An investigation of district nurses confidence and knowledge in providing nutritional advice for end of life and palliative care patients
Cardiff Metropolitan University
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Background- This study aims to identify whether district nurses (DN) have confidence and knowledge to provide nutritional support to palliative and end of life (EOL) patients.80% of palliative care patients experience malnutrition. Preferred place of care and financial constraints on NHS resources are increasing the input required from DNs in this patient group. Method- A mixed method qualitative approach using questionnaires and semi-structured interviews was used. 5 participants were recruited using a convenience sample of researcher acquaintances. All Participants were invited to undertake a semi-structured interview. 3 participants where interviewed .The interview was structured using the questionnaire. A simplified version of grounded theory was used to guide thematic analysis. Results- 100% of DNs consider nutritional support a part of their role 3 main themes emerged; 1. Understanding of terms used to acknowledge stage of palliative illness and its affect on patient care. 2. Lack of formal nutritional training for DNs and impact on nutritional support given to this patient group. 3. Confidence when dealing with strong emotions of patients and families about weight loss and anorexia in end of life care. Conclusions- The findings suggested that an understanding of terms used when assessing stage of illness and providing care for palliative and EOL patients may improve outcomes. DNs consider nutrition as part of their role, however there was little evidence of structured nutritional education being provided. Dealing with emotions of patients and family was a source of concern for nurses in this study.
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