School of Health and Welfare, Halmstad University, Halmstad, Sweden.
Regional Habilitation Centre, Region Halland, Kungsbacka, Sweden.
Disabil Rehabil. 2020 Sep;42(19):2747-2757. doi: 10.1080/09638288.2019.1573383. Epub 2019 Feb 14.
Everyday routines play a vital role in child functioning and development. This study explored health professionals' documentation of everyday life and health care during the first year following gastrostomy tube placement in children and the content of intervention goals. The medical records of 39 children (median age 38 months, min-max: 15-192) in one region of Sweden were analysed. A content analysis approach was used with an inductive qualitative analysis supplemented by a deductive, quantitative analysis of documented intervention goals following the ICF-CY. One overall theme, "Seeking a balance", captured the view of life with a gastrostomy and the health care provided. Two categories, "Striving for physical health" and "Depicting everyday life" with seven sub-categories, captured the key aspects of the documentation. Twenty-one children (54%) had intervention goals related to the gastrostomy, and these goals primarily focused on the ICF-CY component "Body functions". To some extent the medical records reflected different dimensions of everyday life, but the intervention goals clearly focused on bodily aspects. Understanding how health care for children using a gastrostomy is documented and planned by applying an ecocultural framework adds a valuable perspective and can contribute to family-centred interventions for children using a gastrostomy.Implications for RehabilitationThere is a need for increased awareness in healthcare professionals for a more consistent and holistic healthcare approach in the management of children with gastrostomy tube feeding.This study suggests that an expanded focus on children's participation in everyday mealtimes and in the healthcare follow-up of gastrostomy tube feeding is important in enhancing the intervention outcome.Multidisciplinary teams with a shared bio-psycho-social understanding of health would contribute to a situation in which the everyday lives of households adapt to living with gastrostomy.Routine care for children with gastrostomy should follow a checklist combining crucial physiological aspects of gastrostomy tube feeding with seemingly mundane family functions in order to achieve a successful gastrostomy tube feeding intervention.
日常生活在儿童功能和发展中起着至关重要的作用。本研究探讨了健康专业人员在儿童胃造口管放置后第一年记录日常生活和医疗保健的情况，以及干预目标的内容。对瑞典一个地区的 39 名儿童（中位数年龄 38 个月，最小-最大：15-192）的病历进行了分析。采用内容分析法，结合对 ICF-CY 之后记录的干预目标进行的归纳定性分析和演绎定量分析。一个总体主题“寻求平衡”捕捉到了胃造口和所提供的医疗保健的生活观。两个类别，“努力保持身体健康”和“描绘日常生活”，有七个子类别，捕捉到了记录的关键方面。21 名儿童（54%）有与胃造口相关的干预目标，这些目标主要集中在 ICF-CY 组成部分“身体功能”上。在某种程度上，病历反映了日常生活的不同方面，但干预目标显然侧重于身体方面。在应用生态文化框架记录和规划接受胃造口术的儿童的医疗保健时，理解这一点增加了一个有价值的视角，并有助于为接受胃造口术的儿童提供以家庭为中心的干预措施。
康复的意义
医疗保健专业人员需要提高认识，以便在管理接受胃造口管喂养的儿童时采取更一致和全面的医疗保健方法。
这项研究表明，扩大关注儿童参与日常进餐和胃造口管喂养的医疗保健随访对于提高干预效果非常重要。
具有生物心理社会健康共同理解的多学科团队将有助于使家庭生活适应胃造口术的情况。
接受胃造口术的儿童的常规护理应遵循一个检查表，该检查表将胃造口管喂养的关键生理方面与看似平凡的家庭功能结合起来，以实现成功的胃造口管喂养干预。
