Fairrow A M, McCallum T J, Messinger-Rapport B J
Madonna Hall Nursing Home, Cleveland, Ohio, USA.
Aging Ment Health. 2004 Nov;8(6):530-4. doi: 10.1080/13607860412331303829.
The purpose of this study was to elicit preferences and reasons behind preferences for percutaneous endoscopic gastrostomy (PEG) tube placement in an older African-American sample. Five focus groups were conducted with subjects invited from the Geriatric Clinic of an urban tertiary care hospital. Thematic and latent content analyses were used. Five broad themes emerged as reasons behind the acceptance or rejection of a PEG tube, namely: the nature of the illness; the quality of life at the time of the decision; the concern about dependency; experiences; and religion (including issues of death). The issue of proxy also arose and contained three themes: fear of loss of decision-making ability; trust in family or caregivers as proxy even when the proxy choices differed from their own choices; and trust in the doctor and family to respect personal decisions. Use of a qualitative approach enabled potentially sensitive issues to be discussed. Preferences and the reasons behind these preferences may not always be anticipated by clinicians.
本研究的目的是在一个老年非裔美国人样本中，引出对经皮内镜下胃造口术（PEG）置管的偏好及其背后的原因。我们从一家城市三级护理医院的老年诊所邀请了受试者，开展了五个焦点小组讨论。采用了主题分析和潜在内容分析。出现了五个广泛的主题，作为接受或拒绝PEG管的原因，即：疾病的性质；做决定时的生活质量；对依赖的担忧；经历；以及宗教（包括死亡问题）。代理问题也出现了，包含三个主题：担心失去决策能力；即使代理选择与自己的选择不同，仍信任家人或护理人员作为代理；以及信任医生和家人会尊重个人决定。采用定性方法能够讨论潜在的敏感问题。临床医生可能并不总是能预见到这些偏好及其背后的原因。
