recommendations</topic><topic>Dietetics</topic><topic>Dietitians</topic><topic>elderly</topic><topic>elderly nutrition</topic><topic>Enteral nutrition</topic><topic>Female</topic><topic>Florida</topic><topic>Fluid Therapy - standards</topic><topic>food beliefs</topic><topic>Gastroenterology and Hepatology</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Health Services for the Aged - standards</topic><topic>Humans</topic><topic>imitation foods</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Middle Aged</topic><topic>Nurse's Role</topic><topic>Nurses</topic><topic>nutritional intervention</topic><topic>Nutritional Support - standards</topic><topic>Older people</topic><topic>Parenteral nutrition</topic><topic>patient care</topic><topic>patients</topic><topic>Perceptions</topic><topic>perceptions (cognitive)</topic><topic>Quality of Health Care</topic><topic>Surveys and Questionnaires</topic><toplevel>online_resources</toplevel><creatorcontrib>Enrione, Evelyn B., PhD, RD</creatorcontrib><creatorcontrib>Chutkan, Sophia, MS, RD</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Dietetic Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Enrione, Evelyn B., PhD, RD</au><au>Chutkan, Sophia, MS, RD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preferences of Registered Dietitians and Nurses Recommending Artificial Nutrition and Hydration for Elderly Patients</atitle><jtitle>Journal of the American Dietetic Association</jtitle><addtitle>J Am Diet Assoc</addtitle><date>2007-03-01</date><risdate>2007</risdate><volume>107</volume><issue>3</issue><spage>416</spage><epage>421</epage><pages>416-421</pages><issn>0002-8223</issn><issn>2212-2672</issn><eissn>1878-3570</eissn><eissn>2212-2680</eissn><coden>JADAAE</coden><abstract>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 <0.05. Results Responses to the belief statement, “when in doubt, feed” differed significantly ( P <0.001) between RDs and nurses, all other belief statements were not significantly different. In all eight scenarios, significantly more ( P <0.001) RDs recommended ANH than did nurses. Conclusions RDs clearly endorsed feeding when in doubt; therefore, they recommended ANH more than nurses. Nurses, who hesitated to feed when in doubt, were more diverse with their recommendations, either recommending a trial or not recommending ANH. A philosophical difference related to feeding was apparent between RDs and nurses and may affect consistent and quality care in patients without an advance directive or surrogate decision maker.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>17324659</pmid><doi>10.1016/j.jada.2006.12.008</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Advance Directives Aged, 80 and over artificial hydration artificial nutrition Biological and medical sciences Chi-Square Distribution clinical nutrition Comparative studies Decision Making dehydration (animal physiology) diet counseling dietary recommendations Dietetics Dietitians elderly elderly nutrition Enteral nutrition Female Florida Fluid Therapy - standards food beliefs Gastroenterology and Hepatology Health Knowledge, Attitudes, Practice Health Services for the Aged - standards Humans imitation foods Internal Medicine Male Medical sciences Metabolic diseases Middle Aged Nurse's Role Nurses nutritional intervention Nutritional Support - standards Older people Parenteral nutrition patient care patients Perceptions perceptions (cognitive) Quality of Health Care Surveys and Questionnaires |
| title | Preferences of Registered Dietitians and Nurses Recommending Artificial Nutrition and Hydration for Elderly Patients |
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