Approaches to Eating and Drinking with Acknowledged Risk: A Systematic Review

Soar, Naomi; Birns, Jonathan; Sommerville, Peter; Lang, Alex; Archer, Sally

doi:10.1007/s00455-020-10107-0

Cited by 13 publications

(11 citation statements)

References 16 publications

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“…Families were involved in decision‐making, but they did not always agree with the health professionals' views. Similar communication breakdowns are reported elsewhere 19,20 . This suggests the need for open dialogue between families and professionals where all available options are discussed and the nature of the decision‐making process is clear, with roles and responsibilities of each party identified 9 …”

Section: Discussionsupporting

confidence: 67%

“…Poor documentation of risk feeding has been previously reported 20,21 . In our previous work, only 25% of children in one specialist school had written feeding plans.…”

Section: Discussionmentioning

confidence: 78%

“…Poor documentation of risk feeding has been previously reported. 20,21 In our previous work, only 25% of children in one specialist school had written feeding plans. In this study, only 38% of reports were written collaboratively and 63% of reports including risk management.…”

Section: Discussionmentioning

confidence: 97%

“…A recent systematic review of evidence for adults with acknowledged risk reported that having a protocol was insufficient; education for all involved in decision-making is required. 20 Family and child feedback must be incorporated for maximum effect. 18 There is little reason to suspect a different situation for children.…”

Section: Discussionmentioning

confidence: 99%

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Health professionals' perceptions of complex feeding decision‐making in school‐aged children

Jackson

Wong

Miles

2021

J Paediatrics Child Health

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Whilst prevalence of paediatric feeding disorders is high amongst children in specialist schools, there is little guidance for professionals supporting families with a child feeding orally with established risk of aspiration. We sought perceptions of the complex feeding decision-making process amongst health professionals supporting families in the specialist school setting in New Zealand. Methods: An observational, cross-sectional, national online survey of speech-language therapists was followed by in-depth interviews with seven health professionals associated with one specialist school. Results: Survey responses from 32 speech-language therapists showed inconsistency in assessment processes and how family, children and school staff are involved in feeding decisions, with 71% reporting a doctor had been involved. Respondents were not confident in their ability to predict aspiration risk, with 41% reporting that they could often determine risk, 41% sometimes and 16% never. Sixty-three percent of respondents indicated that level of risk was written in a report for a child and 50% reported that every child at high risk had a management plan. Speechlanguage therapists valued professional supervision, but it was not always available. Health professionals were broadly positive about the collaborative nature of decision-making in most but not all situations. They described communication, access/institutional and emotional barriers to timely, shared decision-making. Conclusion: These findings demonstrate variability in how families are supported to make complex feeding decisions. Health professionals identified a need for clearer processes and strengthened communication between family, school and health professionals. Trusting relationships are critical if all families are to be well-supported.

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Section: Discussionsupporting

confidence: 67%

“…Poor documentation of risk feeding has been previously reported 20,21 . In our previous work, only 25% of children in one specialist school had written feeding plans.…”

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Health professionals' perceptions of complex feeding decision‐making in school‐aged children

Jackson

Wong

Miles

2021

J Paediatrics Child Health

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“…Es interesante que el volumen del bolo, más que su consistencia, sabor o temperatura, tiene un efecto diferencial en la función respiratoria 4 . En cuanto al soporte nutricional, el artículo provee una tabla sobre alimentos que se pueden administrar en forma de papillas, la cual será de utilidad para la práctica clínica en el manejo de nuestros pacientes 5 . Concluyen los autores la necesidad de una adecuada evaluación inicial para caracterizar la causa específica de la disfagia orofaríngea y poder personalizar el tratamiento, pero con un enfoque multidisciplinario 6 .…”

unclassified

Disfagia orofaríngea, náuseas y vómito crónicos, terapias alternativas y complementarias en trastornos de la interacción intestino-cerebro... en los tiempos del coronavirus

Schmulson-Wasserman¹,

Saps²

2022

NGL

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A shared decision‐making model about care for people with severe dementia: A qualitative study based on nutrition and hydration decisions in acute hospitals

Anantapong

Sampson

Davies

2023

Int J Geriat Psychiatry

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Objectives: To understand the decision-making processes regarding eating and drinking for hospital patients with severe dementia and use this data to modify a decision-making model about care for people with severe dementia. Methods:From January to May 2021, qualitative semi-structured interviews were conducted with 29 family carers and hospital staff in England who cared for people with severe dementia during hospital admissions. Interviews were transcribed verbatim and analysed using codebook thematic analysis. Results:We demonstrated a modified decision-making model consisting of six stages of the decision-making process: (i) identify a decision to be made; (ii) exchange information and recognise emotions; (iii) clarify values and preferences of all involved; (iv) consider feasibility of each choice; (v) share preferred choice and make a final decision; and (vi) deliver the decision, monitor outcomes and renegotiation.From this study, decision-making needed to be shared among all people involved and address holistic needs and personal values of people with dementia and family carers. However, hospital staff often made assumptions about the persons' ability to eat and drink without adequate consultation with family carers. The process was impacted by ward culture, professional practice, and legal framework, which might overlook cultural and personal beliefs of the persons and families. Treatment escalation plans could help inform stepwise treatments, create realistic expectations, and guide future decisions. Conclusions:Our decision-making model provides clear stages of decision-making processes and can be used to guide clinical practice and policy around care decisions for eating and drinking, which is often poorly supported.

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Approaches to Eating and Drinking with Acknowledged Risk: A Systematic Review

Cited by 13 publications

References 16 publications

Health professionals' perceptions of complex feeding decision‐making in school‐aged children

Health professionals' perceptions of complex feeding decision‐making in school‐aged children

Disfagia orofaríngea, náuseas y vómito crónicos, terapias alternativas y complementarias en trastornos de la interacción intestino-cerebro... en los tiempos del coronavirus

A shared decision‐making model about care for people with severe dementia: A qualitative study based on nutrition and hydration decisions in acute hospitals

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