Healthcare Professionals' Perceptions of Feeding Tube Practices for Patients With Head and Neck Cancer Across 4 International Radiation Oncology Departments.
adult
enteral nutrition
experience
head and neck cancer
nutrition support teams
oncology
perspectives
Journal
JPEN. Journal of parenteral and enteral nutrition
ISSN: 1941-2444
Titre abrégé: JPEN J Parenter Enteral Nutr
Pays: United States
ID NLM: 7804134
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
30
05
2019
revised:
16
07
2019
accepted:
17
08
2019
pubmed:
4
9
2019
medline:
4
3
2021
entrez:
4
9
2019
Statut:
ppublish
Résumé
Malnutrition is common and debilitating among patients with head and neck cancer (HNC). A feeding tube (FT) can help to minimize this. However, there is debate on FT use, including whether a reactive nasogastric tube (NGT) or prophylactic gastrostomy tube (PGT) approach is best. This study aimed to explore interdisciplinary healthcare professionals' perspectives of FT practices for patients with HNC, across 4 radiation departments in Australia and the United States. Healthcare professionals involved in the clinical care of patients undergoing radiotherapy for HNC were recruited from 2 radiation-oncology departments in Australia and 2 in the United States. Individual interviews were recorded and analyzed using a grounded theory approach. Seventeen radiation oncologists, 12 nurses, 11 dietitians, and 6 speech pathologists participated. "Perspectives of FTs for patients with HNC" comprised 4 categories: a valued support, more individualized, no universal practice, and PGT vs NGT. "Placement considerations" comprised 6 patient categories (planned treatment, tumor characteristics, nutrition and swallow status, tube-dependence risk, psychosocial status, and patient preferences) and 4 service-structure categories (dietetic access, speech-pathology access, interdisciplinary collaboration, and nutrition-support infrastructure). Although the targeted use of FTs was valued by healthcare professionals, several patient and service-structure factors may influence whether the PGT or reactive NGT approach is perceived to be more efficacious. Further research is needed to explore patient preferences, tube dependence, interdisciplinary collaboration, and department infrastructure to promote consistent evidence-based and patient-centered FT practices.
Sections du résumé
BACKGROUND
Malnutrition is common and debilitating among patients with head and neck cancer (HNC). A feeding tube (FT) can help to minimize this. However, there is debate on FT use, including whether a reactive nasogastric tube (NGT) or prophylactic gastrostomy tube (PGT) approach is best. This study aimed to explore interdisciplinary healthcare professionals' perspectives of FT practices for patients with HNC, across 4 radiation departments in Australia and the United States.
METHODS
Healthcare professionals involved in the clinical care of patients undergoing radiotherapy for HNC were recruited from 2 radiation-oncology departments in Australia and 2 in the United States. Individual interviews were recorded and analyzed using a grounded theory approach.
RESULTS
Seventeen radiation oncologists, 12 nurses, 11 dietitians, and 6 speech pathologists participated. "Perspectives of FTs for patients with HNC" comprised 4 categories: a valued support, more individualized, no universal practice, and PGT vs NGT. "Placement considerations" comprised 6 patient categories (planned treatment, tumor characteristics, nutrition and swallow status, tube-dependence risk, psychosocial status, and patient preferences) and 4 service-structure categories (dietetic access, speech-pathology access, interdisciplinary collaboration, and nutrition-support infrastructure).
CONCLUSION
Although the targeted use of FTs was valued by healthcare professionals, several patient and service-structure factors may influence whether the PGT or reactive NGT approach is perceived to be more efficacious. Further research is needed to explore patient preferences, tube dependence, interdisciplinary collaboration, and department infrastructure to promote consistent evidence-based and patient-centered FT practices.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
796-805Informations de copyright
© 2019 American Society for Parenteral and Enteral Nutrition.
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