Caregiver Preference for Tube Feeding in Community-Dwelling Persons with Severe Dementia.
Aged
Aged, 80 and over
Caregivers
/ psychology
Decision Making
Enteral Nutrition
/ psychology
Female
Health Knowledge, Attitudes, Practice
Humans
Independent Living
/ psychology
Intubation, Gastrointestinal
/ psychology
Male
Patient Preference
/ psychology
Qualitative Research
Quality of Life
Singapore
community dwelling
decision-making
qualitative
severe dementia
tube feeding
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
24
01
2020
revised:
11
05
2020
accepted:
11
05
2020
pubmed:
20
6
2020
medline:
11
3
2021
entrez:
20
6
2020
Statut:
ppublish
Résumé
Evidence suggests that tube feeding persons with severe dementia (PWSDs) does not improve survival or quality of life, yet many continue to be tube fed. Reasons why caregivers choose to do so are not entirely understood. To understand what shapes caregiver preference toward nasogastric (NG) tube feeding for community-dwelling PWSDs. A qualitative study that employed semistructured interviews. Primary informal caregivers of community-dwelling persons diagnosed with dementia Functional Assessment Staging Test (FAST) stage 7 in Singapore. Caregivers participated in qualitative in-depth interviews during which their preferences toward NG tube feeding of PWSDs were explored. We used principles of reflexive thematic analysis to compare caregivers who expressed a preference for NG tube feeding with those who did not prefer it. We interviewed 27 caregivers of PWSDs. Most caregivers, 67% (n = 18), expressed a preference for tube feeding. We conceptualized four main themes describing what shapes caregiver preference toward NG tube feeding: (1) willingness to use tube feeding to prolong life at the expense of suffering, (2) deference to healthcare provider's (HCP's) recommendation, (3) caregiver knowledge of alternatives to tube feeding, and (4) caregivers' internal and external conflicts. Results from this study highlight the need for new inclusive approaches to shared decision-making between HCPs and caregivers regarding tube feeding for community-dwelling PWSDs. J Am Geriatr Soc 68:2264-2269, 2020.
Sections du résumé
BACKGROUND
Evidence suggests that tube feeding persons with severe dementia (PWSDs) does not improve survival or quality of life, yet many continue to be tube fed. Reasons why caregivers choose to do so are not entirely understood.
OBJECTIVE
To understand what shapes caregiver preference toward nasogastric (NG) tube feeding for community-dwelling PWSDs.
DESIGN
A qualitative study that employed semistructured interviews.
SETTING AND SUBJECTS
Primary informal caregivers of community-dwelling persons diagnosed with dementia Functional Assessment Staging Test (FAST) stage 7 in Singapore.
METHODS
Caregivers participated in qualitative in-depth interviews during which their preferences toward NG tube feeding of PWSDs were explored. We used principles of reflexive thematic analysis to compare caregivers who expressed a preference for NG tube feeding with those who did not prefer it.
RESULTS
We interviewed 27 caregivers of PWSDs. Most caregivers, 67% (n = 18), expressed a preference for tube feeding. We conceptualized four main themes describing what shapes caregiver preference toward NG tube feeding: (1) willingness to use tube feeding to prolong life at the expense of suffering, (2) deference to healthcare provider's (HCP's) recommendation, (3) caregiver knowledge of alternatives to tube feeding, and (4) caregivers' internal and external conflicts.
CONCLUSION
Results from this study highlight the need for new inclusive approaches to shared decision-making between HCPs and caregivers regarding tube feeding for community-dwelling PWSDs. J Am Geriatr Soc 68:2264-2269, 2020.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2264-2269Informations de copyright
© 2020 The American Geriatrics Society.
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