Clinical trial NCT02900573: Withdrawal of Artificial Nutrition at the End of Life (PERCEPAL)
Official title: Caregivers Confronted With the Withdrawal of Artificial Nutrition at the End of Life: Perception and Experienced Difficulties
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Palliative Care Nursing
Lead sponsor: Centre Hospitalier Régional Metz-Thionville
Sponsor class: OTHER
First posted: 2016-09-14
Enrollment: 289
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Senior nurses (which are not directly in contact with the patient but involved in team management), nurses (which perform patient care), and nurses' aides (which are involved in hygiene measures) working in the medicine, surgery, and palliative care departments of the regional hospital of Metz-Thionville.

Brief summary: Withdrawing artificial nutrition in palliative care is an issue that often leads to ethical dilemmas among health care providers, despite clinical guidelines.

Detailed description: The benefit of artificial nutrition in terminally ill patients has been a highly debated issue for the past 30 years, and abundant data are available regarding its effects on patients. Several clinical guidelines have specified the criteria to be considered before initiating artificial nutrition or hydration. If these guidelines appear consensual in theory, the situation is much less straightforward in practice. The attitude of physicians appeared very variable when it came to prescribing or withholding artificial nutrition or hydration, and the lack of training, among other parameters, seemingly encouraged health care professionals to prescribe artificial nutrition or hydration. Furthermore, the decision of the care provider is unconsciously complicated due to figurative representations associated with food regarding, among other aspects, the mother-child relationship, social cohesion, or religious beliefs.

These differences are more important since the opinion of physicians and nurses is the one that carries the most influence on the patients' decision when deciding to initiate artificial nutrition and because artificial nutrition and hydration are a common source of ethical dilemmas in health care teams. Furthermore, stopping artificial nutrition or hydration could be misconstrued as euthanasia.

Eligibility criteria: Inclusion Criteria:

* nurses, and nurses' aides working in medicine, surgery, and palliative care departments of the regional hospital of Metz-Thionville

Exclusion Criteria:

* Care providers working in pediatrics, gynecology and obstetrics, psychiatry, and emergency departments

Primary outcomes:
measure: Experience of health care providers confronted with the withdrawing of artificial nutrition at the end of life
timeFrame: month 4
Secondary outcomes:
measure: Experienced difficulties
timeFrame: month 4
Other outcomes:
Locations:
city: Metz Cedex 03
country: France
facility: CHR Metz-Thionville
Study officials:
affiliation: CHR Metz-Thionville
name: Benoît LEHEUP, MD
role: PRINCIPAL_INVESTIGATOR
References: