[Should hydration and artificial nutrition be accepted as a palliative care?].
BACKGROUND
Ethical considerations are becoming more and more common in clinical practice. There is no unanimous agreement on which measures should be deemed as basic care, specially regarding hydration and artificial nutrition.


OBJECTIVE
To know the opinion of lay people and health professionals, stratified according to their university degree, about which palliative measures, including hydration and artificial nutrition, should be judged as palliative care.


METHODS
A descriptive transversal study has been designed to know the opinion of 256 subjects: 91 users of the National Health System (NHS), 80 nurses, 47 pharmacists and 38 physicians. A questionnaire examined which of the following measures should be considered as palliative care: hygiene, analgesia, pressure ulcer care, position change, sedation, oxygen administration, urinary catheter, hydration, enteral and parenteral nutrition.


RESULTS
More than 50% of the participants think that all the proposed measures can be considered as a palliative care, except parenteral nutrition. There is unanimous agreement to accept analgesia, pressure ulcer care, position change and enteraL nutrition as basic care, but there is disagreement in relation to hygiene (p = 0.000), sedation (p = 0.005), oxygen administration (p = 0.007), urinary catheter (p = 0.011) and parenteral nutrition (p = 0.000). There were not differences of opinion after adjusting for age, sex, religious beliefs, and length of professional experience among the individuals that answered the questionnaire.


CONCLUSIONS
There is no agreement on which measures should be considered as palliative care. Opinions differ regarding hygiene, sedation, oxygen administration, urinary catheterisation and parenteral nutrition. In comparison to enteral nutrition, many responders believe that parenteral nutrition is a therapeutic option. The opinions shown in this questionnaire were independent from the demographic characteristics of the subjects that answered it.
Valero Zanuy
M A
MA
Unidad de Nutrición Clinica, Hospital 12 de Octubre, Madrid, España. mvalero.hdoc@salud.madrid.org
Alvarez Nido
R
R
García Rodríguez
P
P
Sánchez González
R
R
Moreno Villares
J M
JM
León Sanz
M
M
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D018529:Nutritional Support; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D010288:Parenteral Nutrition / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000379:methods / Q000523:psychology