Is There Any Difference Between Physicians' with Nurses' Knowledge, Attitudes and Behavioral Intentions of Providing Artificial Nutrition and Hydration to Terminal Cancer Patients?

Ke, Li-Shan

Wednesday, July 13, 2011: 1:45 PM

Li-Shan Ke, MSN¹
Wen-Yu Hu, PhD, RN²
Su-Yu Chang, RN¹
(1)Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
(2)School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan

Learning Objective 1: The learner will be able to understand present knowledge, attitude, and behavioral intention of clinical nurses and physicians providing ANH for TCP.

Learning Objective 2: The learner will be able to know the difference between physicians’ and nurses’ knowledge, attitudes and behavioral intentions in providing ANH to TCP.

Purpose: The aim of study was to compare knowledge, attitudes and behavioral intentions toward providing artificial nutrition and hydration (ANH) to terminal cancer patients between physicians and nurses.

Methods: A structured questionnaire survey was performed among staffs in a medical center in Taiwan. The main statistical methods were descriptive statistical, X², and t-test.

Results: 45 physicians and 184 nurses were enrolled. Physicians’ knowledge of providing ANH to terminal cancer patients was significantly better than nurses’ (t=2.089, CI=0.057~1.962). The score of physicians’ knowledge was 7.2 (SD=2.79, range 1-15), and the accurate-answer rate was 48%. The score of nurses’ knowledge was 6.2 (SD=2.93, range 1-15), and the accurate-answer rate was 41.3%. However, attitudes and behavioral intentions were not significantly different between physicians and nurses (t=0.590, CI=-7.650~14.184; t=1.168, CI=-0.125~0.489). The volume of hydration to terminal cancer patients between physicians and nurse showed significant difference (X²=19.652, p<0.001). Only 22.9% of nurses tempted to provide terminal cancer patients with more than 1500ml artificial hydration daily, whereas 55.6% of physicians would do so.

Conclusion: Our study showed that physicians and nurses had insufficient knowledge of ANH so that they were tempted to provide more ANH to terminal cancer patients. Nurses seemed more able to aware the discomfort of terminal cancer patients resulting from excessive administration of ANH, leading to higher proportions of nurses favored reduced amounts of ANH. Present study suggests that nurses should aware their essential roles of advocating for the patients in the decision making process of using ANH. The changes in physiologic adaption for fluid and nutrition in terminal cancer patients, and the impact of ANH on patients’ symptoms deserved further study.

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