title: Withdrawal of artificial nutrition: influence of prior experience on the perception of caregivers.
abstract: BACKGROUND
  In spite of the existence of clinical guidelines and a legal framework in France, the withdrawal of artificial nutrition (AN) in palliative care remains a difficult situation for caregivers who are confronted with this reality.
  
  
  OBJECTIVE
  To describe the perception of caregivers on the withdrawal of AN and to compare this perception between caregivers who have already been confronted with this situation and those who have not.
  
  
  METHODS
  Cross-sectional survey questionnaire of nurses and nurses' aides (n = 274) working in medicine, surgery, and palliative care departments of a regional hospital.
  
  
  RESULTS
  Of the caregivers, 59.5% declared having been confronted with the withdrawal of AN in their professional practice. This was associated with a better perception by these caregivers even if their knowledge on the criteria to be considered in the decision was not significantly modified.
  
  
  CONCLUSIONS
  The coherence of the withdrawal of AN with the personal beliefs of the caregivers, already high in the absence of being confronted with this practice, is better among caregivers who have been confronted with this situation. The lack of information perceived by caregivers should prompt us to develop additional training on the withdrawal of AN, its objectives, and its clinical consequences.
authors: Palliative Care Department, Metz-Thionville Regional Hospital, Metz, France b.leheup@chr-metz-thionville.fr.
authors: Benoît F
authors: BF
authors: Leheup
authors: Palliative Care Department, Metz-Thionville Regional Hospital, Metz, France.
authors: Elise
authors: E
authors: Piot
authors: Clinical Research Support Unit, Metz-Thionville Regional Hospital, Metz, France.
authors: Christophe
authors: C
authors: Goetz
authors: Nutrition Department, Nancy University Hospital, Vandoeuvre les Nancy, France.
authors: Didier
authors: D
authors: Quilliot
authors: Geriatrics Department, Nancy University Hospital, Vandoeuvre les Nancy, France.
authors: Jean-Yves
authors: JY
authors: Niemier
authors: Palliative Care Department, Metz-Thionville Regional Hospital, Metz, France.
authors: Bernard
authors: B
authors: Wary
authors: Department of Neurology, Nancy University Hospital, Vandoeuvre les Nancy, France.
authors: Xavier
authors: X
authors: Ducrocq
mesh_terms: D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005066:Euthanasia, Passive / Q000941:ethics / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D018529:Nutritional Support / Q000941:ethics / Q000523:psychology*; D010166:Palliative Care / Q000941:ethics / Q000523:psychology*; D010465:Perception
keywords: artificial nutrition and hydration; caregiver’s burden; end of life; ethics; palliative care; withdrawing treatment