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医疗保健专业人员对启动不同家庭肠内喂养方式的看法和经验。

Health care professionals' perceptions and experience of initiating different modalities for home enteral feeding.

作者信息

Ang Shin Yuh, Lim Siew Hoon, Lim Mei Ling, Ng Xin Ping, Madeleine Lam, Chan Mei Mei, Lopez Violeta

机构信息

Division of Nursing, Singapore General Hospital, Singapore.

Neuroscience Research Australia, Australia.

出版信息

Clin Nutr ESPEN. 2019 Apr;30:67-72. doi: 10.1016/j.clnesp.2019.02.005. Epub 2019 Feb 23.

Abstract

BACKGROUND

With an aging population, there is a concomitant increase in number of patients with dysphagia; and hence increase in prevalence of enteral feeding. Health care professionals play a critical role in informing decisions of patients and caregivers on their choice of modality for long-term home enteral feeding.

AIMS

To explore the perceptions of health care professionals on different modalities for enteral feeding and their experiences in initiating long-term enteral feeding among adult patients.

METHODS

A qualitative explorative descriptive study design with purposive sampling approach was adopted. A total of four speech therapists, fifteen nurses and seven doctors who were ever involved in initiating long term home enteral tube feeding were recruited over a data collection period of August to December 2017. One to one interviews were conducted and audio-recorded. An inductive content analysis approach, with open coding, creation of categories and abstraction of data was adopted.

RESULTS

Four main themes were generated: (1) Naso-gastric Tube Feeding (NGT) is health care professionals' first choice of modality; (2) Percutaneous Endoscopic Gastrostomy Tube Feeding (PEG) is regarded as an alternative approach; (3) Perceived better outcomes with PEG; and (4) Identified barriers to promotion of PEG.

CONCLUSION

NGT remained as the modality of choice although health care professionals perceived that patients will have better outcomes with the use of PEG.

摘要

背景

随着人口老龄化,吞咽困难患者数量随之增加,肠内营养的患病率也相应上升。医疗保健专业人员在告知患者及其护理人员有关长期家庭肠内营养方式选择的决策方面发挥着关键作用。

目的

探讨医疗保健专业人员对不同肠内营养方式的看法以及他们在成年患者中启动长期肠内营养的经验。

方法

采用定性探索性描述性研究设计和目的抽样方法。在2017年8月至12月的数据收集期间,共招募了4名言语治疗师、15名护士和7名曾参与启动长期家庭肠内管饲的医生。进行一对一访谈并录音。采用归纳性内容分析方法,包括开放编码、类别创建和数据抽象。

结果

产生了四个主要主题:(1)鼻胃管喂养(NGT)是医疗保健专业人员的首选方式;(2)经皮内镜下胃造口管喂养(PEG)被视为一种替代方法;(3)认为PEG效果更好;(4)确定了推广PEG的障碍。

结论

尽管医疗保健专业人员认为使用PEG患者会有更好的结果,但NGT仍然是首选方式。

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