title: Artificial nutrition and hydration in terminally ill patients with advanced dementia: opinions and correlates among Italian physicians and nurses.
abstract: BACKGROUND
  Although their benefits are controversial, artificial nutrition and hydration are often administered as a form of basic care to terminally ill patients. An important reason for this may be that these treatments have strong emotional and psychological meanings.
  
  
  OBJECTIVE
  In the present article we investigated the opinions of Italian physicians and nurses on the administration of artificial nutrition and hydration to terminally ill patients with advanced dementia. We also investigated the antecedents of these opinions, considering feelings and thoughts related to death, ethical issues and training in palliative care.
  
  
  METHODS
  A questionnaire was administered to Italian physicians (n=288) and nurses (n=763). We analyzed the percentages of agreement with the administration of artificial nutrition and hydration and, using multivariate logistic regressions, the possible antecedents of these opinions.
  
  
  RESULTS
  Agreement with the provision of artificial hydration was higher (73%) than for artificial nutrition (48%), suggesting that artificial hydration may be seen as a form of basic care. Agreement with their administration was generally lower among professionals in northern Italy working in geriatrics wards who had received training in palliative care. We also found that death-related feelings and thoughts and ethical issues played a different part for physicians and nurses.
  
  
  CONCLUSIONS
  Our findings suggest that opinions concerning artificial nutrition and hydration not only derive from scientific background, but also relate to cultural, ethical, and psychological issues. Our results also reveal important differences between physicians' and nurses' opinions, providing useful information for interpreting and overcoming obstacles to the effective cooperation between these professionals.
authors.affiliation: 1 Geriatrics Division, University of Padova , Padova, Italy .
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Valentini
authors.forename: Valter
authors.initials: V
authors.lastname: Giantin
authors.forename: Alberto
authors.initials: A
authors.lastname: Voci
authors.forename: Mario
authors.initials: M
authors.lastname: Iasevoli
authors.forename: Anna
authors.initials: A
authors.lastname: Zurlo
authors.forename: Valentina
authors.initials: V
authors.lastname: Pengo
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
authors.forename: Renzo
authors.initials: R
authors.lastname: Pegoraro
authors.forename: Massimo
authors.initials: M
authors.lastname: Catarini
authors.forename: Margherita
authors.initials: M
authors.lastname: Andrigo
authors.forename: Matteo
authors.initials: M
authors.lastname: Storti
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003704:Dementia / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D018529:Nutritional Support; D010820:Physicians / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000941:ethics; D019452:Terminally Ill