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0 per os: En analys av sjuksköterskors perspektiv på beslut att ge sondnäring till äldre individer med långt framskriden demenssjukdom
Luleå University of Technology, Department of Health Sciences.
2017 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
NPO : An analysis of the perspective of Registered nurses on decision regarding tube feeding in older individuals with advanced dementia (English)
Abstract [sv]

Sväljsvårigheter uppstår hos individer med avancerad form av demens som en del av sjukdomsprocessen. Det ställer krav på hälso- och sjukvården att bemöta dessa symtom när individen själv saknar den kognitiva förmågan att fullt hävda sin autonomi avseende nutritionsbehandling. Frågan om sondnäring via sond eller PEG är en adekvat behandling för dessa patienter aktualiseras. Även om det rent utav är ett övergrepp och omvårdnaden istället bör ta en palliativ riktning. Sjuksköterskan betraktar ofta sin kunskap inom området som egna personliga preferenser och inte något som kan hänvisas till i ett kliniskt vårdsammanhang. Syftet med denna studie var att utforska sjuksköterskans etiska medvetenhet kring administrering av sondnäring till individer med avancerad form av demens. Studien genomfördes utifrån en kvalitativ design med en empiriskt utformad intervju, en litteraturöversikt samt en etisk analys utifrån sjuksköterskans möjliga handlingsalternativ i beslutandeprocessen. Slutsatser av denna studie består till en del av att sjuksköterskan bör agera som advokat för individens upplevda bästa och önskemål, ej stödja läkares beslut om administrering av sondnäring till dessa patienter samt bidra till en värdig död inom den palliativa domänen för individen med minsta möjliga lidande som resultat.

Abstract [en]

Swallowing difficulties occur as a part of the disease process in individuals with advanced dementia. Demands is set on the healthcare-staff to meet with these symptoms when the individual due to loss in cognitive function, lack a complete ability to claim autonomy regarding nutritional treatment. The issue arises regarding enteral feeding by PEG or NG-tube as a viable treatment option for these patients. Even if it is an encroachment and that the care instead should be performed from a palliative point of view. Registered nurses view their knowledge within the area as personal preferences that they cannot refer to in a clinical setting. The aim of this study was to explore the nurse´s ethical awareness regarding enteral nutrition to individuals with advanced dementia. The study was conducted from a qualitative approach with an empirical interview, a literature review and an ethical analysis concerning the nurse’s possible actions’ in the decision making-process. Conclusions of this study consists to a part of that the nurse should act as the patient’s advocate regarding from what’s perceived to be the best for the patient and the patient’s wishes. Also, not supporting the doctor’s decision of tube feeding to these patients’ and to contribute to a dignified death within the palliative domain, with least possible suffering as a result.

Place, publisher, year, edition, pages
2017. , p. 46
Keywords [en]
enteral feeding, PEG, NG-tube, dementia, autonomy
Keywords [sv]
sondnäring, demens, PEG, nasogastrisk sond, autonomi
National Category
Nursing
Identifiers
URN: urn:nbn:se:ltu:diva-65564OAI: oai:DiVA.org:ltu-65564DiVA, id: diva2:1140056
Subject / course
Student thesis, at least 15 credits
Educational program
Specialist Nursing, Elderly Care
Supervisors
Examiners
Available from: 2017-09-12 Created: 2017-09-11 Last updated: 2017-09-12Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
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