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. 2025 Jun;38(3):e70060.
doi: 10.1111/jhn.70060.

Healthcare Professionals' Knowledge, Attitudes and Practices Toward Providing Artificial Nutrition and Hydration for Patients With Terminal Cancer

Beatri Coetzee  1 , Daan G Nel  2 , Janicke Visser  1
Affiliations

Healthcare Professionals' Knowledge, Attitudes and Practices Toward Providing Artificial Nutrition and Hydration for Patients With Terminal Cancer

Beatri Coetzee et al. J Hum Nutr Diet. 2025 Jun.

Abstract

Background: Decisions related to artificial nutrition and hydration (ANH) provision for patients with terminal cancer are a complex topic that can affect the patients' quality of life (QoL). This study aimed to investigate the knowledge, attitudes and practices of healthcare professionals (HCPs) in South Africa concerning the provision of ANH for patients with terminal cancer.

Methods: This descriptive, cross-sectional study with an analytical component, involved doctors, nurses and dietitians experienced in caring for patients with terminal cancer. Data were collected via an electronic platform (n = 151), utilising a validated questionnaire with close-ended questions. Statistical analysis was performed using Statistica Version 14.0, with p < 0.05 indicating statistical significance.

Results: Notable disparities were observed in HCPs' knowledge, attitudes and practices related to ANH provision. Participants demonstrated a high level of knowledge about palliative care (PC) (92%) but scored lower for ANH provision (56%). Most participants were aware of the burdens associated with ANH provision (mean score: 4.1 ± 0.7 [5-point Likert scale]), yet optimism emerged regarding its perceived psychological benefits. Factors such as patient autonomy (4.5 ± 0.8) and communication between the medical team and patients (4.4 ± 1.0) appeared to influence HCPs' practices. Furthermore, a notable difference was observed in knowledge scores and attitudes based on certain socio-demographic variables.

Conclusion: This study suggests that HCPs have inadequate knowledge about, and contradictory attitudes toward, ANH provision in patients with terminal cancer. The study highlights the need for targeted education on terminal care, thereby informing efforts to improve the overall quality of care of these patients.

Keywords: artificial nutrition and hydration; attitudes; healthcare professionals; knowledge; practices; terminal cancer.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Stages during which referral to a dietitian takes place (n = 99). NIS, nutrition impact symptoms.
See this image and copyright information in PMC

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