Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria.
S Afr J Commun Disord. 2024 Feb 12;71(1):e1-e11. doi: 10.4102/sajcd.v71i1.970.
Speech-language therapists (SLTs) may recommend tube feeding even with minimal research evidence of its effectiveness, and an understanding of SLTs' perceived practices is warranted.
To qualitatively describe a sample of South African SLTs' perceived practices regarding feeding tube placement in people with advanced dementia.
Semi-structured online interviews were conducted via Microsoft Teams. Eight South African SLTs with a particular interest in advanced dementia, in public and private settings, were recruited. Data were analysed using inductive reflexive thematic analysis.
Three main themes were identified: (1) factors influencing SLTs' decisions for feeding tube placement in people with advanced dementia; (2) nature of clinical setting and SLTs' decision-making and (3) SLTs' considerations to improve management of people with advanced dementia. Existing local palliative care guidelines were not employed in decisions about tube feeding. Most participants did not recommend tube feeding during end-of-life care. Perceived burden of care influenced participants' decisions about tube feeding.
Speech-language therapists in South Africa likely have an increased reliance on clinical experience rather than recent research and guidelines for decisions about feeding tube placement. Findings accentuate the importance of clinical supervision, mentoring and continuous professional development in the workplace. The findings are an urgent call to action to improve SLTs' overall practices and ethical service delivery for people with advanced dementia and their families.Contribution: Factors and needs regarding SLTs' decision-making about feeding tubes in people with advanced dementia are highlighted.
言语治疗师（SLT）可能会推荐管饲，即使其有效性的研究证据很少，而且了解 SLT 的感知实践是有必要的。
定性描述南非一组 SLT 对晚期痴呆患者置管喂养的感知实践。
通过 Microsoft Teams 进行半结构化在线访谈。招募了 8 名对晚期痴呆症特别感兴趣的南非 SLT，他们分别来自公共和私人环境。使用归纳性反思主题分析对数据进行分析。
确定了三个主要主题：（1）影响 SLT 对晚期痴呆患者进行置管喂养决策的因素；（2）临床环境的性质和 SLT 的决策；（3）SLT 改善对晚期痴呆患者管理的考虑因素。当地现有的姑息治疗指南并未用于管饲决策。大多数参与者不建议在生命末期护理期间进行管饲。护理负担的感知影响了参与者关于管饲的决定。
南非的言语治疗师可能更加依赖临床经验，而不是最近的研究和指南来决定是否进行管饲。研究结果强调了临床监督、指导和在职持续专业发展的重要性。研究结果迫切需要采取行动，以改善 SLT 对晚期痴呆症患者及其家属的整体实践和道德服务提供。
突出了 SLT 在决定晚期痴呆患者置管喂养时的因素和需求。
