Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-19917
Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: The associations of palliative care experts regarding food refusal : a cross-sectional study with an open question evaluated by triangulation analysis
Authors: Fringer, André
Stängle, Sabrina
Büche, Daniel
Ott, Stefan Ch.
Schnepp, Wilfried
et. al: No
DOI: 10.1371/journal.pone.0231312
10.21256/zhaw-19917
Published in: PLOS ONE
Volume(Issue): 15
Issue: 4
Page(s): e0231312
Issue Date: Apr-2020
Publisher / Ed. Institution: Public Library of Science
ISSN: 1932-6203
Language: English
Subject (DDC): 610.73: Nursing
Abstract: Introduction: Health professionals in oncologic and palliative care settings are often faced with the problem that patients stop eating and drinking. While the causes of food refusal are very different, the result is often malnutrition, which is linked to health comorbidities and a high mortality rate. However, the professionals lack the time and knowledge to clarify the cause for each patient. What associations do health professionals have when faced with food refusal? Objective: To investigate the associations that health professionals in oncological and palliative settings have about denied eating behavior. Methods: A cross-sectional study, starting with an open question focusing professionals’ associations regarding food refusal. The results were inductively analyzed, whereby generic categories were developed. Subsequently, the categories were transformed into quantitative data to calculate the relationships between the categories. Results: A total of 350 out of 2000 participants completed the survey, resulting in a response rate of 17.5%. Food refusal is primarily associated with physical and ethical aspects and with endof-life. Half of the participants frequently find that patients refuse to eat. The attitudes show that the autonomy of the patient is the highest good and is to be respected. Even in the case of patients with limited decision-making capacity, the refusal to eat is acceptable. Conclusion: Clarifying the cause of food refusal requires a great deal of knowledge and is strongly influenced by the associations of health professionals. While the associations have very negative connotations, information and training is needed to make professionals aware of this and to change their associations. With this knowledge and in an interprofessional cooperation, mis-labelling of patient settings can be avoided and fears can be reduced
URI: https://digitalcollection.zhaw.ch/handle/11475/19917
Fulltext version: Published version
License (according to publishing contract): CC BY 4.0: Attribution 4.0 International
Departement: School of Health Sciences
Organisational Unit: Institute of Nursing (IPF)
Published as part of the ZHAW project: Voluntary Stopping of Eating and Drinking (VSED) in Switzerland from different points of view
Appears in collections:Publikationen Gesundheit

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Fringer, A., Stängle, S., Büche, D., Ott, S. Ch., & Schnepp, W. (2020). The associations of palliative care experts regarding food refusal : a cross-sectional study with an open question evaluated by triangulation analysis. Plos One, 15(4), e0231312. https://doi.org/10.1371/journal.pone.0231312
Fringer, A. et al. (2020) ‘The associations of palliative care experts regarding food refusal : a cross-sectional study with an open question evaluated by triangulation analysis’, PLOS ONE, 15(4), p. e0231312. Available at: https://doi.org/10.1371/journal.pone.0231312.
A. Fringer, S. Stängle, D. Büche, S. Ch. Ott, and W. Schnepp, “The associations of palliative care experts regarding food refusal : a cross-sectional study with an open question evaluated by triangulation analysis,” PLOS ONE, vol. 15, no. 4, p. e0231312, Apr. 2020, doi: 10.1371/journal.pone.0231312.
FRINGER, André, Sabrina STÄNGLE, Daniel BÜCHE, Stefan Ch. OTT und Wilfried SCHNEPP, 2020. The associations of palliative care experts regarding food refusal : a cross-sectional study with an open question evaluated by triangulation analysis. PLOS ONE. April 2020. Bd. 15, Nr. 4, S. e0231312. DOI 10.1371/journal.pone.0231312
Fringer, André, Sabrina Stängle, Daniel Büche, Stefan Ch. Ott, and Wilfried Schnepp. 2020. “The Associations of Palliative Care Experts Regarding Food Refusal : A Cross-Sectional Study with an Open Question Evaluated by Triangulation Analysis.” Plos One 15 (4): e0231312. https://doi.org/10.1371/journal.pone.0231312.
Fringer, André, et al. “The Associations of Palliative Care Experts Regarding Food Refusal : A Cross-Sectional Study with an Open Question Evaluated by Triangulation Analysis.” Plos One, vol. 15, no. 4, Apr. 2020, p. e0231312, https://doi.org/10.1371/journal.pone.0231312.


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