Evidence map›Paper›PMID 40095086›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025

The use of artificial nutrition at the end-of-life: a cross-sectional survey exploring the beliefs and decision-making among physicians and nurses.

Christophe Pala, Claudia Gamondi, Steffen Eychmuller, Francois Herrmann, Sophie Pautex

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Delivering Palliative Care in Mental Health Nursing Settings: A Systematic Review.Journal of psychiatric and mental health nursing · 2026
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Christophe PalaDepartment of Rehabilitation and Geriatrics, Division of Palliative Medicine, Geneva University Hospitals, 11 Chemin de La Savonnière, 1245 Collonge-Bellerive, Geneve, Switzerland. christophe.pala@hug.ch.ORCID http://orcid.org/0009-0005-4324-1319
Claudia GamondiPalliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID http://orcid.org/0000-0002-1537-9055
Steffen EychmullerUniversity Centre for Palliative Care, Inselspital, University Hospital Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0003-1734-2237
Francois HerrmannDepartment of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.ORCID http://orcid.org/0000-0003-1312-1517
Sophie PautexDepartment of Rehabilitation and Geriatrics, Division of Palliative Medicine, Geneva University Hospitals and Faculty of Medicine, Geneve, Switzerland.ORCID http://orcid.org/0000-0001-7248-3513

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of artificial nutrition in the last month of life raises many concerns for patients, relatives, and healthcare professionals.

aimTo describe physicians and nurses' beliefs, knowledge, and decision-making related to introducing and withdrawing artificial nutrition at the end-of-life. Physicians and nurses' factors affecting these decisions were examined.

designA cross-sectional study was conducted between May and July 2022. A questionnaire was sent by email to physicians and nurses. SETTING AND

participantsPhysicians and nurses working in internal medicine, oncology, and palliative medicine divisions in three Swiss University Hospitals.

resultsTwo hundred and thirty physicians and nurses completed the survey (21% response rate). Most responders, aged 25-45, were women with < 10 years of experience, 61% lacked palliative care experience. End-of-life decision-making on artificial nutrition was reported as common by 89%. Whereas physicians and nurses played an important role in the decision, fulfilling patients' wishes (84% of cases) tended to dominate over professionals' intentions (physicians 52%, nurses 67%) as motivators at final decision. The main reasons for introducing artificial nutrition included improving nutritional status (54%), reducing broncho-aspiration (67%), and preventing pressure ulcers (53%). Having palliative care experience was the only variable modifying the beliefs of these motivations.

conclusionWhereas decisions on artificial nutrition at the end of life are common they may be mostly guided by physicians and nurses' beliefs, and patients' requests more than by robust evidence. Fostering palliative care education is pivotal. Our results emphasize the need to improve physicians and nurses' awareness of the complex interplay between values and evidence when decisions concerning artificial nutrition are taken.

Indexed as

Attitude of Health PersonnelDecision MakingHealth Knowledge, Attitudes, PracticeNursesNutritional SupportPhysiciansTerminal CareAdultCross-Sectional StudiesFemaleHumansMaleMiddle AgedPalliative CareSurveys and QuestionnairesSwitzerlandArtificial feeding/nutritionAttitude of health personnelEnd-of-lifeHealth personnel knowledgePalliative careTerminal care

Identifiers

PMID40095086
PMCPMC11914226

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.