Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden.
Department of Paediatric Cancer Centre, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
BMC Pediatr. 2019 Mar 11;19(1):76. doi: 10.1186/s12887-019-1447-1.
Children with cancer often suffer side effects from their treatment, for example nausea and vomiting, which can lead to malnutrition. If a child cannot eat orally, a percutaneous endoscopic gastrostomy (PEG) can improve his or her well-being, psychosocial development and growth by enabling the supply of nourishment and facilitating the administration of necessary medicines. Few data exist on children's comfort when using a PEG. The aim of this study was firstly to develop three versions of a web-based assessment tool in which children, families, and healthcare professionals would be able to register their observations and assessments for evaluating the meal situation when a child has a PEG and secondly to validate the content of the tool.
A qualitative design was chosen with purposive sampling of participants. Five children with cancer, five parents, five registered nurses and five paediatricians participated first in an interview and then in a member check of the web-based tool. The data were analysed with manifest qualitative content analysis.
The results highlighted four categories of issues which needed to be revised in the web-based tool: words which were difficult for the participants to understand, items which contained several questions, items which needed to be split into more items to be answerable and the layout of the questionnaire. The web-based tool was revised according to the categories, and then a member check evaluated and finally confirmed the revisions.
A web-based tool may be able to evaluate the meal situation when a child with cancer has a PEG. The tool may be able to detect early failures of the PEG, facilitating early action from the healthcare professionals in supporting the child and his or her parents in their care of the PEG. In the long run, this web-based tool may also be able to increase the quality of care of children living with a PEG.
癌症患儿在治疗过程中经常会出现副作用,例如恶心和呕吐,这可能导致营养不良。如果儿童无法经口进食,可以通过经皮内镜下胃造口术(PEG)改善其福祉、心理社会发展和生长,从而提供营养并方便施用必要的药物。关于儿童使用 PEG 时的舒适度,相关数据较少。本研究的目的首先是开发三个版本的基于网络的评估工具,使儿童、家庭和医疗保健专业人员能够记录他们的观察和评估结果,以评估儿童使用 PEG 时的进食情况;其次是验证该工具的内容。
采用定性设计,通过目的性抽样选择参与者。5 名癌症儿童、5 名家长、5 名注册护士和 5 名儿科医生首先参与了访谈,然后对基于网络的工具进行了成员检查。使用明显的定性内容分析对数据进行了分析。
结果突出了需要在基于网络的工具中修订的四个类别的问题:参与者难以理解的词语、包含多个问题的项目、需要拆分为可回答的更多项目的项目以及问卷的布局。根据类别修订了基于网络的工具,然后成员检查对修订进行了评估和最终确认。
基于网络的工具可能能够评估患有癌症的儿童使用 PEG 时的进食情况。该工具可能能够及早发现 PEG 的失败,从而促使医疗保健专业人员及早采取行动,为儿童及其父母提供 PEG 护理支持。从长远来看,这种基于网络的工具也可能能够提高儿童 PEG 护理的质量。