School of Life and Medical Sciences, University of Hertfordshire and Therapies Department, North Middlesex University Hospital Trust, Hatfield, Hertfordshire, UK.
School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK.
J Hum Nutr Diet. 2024 Aug;37(4):1050-1060. doi: 10.1111/jhn.13320. Epub 2024 May 22.
Guidelines recommend enteral feeding via gastrostomy should be considered for adult survivors of stroke with dysphagia who cannot eat or drink sufficiently for >4 weeks. Many people continue long-term tube-feeding via this route in the community where healthcare professionals contribute to their care and nutritional management, although little is known about their experiences of or attitudes towards enteral feeding in this situation. The present study aimed to explore the experiences and attitudes of healthcare professionals working with this patient group.
Healthcare professionals were invited to complete a questionnaire devised for the study which comprised closed and open questions about tube-feeding including their patients' participation in feeding processes and mealtimes and how these might be improved. Responses to closed questions were analysed descriptively and free-text responses analysed using thematic analysis.
Fifty-seven participants met the inclusion criteria. They identified patients' quality of life (77% of respondents) and nutritional support (75%) as the most important aspects of tube-feeding. Good communication and training with healthcare teams and carers were considered important. Their patients' participation in tube-feed administration and mealtime involvement were described as variable and potentially beneficial, but both were related to patients' choice and health impairment. Blended tube-feeding was considered an option by 89% provided practical and safety conditions were met.
Participants' experiences of and attitudes towards tube feeding in adults living with stroke in the community in the sample in the present study are varied and focussed on individual patients' needs, safety and professional standards.
指南建议，对于不能进食或饮水超过 4 周的吞咽困难的成年卒中幸存者，应考虑通过胃造口术进行肠内喂养。许多人在社区中通过这种途径长期接受管饲喂养，在此过程中，医护人员为他们提供护理和营养管理，但对于他们在这种情况下对肠内喂养的体验或态度知之甚少。本研究旨在探讨从事这一患者群体工作的医护人员的经验和态度。
邀请医护人员填写为该研究设计的问卷，该问卷包括关于管饲的封闭式和开放式问题，包括他们的患者参与喂养过程和用餐时间，以及如何改善这些问题。对封闭式问题的回答进行描述性分析，对自由文本回答进行主题分析。
57 名参与者符合纳入标准。他们将患者的生活质量（77%的受访者）和营养支持（75%）视为管饲最重要的方面。与医疗团队和护理人员进行良好的沟通和培训被认为是重要的。他们的患者参与管饲管理和用餐时间参与被描述为可变的，并且具有潜在的益处，但两者都与患者的选择和健康受损有关。89%的参与者认为混合管饲是一种选择，但需要满足实际和安全条件。
本研究样本中，社区中成年卒中幸存者的医护人员对管饲的体验和态度各不相同，主要关注患者的个体需求、安全性和专业标准。
