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Title: The lived experience of dietitians' involvement in decision-making related to artificial nutrition and hydration
Author: Tighe, Bernice J.
ISNI:       0000 0004 5992 3547
Awarding Body: University of Warwick
Current Institution: University of Warwick
Date of Award: 2016
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Background Artificial nutrition and hydration (ANH) is the provision of nutrition and/or fluid via artificial means into the gut or into the blood. Decisions about ANH can be difficult and emotive. Dietitians assess patients to recommend whether ANH is indicated, and manage patients once ANH has begun. This research aimed to give voice to dietitians’ experiences of their involvement in decision-making about ANH, by exploring dietitians’ perceptions of their role and exploring how different contexts influenced dietitians’ experiences of decision-making about ANH. Methods Sixteen dietitians were interviewed twice for a qualitative phenomenological study which explored their experiences of decision-making related to ANH. The transcribed interviews were analysed using an interpretive phenomenological framework. Findings Three themes emerged from the data: ‘so much more than just deciding on a feed’; ‘wanting to be heard’; and ‘the emotional roller coaster’. Professional autonomy, being recognised as an expert, and wanting to be involved in decisions were important for all participants. Some participants were involved in decision-making and some implemented decisions made by others. When their professional expertise was not recognised, the emotional experiences were negative. Emotional labour and moral distress were displayed by some. Professionalism was shown by speaking out and acting as moral agents. Some believed that their emotions should not be shown. None of these experiences have been reported by UK dietitians before. Conclusions This study contributes rich and complex new knowledge to the understanding of dietitians’ experiences. These experiences included strong and complex emotional responses and correspondingly complex strategies to cope, which enabled dietitians to protect themselves, colleagues, and patients. Professional identity and challenges to their professionalism were also important aspects of their experiences. This research has expanded the concept of professionalism within dietetics. Implications for practice include the need to develop emotional intelligence and for dietitians to raise their profile by building strong collaborative partnerships with healthcare staff to facilitate their professionalism. Guidance on ethical decision-making for dietitians is required.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RM Therapeutics. Pharmacology