| 1. |
- Rothenberg, Elisabet, et al.
(författare)
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Texture-modified meat and carrot products for elderly people with dysphagia : preference in relation to health and oral status
- 2007
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Ingår i: Scandinavian Journal of Food and Nutrition. - : Taylor & Francis. - 1748-2976 .- 1748-2984. ; 51:4, s. 141-147
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reduced taste and smell, chewing problems and swallowing dysfunction are common among elderly people and affect perception, food choice and the ability to eat. Objective: To study the preference for texture-modified carrot and meat products in elderly people aiming to meet the needs of people with impaired chewing and/or swallowing. Design: Data were collected using questionnaires focusing on health, oral status and preference for the products. Altogether, 108 elderly people in ordinary housing (OH) and 50 living in special housing (SH) in Malmö (SH-M) and Göteborg (SH-G) participated. Results: 19% had a body mass index 522, predominantly in SH (24%). Stroke was reported by 20% of the subjects in SH. Among those with subjectively experienced difficulties in swallowing (12%), 58% reported coughing, 21% a gurgly voice in association with food intake and 50% obstruction during swallowing. Only 20% with subjective swallowing difficulties had been specifically examined regarding this problem. All the tested products were easy to masticate and swallow. Compared with OH, people in SH-M found the meatproducts easier to masticate and swallow. Compared with OH, subjects in SH found the carrot products easier to masticate. Conclusions: There is a need to develop tasty texture-modified nutritious food products for people with mastication and/or swallowing problems. Possible factors for differences in preference between groups, in this study OH and SH, may be related to health status in general and specifically mastication and swallowing functions.
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| 2. |
- Benbenishty, Julie, et al.
(författare)
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Nurse involvement in end-of-life decision making : the ETHICUS Study
- 2006
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Ingår i: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 32:1, s. 129-132
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The purpose was to investigate physicians' perceptions of the role of European intensive care nurses in end-of-life decision making. DESIGN: This study was part of a larger study sponsored by the Ethics Section of the European Society of Intensive Care Medicine, the ETHICUS Study. Physicians described whether they thought nurses were involved in such decisions, whether nurses initiated such a discussion and whether there was agreement between physicians and nurses. The items were analyzed and comparisons were made between different regions within Europe. SETTING: The study took place in 37 intensive care units in 17 European countries. PATIENTS AND PARTICIPANTS: Physician investigators reported data related to patients from 37 centers in 17 European countries. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Physicians perceived nurses as involved in 2,412 (78.3%) of the 3,086 end-of-life decisions (EOLD) made. Nurses were thought to initiate the discussion in 66 cases (2.1%), while ICU physicians were cited in 2,438 cases (79.3%), the primary physician in 328 cases (10.7%), the consulting physician in 105 cases (3.4%), the family in 119 cases (3.9%) and the patient in 19 cases (0.6%). In only 20 responses (0.6%) did physicians report disagreement between physicians and nurses related to EOLD. A significant association was found between the region and responses to the items related to nursing. Physicians in more northern regions reported more nurse involvement. CONCLUSIONS: Physicians perceive nurses as involved to a large extent in EOLDs, but not as initiating the discussion. Once a decision is made, there is a sense of agreement. The level of perceived participation is different for different regions.
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| 3. |
- Bulow, Hans-Henrik, et al.
(författare)
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Are religion and religiosity important to end-of-life decisions and patient autonomy in the ICU? : The Ethicatt study
- 2012
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Ingår i: Intensive Care Medicine. - : Springer. - 0342-4642 .- 1432-1238. ; 38:7, s. 1126-1133
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Tidskriftsartikel (refereegranskat)abstract
- This study explored differences in end-of-life (EOL) decisions and respect for patient autonomy of religious members versus those only affiliated to that particular religion (affiliated is a member without strong religious feelings).In 2005 structured questionnaires regarding EOL decisions were distributed in six European countries to ICUs in 142 hospital ICUs. This sub-study of the original data analyzed answers from Protestants, Catholics and Jews.A total of 304 physicians, 386 nurses, 248 patients and 330 family members were included in the study. Professionals wanted less treatment (ICU admission, CPR, ventilator treatment) than patients and family members. Religious respondents wanted more treatment and were more in favor of life prolongation, and they were less likely to want active euthanasia than those affiliated. Southern nurses and doctors favored euthanasia more than their Northern colleagues. Three quarters of doctors and nurses would respect a competent patient's refusal of a potentially life-saving treatment. No differences were found between religious and affiliated professionals regarding patient's autonomy. Inter-religious differences were detected, with Protestants most likely to follow competent patients' wishes and the Jewish respondents least likely to do so, and Jewish professionals more frequently accepting patients' wishes for futile treatment. However, these findings on autonomy were due to regional differences, not religious ones.Health-care professionals, families and patients who are religious will frequently want more extensive treatment than affiliated individuals. Views on active euthanasia are influenced by both religion and region, whereas views on patient autonomy are apparently more influenced by region.
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| 4. |
- Bülow, Margareta, et al.
(författare)
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Ätstudie med alder respondenter. Acceptants och preferens av konstistensanpassade produkter.
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- SUMMARY In many countries, the proportion of elderly people is growing faster than any other age group. Today, people aged 65 years and over represents 17% of the Swedish population. With aging comes increasing prevalence of diminished taste and smell abilities and impaired function of chewing and swallowing. Many elderly, 30-35% suffers from chewing and swallowing disorders, i.e. dysphagia. Dysphagia has further been reported to affect eating habits, since certain foods can be too difficult to eat. “Sensory design and optimisation of consistency to promote health and comfort in elderly people” is a VINNOVA funded research project. The objective of the project is to gain knowledge on and study how and with which ingredients it is possible to develop innovative and healthy food products with sensory and consistency qualities that are in line with elderly consumers´ need of health and comfort. In one work package, elderly people (living in ordinary home; OH and in special housing; SH) evaluated texture modified meat and carrot products developed within the project. Their health status, chewing and swallowing functions were also studied. Some of the participants were further interviewed about attitudes to food and meals. About 12% in the studied population perceived difficulties in swallowing, most frequently reported in SH. Only 20% of those with impaired function had however been examined. Thereby, the risk of diseases and malnutrition may increase in those people, since texture modified diet has not been offered. The meat- and carrot products in this study were chewed and swallowed with ease. Overall, subjects in SH perceived the meat products easier to chew and swallow, and the carrot products easier to chew in comparison with OH. Possible factors for these differences might be related to health status. The prevalence of impaired swallowing and/or chewing function and prescribed oral drugs were higher in SH. A reduced appetite and prevalence of low BMI were more common in SH compared to OH. For an increasing number of elderly people with diseases related to dysphagia and/or malnutrition development of texture modified food is needed. Men in ordinary home reported mostly changes in attitudes to food and meals, comparing life as working with life as retired. Spending more time at home as retired, resulted in an increased interest in cooking for many of the men. For the elderly living in special housing, the appetite and willingness to try new meals and food products have decreased, comparing life as working with life as retired. Depending on the way of living, the meal times had been more regular and meals were often eaten with others.
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| 5. |
- Sprung, Charles L., et al.
(författare)
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Attitudes of European physicians, nurses, patients, and families regarding end-of-life decisions : the ETHICATT study
- 2007
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Ingår i: Intensive Care Medicine. - Berlin : Springer. - 0342-4642 .- 1432-1238. ; 33:1, s. 104-110
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate attitudes of Europeans regarding end-of-life decisions. DESIGN AND SETTING: Responses to a questionnaire by physicians and nurses working in ICUs, patients who survived ICU, and families of ICU patients in six European countries were compared for attitudes regarding quality and value of life, ICU treatments, active euthanasia, and place of treatment. MEASUREMENTS AND RESULTS: Questionnaires were distributed to 4,389 individuals and completed by 1,899 (43%). Physicians (88%) and nurses (87%) found quality of life more important and value of life less important in their decisions for themselves than patients (51%) and families (63%). If diagnosed with a terminal illness, health professionals wanted fewer ICU admissions, uses of CPR, and ventilators (21%, 8%, 10%, respectively) than patients and families (58%, 49%, 44%, respectively). More physicians (79%) and nurses (61%) than patients (58%) and families (48%) preferred being home or in a hospice if they had a terminal illness with only a short time to live. CONCLUSIONS: Quality of life was more important for physicians and nurses than patients and families. More medical professionals want fewer ICU treatments and prefer being home or in a hospice for a terminal illness than patients and families.
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