A survey of the reasons patients do not chose percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) as a route for long-term feeding
A survey of the reasons patients do not chose percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) as a route for long-term feeding
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DOI：
10.1111/j.1365-2702.2010.03541.x
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发表时间：
2011-03-01
影响因子：
4.2
通讯作者：
Watson, Roger
中科院分区：
文献类型：
--
作者：
Lin, Li-Chan;Li, Mei-Hui;Watson, Roger
目的：调查患者为何不选择经皮内镜下胃造口术或经皮内镜下空肠造口术作为长期喂养的途径。背景：家庭肠内管饲被公认为是出院后需要营养支持的患者的一种有价值的治疗选择。台湾出院并接受家庭肠内管饲的患者数量每年都在增加。设计。一项横断面研究。方法。参与者（n = 607）选自台北的一家独立家庭护理机构和三个医院家庭护理部门。在家访之前，我们对患者的记录进行了审查，以收集人口统计数据、医疗诊断、家庭护理时间和插管时间。家访时进行了面对面访谈。调查结果。家庭肠内管饲的流行率为 70 中心点 3%（n = 427）。在 427 名管饲受试者中，93 名中心点（4%）接受鼻胃管喂养。拒绝使用经皮内镜下胃造口术或经皮内镜下空肠造口术的最常见原因是“年龄太大，无法接受手术”、“担心进行经皮内镜下胃造口术后伤口感染或渗漏”和“为了保持受试者的身体完整性”。中风、无痴呆、日常生活活动能力差和认知状态差是管饲的显着预测因素，而较高的教育程度和较好的认知状态是使用经皮内镜胃造口术或经皮内镜空肠造口术的显着预测因素。结论：患者拒绝使用经皮内镜胃造口术或经皮内镜空肠造口术的原因反映了文化价值观和患者教育水平的影响，家庭保健护士需要与患者讨论这些因素。细节。与临床实践的相关性。建议护士调查患者对台湾文化中“身体”含义的看法以及与家庭肠内喂养相关的决策过程，以便护士在选择家庭肠内喂养时提供更好的护理和支持。
Aims.To investigate why patients do not choose percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy as a route for long-term feeding.Background.Home enteral tube feeding is well recognised as a valuable therapeutic option for patients requiring nutritional support following discharge from hospital. The number of patients discharged from hospital and receiving home enteral tube feeding increases annually in Taiwan.Design.A cross-sectional study.Method.Participants (n = 607) were chosen from one free-standing home care agency and three hospital-based home care departments in Taipei. A review of the patients' records to gather demographic data, medical diagnosis, length of home care and length of intubation prior to the home visit was conducted. A face-to-face interview was conducted at the time of the home visit.Findings.The prevalence rate of home enteral tube feeding was 70 center dot 3% (n = 427). Of the 427 tube-fed subjects, 93 center dot 4% were fed with a nasogastric tube. The most common reasons for refusing to use percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy were 'too old to suffer from an operation', 'worried about wound infection or leakage after performing percutaneous endoscopic gastrostomy' and 'to keep subjects' body integrity'. Stroke, no dementia, poor activities of daily living and poor cognitive status were significant predictors of being tube-fed, while higher education and better cognitive status were significant predictors of percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy use.Conclusion.The reasons patients refused to use percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy reflect the influence of cultural values and the level of patients' education, which home health care nurses need to discuss with patients in detail.Relevance to clinical practice.Investigating patients' perspective on the meaning of 'body' in Taiwanese culture and the decision-making processes related to home enteral tube feeding is recommended for nurses to provide better care and support when home enteral tube feeding in an option.