期刊论文详细信息
BMC Gastroenterology
Patients’ perspectives of living with a percutaneous endoscopic gastrostomy (PEG)
Pernilla Lagergren3  John Blomberg1  Lena Martin2 
[1]Department of Surgical Gastroenterology, Karolinska University Hospital, Stockholm, Sweden
[2]Department of Clinical Nutrition and Dietetics, Karolinska University Hospital, Stockholm, Sweden
[3]Unit of Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Norra Stationsgatan 67, 2nd floor, SE-171 76 Stockholm, Sweden
关键词: Support;    Nutrition;    Impact;    Experience;   
Others  :  1088665
DOI  :  10.1186/1471-230X-12-126
 received in 2012-05-03, accepted in 2012-08-27,  发布年份 2012
PDF
【 摘 要 】

Background

Since enteral nutrition therapy is the preferred nutritional support for dysphagic patients with a range of diagnoses, PEG has become part of traditional care. However, enteral nutrition with PEG transfers treatment responsibility and activity to the patients and their carers, so the advantages should be discussed. The aim of this study was therefore to investigate patients’ experience of living with a percutaneous endoscopic gastrostomy (PEG) in order to increase the understanding of patients’ need for support.

Method

In a prospective study at Karolinska University Hospital in Sweden, data were collected consecutively at the time of PEG and two months later using a study-specific questionnaire about each patient’s experience of living with a PEG. Fishers exact test was used to test for statistically significant difference at five per cent level.

Results

There were 104 responders (response rate of 70%). Women felt more limited in daily activity compared to men (p = 0.004). Older patients experienced a more limited ability to influence the number of feeding times compared to younger (p = 0.026). Highly educated patients found feeding more time-consuming (p = 0.004). Patients with a cancer diagnosis reported that the PEG feeding interfered with their oral feeding more than patients with a neurological disease (p = 0.009). Patients mostly contacted the PEG outpatient clinic with problems regarding their PEG, and were mainly assisted by their spouse rather than district nurses.

Conclusions

PEG feeding is time-consuming and interferes with daily life. Although 73% was satisfied, patients’ experiences of living with a PEG may be dependent on age, sex, education and diagnosis. Spouses are the main carers for PEG patients at home, and patients prefer to go to the PEG outpatient clinic for help if problems occur.

【 授权许可】

   
2012 Martin et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150121010108300.pdf 181KB PDF download
【 参考文献 】
  • [1]Scoping our practice:The 2004 report of National Confidential Enquiry into Patient Outcome and Death. http://www.ncepod.org.uk/2004report/index.htm webcite
  • [2]Gauderer MW: Percutaneous endoscopic gastrostomy and the evolution of contemporary long-term enteral access. Clin Nutr 2002, 21(2):103-110.
  • [3]Kurien M, McAlindon ME, Westaby D, Sanders DS: Percutaneous endoscopic gastrostomy (PEG) feeding. BMJ 2010, 340:c2414.
  • [4]Bozzetti F, Braga M, Gianotti L, Gavazzi C, Mariani L: Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomised multicentre trial. Lancet 2001, 358(9292):1487-1492.
  • [5]Pirlich M, Schutz T, Norman K, Gastell S, Lubke HJ, Bischoff SC, Bolder U, Frieling T, Guldenzoph H, Hahn K, et al.: The German hospital malnutrition study. Clin Nutr 2006, 25(4):563-572.
  • [6]Braga M, Gianotti L, Nespoli L, Radaelli G, Di Carlo V: Nutritional approach in malnourished surgical patients: a prospective randomized study. Arch Surg 2002, 137(2):174-180.
  • [7]Stratton RJ, Elia M: Who benefits from nutritional support: what is the evidence? Eur J Gastroenterol Hepatol 2007, 19(5):353-358.
  • [8]Scott F, Beech R, Smedley F, Timmis L, Stokes E, Jones P, Roffe C, Bowling TE: Prospective, randomized, controlled, single-blind trial of the costs and consequences of systematic nutrition team follow-up over 12 mo after percutaneous endoscopic gastrostomy. Nutrition 2005, 21(11–12):1071-1077.
  • [9]Katzberg HD, Benatar M: Enteral tube feeding for amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database Syst Rev 2011, 19(1):CD004030.
  • [10]Nugent B, Lewis S, O'Sullivan JM: Enteral feeding methods for nutritional management in patients with head and neck cancers being treated with radiotherapy and/or chemotherapy. Cochrane Database Syst Rev 2010, 17(3):CD007904.
  • [11]Bjuresäter K: Home enteral tube feeding - from patients´, relatives´ and nurses´ perspectives. Karlstad University, Karlstad; 2010.
  • [12]Rogers SN, Thomson R, O'Toole P, Lowe D: Patients experience with long-term percutaneous endoscopic gastrostomy feeding following primary surgery for oral and oropharyngeal cancer. Oral Oncol 2007, 43(5):499-507.
  • [13]Blomberg J, Lagergren P, Martin L, Mattsson F, Lagergren J: Novel approach to antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG): randomised controlled trial. BMJ 2010, 341:c3115.
  • [14]Bozzetti F: Quality of life and enteral nutrition. Curr Opin Clin Nutr Metab Care 2008, 11(5):661-665.
  • [15]Carlsson E: Stroke and eating difficulties. long-term experiences 2004, 13(7):825.
  • [16]Sidenvall B, Nydahl M, Fjellstrom C: The Meal as a Gift-The Meaning of Cooking Among Retired Women. J Appl Gerontol 2000, 19(4):405-423.
  • [17]Orfila F, Ferrer M, Lamarca R, Tebe C, Domingo-Salvany A, Alonso J: Gender differences in health-related quality of life among the elderly: the role of objective functional capacity and chronic conditions. Soc Sci Med 2006, 63(9):2367-2380.
  • [18]Silver HJ, Wellman NS, Arnold DJ, Livingstone AS, Byers PM: Older adults receiving home enteral nutrition: enteral regimen, provider involvement, and health care outcomes. JPEN J Parenter Enteral Nutr 2004, 28(2):92-98.
  • [19]From I, Johansson I, Athlin E: The meaning of good and bad care in the community care: older people's lived experiences. Int J Older People Nurs 2009, 4(3):156-165.
  • [20]Findik UY, Unsar S, Sut N: Patient satisfaction with nursing care and its relationship with patient characteristics. Nurs Health Sci 2010, 12(2):162-169.
  • [21]Morton RP, Crowder VL, Mawdsley R, Ong E, Izzard M: Elective gastrostomy, nutritional status and quality of life in advanced head and neck cancer patients receiving chemoradiotherapy. ANZ J Surg 2009, 79(10):713-718.
  • [22]Rutter CE, Yovino S, Taylor R, Wolf J, Cullen KJ, Ord R, Athas M, Zimrin A, Strome S, Suntharalingam M: Impact of early percutaneous endoscopic gastrostomy tube placement on nutritional status and hospitalization in patients with head and neck cancer receiving definitive chemoradiation therapy. Head Neck 2011, 33(10):1441-1447.
  • [23]Talwar B, Findlay M: When is the optimal time for placing a gastrostomy in patients undergoing treatment for head and neck cancer? Curr Opin Support Palliat Care 2012, 6(1):41-53.
  • [24]Silander E, Nyman J, Bove M, Johansson L, Larsson S, Hammerlid E: Impact of prophylactic percutaneous endoscopic gastrostomy on malnutrition and quality of life in patients with head and neck cancer - a randomized study. Head Neck 2011, 34(1):1-9.
  • [25]Radunovic A, Mitsumoto H, Leigh PN: Clinical care of patients with amyotrophic lateral sclerosis. Lancet Neurol 2007, 6(10):913-925.
  • [26]Terrell JE, Ronis DL, Fowler KE, Bradford CR, Chepeha DB, Prince ME, Teknos TN, Wolf GT, Duffy SA: Clinical predictors of quality of life in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 2004, 130(4):401-408.
  • [27]Bannerman E, Pendlebury J, Phillips F, Ghosh S: A cross-sectional and longitudinal study of health-related quality of life after percutaneous gastrostomy. Eur J Gastroenterol Hepatol 2000, 12(10):1101-1109.
  • [28]Verhoef MJ, Van Rosendaal GM: Patient outcomes related to percutaneous endoscopic gastrostomy placement. J Clin Gastroenterol 2001, 32(1):49-53.
  • [29]Brotherton A, Abbott J, Aggett P: The impact of percutaneous endoscopic gastrostomy feeding upon daily life in adults. J Hum Nutr Diet 2006, 19(5):355-367.
  • [30]Paramsothy S, Papadopoulos G, Mollison LC, Leong RW: Resumption of oral intake following percutaneous endoscopic gastrostomy. J Gastroenterol Hepatol 2009, 24(6):1098-1101.
  • [31]National Collaborating Centre for Acute Care: Nutrition support in adults: Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition. National Institute for Health and Clinical Excellence, London; 2006:175.
  • [32]Kurien M, White S, Simpson G, Grant J, Sanders DS, McAlindon ME: Managing patients with gastrostomy tubes in the community: can a dedicated enteral feed dietetic service reduce hospital readmissions? Eur J Clin Nutr 2012, 66(6):757-760.
  • [33]Mowe M, Bosaeus I, Rasmussen HH, Kondrup J, Unosson M, Rothenberg E, Irtun O, Scandinavian Nutrition G: Insufficient nutritional knowledge among health care workers? Clin Nutr 2008, 27(2):196-202.
  文献评价指标  
  下载次数:2次 浏览次数:6次