The associations of palliative care experts regarding food refusal : a cross-sectional study with an open question evaluated by triangulation analysis

Introduction: Health professionals in oncologic and palliative care settings are often faced with the problem that patients stop eating and drinking. While the causes of food refusal are very different, the result is often malnutrition, which is linked to health comorbidities and a high mortality rate. However, the professionals lack the time and knowledge to clarify the cause for each patient. What associations do health professionals have when faced with food refusal? Objective: To investigate the associations that health professionals in oncological and palliative settings have about denied eating behavior. Methods: A cross-sectional study, starting with an open question focusing professionals’ associations regarding food refusal. The results were inductively analyzed, whereby generic categories were developed. Subsequently, the categories were transformed into quantitative data to calculate the relationships between the categories. Results: A total of 350 out of 2000 participants completed the survey, resulting in a response rate of 17.5%. Food refusal is primarily associated with physical and ethical aspects and with endof-life. Half of the participants frequently find that patients refuse to eat. The attitudes show that the autonomy of the patient is the highest good and is to be respected. Even in the case of patients with limited decision-making capacity, the refusal to eat is acceptable. Conclusion: Clarifying the cause of food refusal requires a great deal of knowledge and is strongly influenced by the associations of health professionals. While the associations have very negative connotations, information and training is needed to make professionals aware of this and to change their associations. With this knowledge and in an interprofessional cooperation, mis-labelling of patient settings can be avoided and fears can be reduce

Development of a questionnaire to determine incidence and attitudes to “voluntary stopping of eating and drinking”

‘‘Voluntary stopping of eating and drinking’’ (VSED) is an option to hasten death at the end of life. There are no data available about incidence of either the explicit VSED or implicit (V)SED nor information about experiences and attitudes of health professionals about VSED in Switzerland

Long‐term care nurses' attitudes and the incidence of voluntary stopping of eating and drinking : a cross‐sectional study

This article has been accepted for publication and undergone full peer review (not applicable for Editorials) but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/jan.14249Aims: 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

Experiences, personal attitudes, and professional stances of Swiss health care professionals toward voluntary stopping of eating and drinking to hasten death : a cross-sectional study

Voluntary stopping of eating and drinking (VSED) is the self-determined decision of an individual with the decision-making capacity to cause premature death. During the course of VSED, the person is dependent on the support of relatives and health professionals. To date, little is known of the attitudes of Swiss health professionals on this topic

Voluntary stopping of eating and drinking in Swiss outpatient care

Besides physician-assisted suicide, there is another end-of-life practice under discussion: voluntary stopping of eating and drinking (VSED). In this study, we assess the occurrence of VSED in outpatient care and evaluate nurses’ attitudes about it. We recruited 395 nurses (24% response rate) in our online survey. The occurrence of VSED in Switzerland lies at 0.5%. Most nurses (84.6%) were aware of VSED, and 39.5% had experienced it with patients. VSED was mostly (70.3%) regarded as a natural death, and nearly all (95.1%) were willing to care for these patients; however, about one-quarter (26.5%) expressed moral concerns. Our results show that VSED occurs in rare cases, and that nurses are willing to accompany patients during this VSED, but express moral concerns

Family physicians’ perspective on voluntary stopping of eating and drinking : a cross-sectional study

We aimed to determine how often patients who choose voluntary stopping of eating and drinking (VSED) are accompanied by Swiss family physicians, how physicians classify this process, and physicians' attitudes and professional stance toward VSED

Ist eine Handlungsempfehlung für den Einsatz von Ketamin / Esketamin zur Behandlung von Depression und Angst in der Palliative Care möglich?

Aufgrund der oft limitierten Lebenserwartung von Patientinnen und Patienten in der Palliative Care stellt sich insbesondere in Bezug auf die Behandlung möglicher psychischer Störungen wie Depression oder Angst die Herausforderung rasch wirksamer und möglichst einfach zu applizierender Medikamente. Ziel dieser Arbeit ist es, die aktuelle Literatur und ausgewählte Leitlinien in Hinblick auf Evidenz bezüglich Einsatz von Ketamin und Esketamin als Medikamente zur Behandlung von Depression und Angststörung bei palliativen Patientinnen und Patienten zu untersuchen