Nurses' perceived knowledge and benefits of artificial nutrition and hydration for patients nearing death: A survey among Jordanian nurses

Abstract

Globally, cancer is the second major cause of death and its incidence rate is rising significantly every year (World Health Organization, 2014). Among Jordanians, cancer was found to be the leading cause of death (Jordanian Ministry of Health [JMOH], 2017). In 2015, the total number of Jordanian patients diagnosed with cancer in the last ten years was 6820, indicating that the morbidity and mortality rate of this disease rapidly increased in Jordan (JMOH, 2015).The consequences of cancer diagnoses burden not only the patients and their families, but also their communities; they influence the patients physically and psychosocially (Sarfati et al., 2016). The burdens associated with this disease increase with disease progression; patients with advanced cancer, particularly those who are in stage III cancer and expect death within 6 months, often experience several distressing symptoms that reduce their quality of life, such as nausea, vomiting, dysphagia, anorexia, cachexia and physical intestinal obstruction and have a reduced response to cancer treatment (Good et al., 2014). Patients with cancer are at an increased risk of malnutrition as a result of the disease and as a side effect of treatment; malnutrition prolongs hospital stay, reduces the patient's quality of life and impairs overall disease prognosis (Arends et al., 2017;Caccialanza et al., 2017).

Incidence of Enteral Nutrition-Related Diarrhea Among Critically Ill Patients in Intensive Care Units

“…This study investigated the characteristics of critically ill patients receiving EN and the incidence of EN-related diarrhea in Jordan. Initially, the delivery of inadequate nutritional requirements was observed through inadequate nutritional practices, which is consistent with previous Jordanian studies in this regard (Darawad et al, 2018; Mosleh et al, 2021). In addition to the interruptions in the EN course due to invasive procedures that further exacerbate malnutrition (Lee & Heyland, 2019), the recommended early EN initiation within 24–48 hours after admission to the ICU was done for only 38.1% of patients, which is still inadequate compared with the standard and ideal practice.…”

“…Despite the prevalence of EN-associated diarrhea among critically ill patients, few studies investigated this complication in Jordan. Indeed, most studies in the field of EN in Jordan focused on nurses' practices concerning EN (Al Kalaldeh & Shahein, 2014; Al Kalaldeh, Watson, & Hayter, 2015; Darawad et al, 2015, 2018; Hammad, Al-hussami, & Darawad, 2015; Mosleh, Alnajar, & Almalik, 2021). So, it is of a clinical importance to focus on the characteristics of critically ill patients themselves as a target population fed by the EN modality.…”

Do Nursing Staff Accept no Artificial Nutrition and Hydration for Terminal Patients?

“…Studies have indicated that those who were older had a higher level of education and had longer years of work experience had better knowledge resources as well as better skills in utilizing the resources. Nursing staff who worked at the oncology or hospice unit had more experience in care [18,19,21] and also diligently cultivated clinical talents [13]. In particular, clinical nursing staff who had participated in hospice care training had a more positive attitude towards non-ANH in terminal patients when the patient's body system deteriorates [15,21,22], and a significantly positive correlation was observed when clinical nursing staff had a better understanding of the concept of hospice care and the timing and decision-making for ANH, they had a more positive attitude towards accepting ANH [5,14,15,21,22].…”