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Clinical Nursing Research
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*Endoscopy
*Family Issues
*Nursing Homes
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Percutaneous Endoscopic Gastrostomy Feeding in Nursing Homes

Relatives' Perceptions

Ailsa M. Brotherton

University of Central Lancashire, Preston, UK

Bernie Carter

University of Central Lancashire, Preston, UK

The aim of this study is to explore the experiences of relatives of nursing home residents receiving percutaneous endoscopic gastrostomy feeding. Qualitative methodology using semistructured interviews explores the experiences and perceptions of eight relatives. Data are analyzed using thematic analysis. Four themes are constructed from the data: dependence and resulting disempowerment, having minimal or no involvement in the decision-making process for PEG placement, betrayal, and the losses associated with the social aspects of eating. There is a need for professional education about the psychosocial implications of feeding and an increased level of support for relatives to assist them to develop coping strategies. This will require an expansion of current professional roles to include assessment of individual need, setting of appropriate goals, and the coordination of the provision of multiagency services, likely to include counseling and social support. Further research is required in this field to inform service developments.

Key Words: percutaneous endoscopic gastrostomy feeding • nursing homes • relatives • dependence and loss

References

  • Bannerman, E., Pendlebury, J., Phillips, F., & Ghosh, S. (2000). A cross-sectional and longitudinal study of health-related quality of life after percutaneous gastrostomy. European Journal of Gastroenterology and Hepatology, 12(10), 1101-1109.
  • Brotherton, A., Abbott, J., & Aggett, P. (2006). The impact of percutaneous endoscopic gastrostomy feeding upon daily life in adults. Journal Human Nutrition and Dietetics, 19, 355-367.[CrossRef]
  • Brown, D., McWilliam, C., & Ward-Griffin, C. (2006). Client-centred empowering partnering in nursing. Journal of Advanced Nursing, 53, 160—168.[CrossRef][Medline] [Order article via Infotrieve]
  • Carter, B. (2004). How do you analyse qualitative data? In T. Lavender, G. Edwards, & Z. Alfirevic (Eds.), Demystifying qualitative research in pregnancy and childbirth (pp. 87-108). Shropshire, UK: MA Healthcare Ltd.
  • Cowan, D.T., Roberts, J.D., Fitzpatrick, J.M., While, A.E., & Baldwin, J. (2004). Nutritional status of older people in long term care settings: Current status and future directions. International Journal of Nursing Studies, 41, 225-237.[CrossRef][Medline] [Order article via Infotrieve]
  • Crogan, N.L., Schultz, J.A., Adams, C.E., & Massey, L.K. (2001). Barriers to nutrition care for nursing-home residents. Journal of Gerontological Nursing, 12, 25-31.
  • Davies, D., & Dodd, J. (2002). Qualitative research and the question of rigor. Qualitative Health Research, 12, 279-289.[Abstract/Free Full Text]
  • Department for Constitutional Affairs. (2007 ). Mental Capacity Act 2005: Code of practice. Retrieved from http://www.dca.gov.uk/legal-policy/mental-capacity/mca-cp.pdf
  • Department of Health. (2002). Care homes for older people. National minimum standards. London: Stationery Office.
  • Department of Health. (2005). Long-Term (Neurological) Conditions National Service Framework. London: Stationery Office.
  • Eberhardie, C. (2002). Nutrition and the older adult. Nursing Older People, 14, 22-27.
  • Elia, M. (Ed.). (2003). The `MUST' report: Nutritional screening for adults: A multidisciplinary responsibility: Executive summary. Redditch, UK: Malnutrition Advisory Group of the British Association for Parenteral and Enteral Nutrition.
  • Elia, M., Zellipour, L., & Stratton, R.J. (2005). To screen or not to screen for adult malnutrition? Clinical Nutrition, 24, 867-884.
  • Finucane, T.E., Christmas, C., & Travis, K. (1999). Tube feeding in patients with advanced dementia: A review of the evidence. Journal of the American Medical Association, 282, 1365-1370.[CrossRef]
  • Gillick, M.R. (2000). Rethinking the role of tube feeding in patients with advanced dementia. New England Journal of Medicine, 342, 206-210.[Free Full Text]
  • Hull, M.A., Rawlings, J., Murray, F.E., Field, J., McIntyre, A.S., Mahida, Y.R., Hawkey, C.J., & Allison, S.P. (1993). Audit of outcome of long-term enteral nutrition by percutaneous endoscopic gastrostomy. Lancet, 341, 869-872.[CrossRef][Medline] [Order article via Infotrieve]
  • James, A., Kapur, K., & Hawthorne, A.B. (1998). Long-term outcome of percutaneous endoscopic gastrostomy feeding in patients with dysphagic stroke. Age and Ageing, 27(6), 671-676.[CrossRef]
  • Kellett, U.M. (1999). Transition in care: Family carers' experience of nursing home placement. Journal of Advanced Nursing, 29, 1474-1481.[CrossRef][Medline] [Order article via Infotrieve]
  • Kincheloe, J.L. (2001). Describing the bricolage: Conceptualizing a new rigor in qualitative research. Qualitative Inquiry, 7, 679-692.[Abstract/Free Full Text]
  • King's Fund. (1992). A positive approach to nutrition as treatment (J. Lennard-Jones, Ed.). London: King's Fund Centre.
  • Lauque, S., Arnaud-Battandier, F., Mansourian, R., Guigoz, Y., Paintin, M., Nourhashemi, F., & Vellas, B. (2000). Protein-energy oral supplementation in malnourished nursing-home residents. A controlled trial. Age and Ageing, 29, 51-56.[CrossRef]
  • Lennard-Jones, J.E. (2000). Ethical and legal aspects of clinical hydration and nutritional support. BJU International, 85, 398-403.[CrossRef][Medline] [Order article via Infotrieve]
  • Lewis, C.L., Cox, C.E., Garret, J.M., Hanson, L., Holmes, G.M., Howard, A., et al. (2004). Trends in the use of feeding tubes in North Carolina hospitals, 1989 to 2000. Journal of General Internal Medicine, 19, 1034-1038.[CrossRef][Medline] [Order article via Infotrieve]
  • Light, V.L., Slezak, F.A., Porter, J.A., Gerson, L.W., & McCord, G. (1995). Predictive factors for early mortality after percutaneous endoscopic gastrostomy. Gastrointestinal Endoscopy, 42, 330-335.[CrossRef][Medline] [Order article via Infotrieve]
  • Liley, A.J., & Manthorpe, J. (2003). The impact of home enteral tube feeding in everyday life: A qualitative study. Health and Social Care in the Community, 11, 415-422.[CrossRef]
  • Lindgren, C.L., & Murphy, A.M. (2002). Nurses' and family members' perceptions of nursing-home residents' needs. Journal of Gerontological Nursing, 28, 45-53.
  • McMahon, M.M., Hurley, D., Kamath, P.S., & Mueller, P.S. (2005). Medical and ethical aspects of long-term enteral tube feeding. Mayo Clinic Proceedings, 80, 1461-1476.[Abstract/Free Full Text]
  • McWhirter, J.P., & Pennington, C.R. (1994). Incidence and recognition of malnutrition in hospital. British Medical Journal, 308, 945-948.[Abstract/Free Full Text]
  • Miles, M.B., & Huberman, A.M. (1994). Qualitative data analysis (2nd ed.). Thousand Oaks, CA: Sage.
  • Murphy, L.M., & Lipman, T.O. (2003). Percutaneous endoscopic gastrostomy does not prolong survival in patients with dementia. Archives of Internal Medicine, 163, 1351-1353.[CrossRef]
  • Neel, A.B. (2001). Malnutrition in the elderly: Interactions with drug therapy. Annals of Long-Term Care, 9, 24-30.
  • Norton, B., Homer-Ward, M., Donelly, M.T., Long, R.G., & Holmes, G.K. (1996). A randomised prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding after acute dysphagic stroke. British Medical Journal, 312, 13-16.[Abstract/Free Full Text]
  • Park, R.H., Allison, M.C., Lang, J., Spence, E., Morris, A.J., Danesh, B.J., et al. (1992). Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. British Medical Journal, 304, 1406-1409.[Abstract/Free Full Text]
  • Pennington, C.R. (2002). Nutritional management: When and how should we become involved? Clinical Nutrition, 21, 191-194.
  • Poland, B.D. (1995). Transcription quality as an aspect of rigor in qualitative research. Qualitative Inquiry, 1, 290-310.[Abstract/Free Full Text]
  • Raha, S.K., & Woodhouse, K. (1994). The use of percutaneous endoscopic gastrostomy in 161 consecutive elderly patients. Age and Ageing, 23, 162-163.[CrossRef]
  • Rickman, J. (1998). Percutaneous endoscopic gastrostomy: Psychological effects. British Journal of Nursing, 7(12), 723-729.[Medline] [Order article via Infotrieve]
  • Roberge, C., Tran, M., Massoud, C., Poiree, B., Duval, N., Damecour, E., et al. (2000). Quality of life and home enteral feeding: A French prospective study in patients with head and neck or oesophageal cancer. British Journal of Cancer, 82(2), 263-269.[CrossRef][Medline] [Order article via Infotrieve]
  • Rudberg, M.A., Egleston, B.L., Grant, M.D., & Brody, J.A. (2000). Effectiveness of feeding tubes in nursing-home residents with swallowing disorders. Journal of Parenteral and Enteral Nutrition, 24, 97-102.
  • Ryan, A.A., & Scullion, H.F. (2000a). Family and staff perceptions of the role of families in nursing-homes. Journal of Advanced Nursing, 32(3), 626-634.[CrossRef][Medline] [Order article via Infotrieve]
  • Ryan, A.A., & Scullion, H.F. (2000b). Nursing-home placement: An exploration of the experiences of family carers. Journal of Advanced Nursing, 32(5), 1187-1195.[CrossRef][Medline] [Order article via Infotrieve]
  • Sanders, D.S., Carter, M.J., D'Silva, J., James, G., Bolton, R.P., & Bardhan, K.D. (2000). Survival analysis in percutaneous endoscopic gastrostomy feeding: A worse outcome in patients with dementia. American Journal of Gastroenterology, 95, 1472-1475.[CrossRef]
  • Schneider, S.M., Pouget, I., Staccini, P., Rampal, P., & Hebuterne, X. (2000). Quality of life in long-term home enteral nutrition patients. Clinical Nutrition, 19(1), 23-28.[Medline] [Order article via Infotrieve]
  • Skelly, R.H., Kupfer, R.M., Metcalfe, M.E., Allison, S.P., Holt, M., Hull, M.A., et al. (2002). Percutaneous endoscopic gastrostomy (PEG): Change in practice since 1988. Clinical Nutrition, 21, 389-394.[CrossRef][Medline] [Order article via Infotrieve]
  • Stabell, A., Eide, H., Solheim, G.A., Solberg, K.N., & Rustoen, T. (2004). Nursing-home residents' dependence and independence. Journal of Clinical Nursing, 13, 677-686.[CrossRef][Medline] [Order article via Infotrieve]
  • Stratton, R.J., & Elia, M. (2007). A review of reviews: A new look at the evidence for oral nutritional supplements in clinical practice. Clinical Nutrition Supplements, 2(1), 5-23.
  • Stratton, R.J., Green, C.J., & Elia, M. (2003). Disease-related malnutrition: An evidence-based approach to treatment. Oxon, UK: CABI Publishing.
  • Stroud, M., Duncan, H., & Nightingale, J. (2003). Guidelines for enteral feeding in adult hospital patients. Gut, 52(Suppl. VII), vii1—vii12.[Free Full Text]
  • Tuckett, A. (2005). The care encounter: Pondering caring, honest communication and control. International Journal of Nursing Practice, 11, 77-84.[CrossRef][Medline] [Order article via Infotrieve]
  • Wolfinger, N.H. (2002). On writing fieldnotes: Collection strategies and background expectancies. Qualitative Research, 2, 85-95.[Abstract/Free Full Text]

Clinical Nursing Research, Vol. 16, No. 4, 350-369 (2007)
DOI: 10.1177/1054773807306551
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This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
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Services
Right arrow Email this article to a friend
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Right arrow Similar articles in PubMed
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Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Brotherton, A. M.
Right arrow Articles by Carter, B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Brotherton, A. M.
Right arrow Articles by Carter, B.
Right arrowPubmed/NCBI databases
Medline Plus Health Information
*Endoscopy
*Family Issues
*Nursing Homes
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?