Abstract
Thirst is distressing but overlooked by healthcare professionals. Patients experience thirst due to comorbidities, physical or cognitive limitations, and iatrogenesis. Nasogastric tube (NGT) use and nil-by-mouth(NBM) orders are common practices that can lead to thirst. However, thirst in these populations has never been formally studied. We aim to examine prevalence of recognition and treatment of thirst among NGT + NBM and NBM patients. Our descriptive study was conducted intermittently over 25 weeks, across 1.5 years, in 12 adult general medicine wards of a tertiary hospital. Cognitively intact NGT + NBM or NBM inpatients, defined as Abbreviated Mental Test score ≥ 8, were studied. One-time questionnaire was administered. Variables included: demography, co-morbidities, clinical condition, feeding route, thirst defined by thirst distress and/or intensity ≥ 3, pain, hunger and volume status. 88 NGT + NBM and NBM patients were studied. 69.3% suffered from thirst. Thirsty patients experienced significant thirst-related distress (mean score ± SD: 5.7 ± 2.5). Subjects with previous stroke and who were euvolemic tended towards thirst. 13.6% were asked about thirst by doctors or nurses. Thirst was a major source of patient distress in our study. We suggest that thirst needs to be actively identified and targeted to achieve person-centred care.
Highlights
Thirst is distressing but overlooked by healthcare professionals
Median length of stay in hospital was 5 (2–15) days when interviewed, with 29.5% transferred from an intensive care unit (ICU) or a high dependency unit (HD) to the general floor
Subjects in the Nasogastric tube (NGT) + NBM group had stayed in hospital longer and tended to need ICU or HDU care
Summary
Thirst is distressing but overlooked by healthcare professionals. Patients experience thirst due to comorbidities, physical or cognitive limitations, and iatrogenesis. Nasogastric tube (NGT) use and nil-by-mouth(NBM) orders are common practices that can lead to thirst. They are often kept nil-by-mouth (NBM) and if otherwise, often have limited mobility which may restrict their access to oral fluids and further perpetuate their thirst distress. They often breathe through their mouths and dry mouths can cause significant d iscomfort[10]. The positive impact on thirst and lack of increased aspiration risk from Puntillo’s ICU study are assuring, and we feel that that patients on NGT needs to be studied closer for implementation of safe cost-effective interventions for improving quality of life
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