A qualitative study into the impact of fasting within a large tertiary hospital in Australia - the patients' perspective
A qualitative study into the impact of fasting within a large tertiary hospital in Australia - the patients' perspective
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DOI：
10.1111/jocn.12847
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发表时间：
2015-07-01
影响因子：
4.2
通讯作者：
Bloomfield-Stone, Susan
中科院分区：
文献类型：
--
作者：
Carey, Sharon K.;Conchin, Simone;Bloomfield-Stone, Susan
Aims and objectivesThis定性研究旨在探讨禁食的身体和情绪的影响，从patients' perspective.BackgroundFasting患者在医院是常见的做法，一般被视为必要的症状管理或安全的医疗保健规定。负面影响反复或长时间禁食对营养状况的研究，但很少有记录如何禁食影响个别患者的psyche.DesignQualitative描述性设计在一家三级医院在悉尼，Australia.MethodsTwelve连续或间歇性禁食时间延长的患者被邀请参加半结构化访谈1月至2012年9月。访谈问题探讨了每位患者的禁食经历，包括身体和情感影响，对禁食沟通的解释以及重新开始液体或食物的过程。一个归纳性的主题分析approaches.ResultsAnalyses显示了六个主要主题：身体的影响;情感的影响;食物的结构;零口行话;恐惧的食物重新引入;和不满意的不必要的禁食。绝大多数情况下，口渴被认为是禁食对身体最严重的影响。在禁食的最初几天，患者变得情绪化地专注于食物。这迅速消散导致缺乏食欲和恐惧的开始吃again.ConclusionsDiscomfort患者经历的加上缺乏食欲导致长期禁食和困难的食物重新引入加强了减少禁食时间在医院的论点。当患者禁食时，适当的水合作用和建立药物给药的替代途径应该是优先考虑的问题。与临床实践的相关性众所周知，长时间禁食对健康结果有害，但这项研究也显示了禁食可能导致的痛苦。医院系统不足和过时的做法需要用以证据为基础、以患者为中心的治理来取代，解决禁食对身体、情感和心理社会的影响。
Aims and objectivesThis qualitative study aims to explore the physical and emotional impact of fasting from the patients' perspective.BackgroundFasting patients in hospital is common practice and generally viewed as necessary for symptom management or for safety of healthcare provision. Negative impacts of repeated or prolonged fasting on nutritional status have been well researched, but little is documented as to how fasting impacts an individual patient's psyche.DesignQualitative descriptive design within a tertiary hospital in Sydney, Australia.MethodsTwelve patients having had prolonged periods of continuous or intermittent fasting were invited to participate in a semi-structured interview between January-September 2012. Questions for interview explored each patient's experience of fasting, including physical and emotional impacts, interpretation of communication regarding fasting and the process of recommencing on fluids or foods. An inductive thematic analysis approach was used.ResultsAnalyses showed six main themes: physical impacts; emotional impacts; food as structure; nil by mouth as jargon; fear of food re-introduction; and dissatisfaction regarding unnecessary fasting. Overwhelmingly, thirst was reported as the worst physical effect of fasting. In the first few days of fasting, patients became emotionally fixated on food. This quickly dissipated leading to a lack of appetite and fear of starting to eat again.ConclusionsDiscomfort experienced by patients coupled with lack of appetite resulting from prolonged fasting and difficulty with food re-introduction strengthens the argument for reducing fasting times in hospital. When patients are fasted, proper hydration and establishing alternate routes of medication administration should be a priority.Relevance to clinical practiceIt is well recognised that fasting for prolonged periods is detrimental to health outcomes, but this study also shows the distress that fasting can cause. Inadequate hospital systems and out-dated practices need to be replaced with evidence-based, patient-centred governance, addressing the physical, emotional and psychosocial impact of fasting.