Long-term effects of gastrostomy in elderly patients as observed by nurses

点击翻译按钮获取中文摘要

1. Objective and methodsThe objective of the present study was to elucidate the effects of gastrostomy on elderly patients from the perspective of nurses. An interview on nurses and a questionnaire survey on visiting nurses were conducted.2. Results of the interview survey1) Gastrostomy was performed due to social factors such as discharge and admission to facilities in addition to aspiration and malnutrition.2) The most beneficial effect of gastrostomy was the recovery of oral ingestion.3) Nurses reported that it was difficult to elucidate benefits of gastrostomy to patients in cases where serious postoperative complications occurred, cases where gastrostomy was performed according to the wishes of the family over those of the patient, and cases in which the family no longer paid visits following gastrostomy.3. Results of the questionnaire survey1) Among the 422 visiting nurses surveyed, 151 (35.8%) had provided care for an elderly with a history of gastrostomy who had died within the past year.2) A total of 65.5% of the deceased elderly had already received gastrostomy by the start of visiting nursing. In addition, 35.8% of patients died〓3 years after gastrostomy.3) Common physical signs observed one year before death included dysphagia, increased sputum, and skin problems at the fistula site, while those observed one week before death included constipation, fever, edema, bedsores, contracture, and increased sputum.4. SummaryThe main effect observed by nurses was the recovery of oral ingestion. However, the risks of aspiration and pneumonia increased again up to one year before death. These findings indicate the need to investigate the use of gastrostomy during the terminal phase.