Nasogastric tube feeding under physical restraint: understanding the effects on parents and how to support them
Sarah Fuller1, Sharon Thomson2, Dasha Nicholls3
1Child and Adolescent Mental Health, Northamptonshire Healthcare NHS Foundation Trust, Northampton, England.
Insights
Parents found nasogastric tube (NGT) feeding with physical restraint traumatic, experiencing relief and shame. Understanding the necessity did not negate the distress, highlighting the need for trauma-informed care for children requiring NGT feeding.
Area of Science:
- Pediatric care
- Clinical psychology
- Child psychiatry
Background:
- Nasogastric tube (NGT) feeding under physical restraint is a critical intervention for medically unstable children with restrictive eating.
- This intervention is often necessary for children experiencing severe eating disorders or medical conditions impacting nutrition.
- Parental experiences during this process are crucial for understanding the holistic impact of such treatments.
Purpose of the Study:
- To explore parental experiences of children undergoing nasogastric tube (NGT) feeding with physical restraint.
- To understand the emotional and psychological effects of this intervention on parents.
- To identify potential areas for improving support for families during NGT feeding.
Main Methods:
- Secondary analysis of qualitative data from two prior studies involving NGT feeding under physical restraint.
- Thematic analysis of 31 semi-structured interview transcripts from parents.
- Data synthesis from both mental health and children's ward settings.
Main Results:
- Parents reported complex emotions, including relief and shame, regarding NGT feeding with restraint.
- Despite understanding the medical necessity, parents found the intervention traumatic.
- Some parents experienced strained relationships with staff, with a few actively participating in restraining their child.
Conclusions:
- Nursing staff must recognize the significant distress parents experience during NGT feeding with physical restraint.
- Implementing a trauma-informed care framework can help mitigate the adverse effects on parents and their children.
- Further research into supportive interventions for parents during pediatric NGT feeding is warranted.
Background:
Nasogastric tube (NGT) feeding under physical restraint is a clinical intervention that may be required when a child or young person is medically unstable secondary to restrictive eating.
Aim:
To explore the experiences of parents when their child receives NGT feeding under physical restraint and understand the effects of this on them.
Method:
This is a secondary analysis of data from two previous studies on NGT feeding under physical restraint - one in mental health wards and one in children's wards - in which semi-structured interviews had been conducted with patients, staff and parents. For this secondary analysis, the authors thematically analysed 31 transcripts of interviews with parents.
Findings:
Parents reported a range of emotions which could be conflicting in nature, notably relief and shame. In both studies, parents understood the necessity of NGT feeding under physical restraint but experienced the intervention as traumatic. They expressed empathy for staff facilitating the restraint. In the children's wards study, some parents described conflict and damaged relationships with staff, and three parents had participated in physically restraining their child for NGT feeding.
Conclusion:
Nursing staff should be aware that NGT feeding under physical restraint is distressing for parents. Adopting a trauma-informed framework may help to mitigate the traumatic effects on parents and, in turn, on their child.
Related Concept Videos
01:26Enteral Nutrition I: Orogastric and Nasogastric Feeding
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
01:17Endotracheal Intubation II: Nursing Management
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
01:15Endotracheal Intubation I: Procedure
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:29Administering Oxygen by Nasal Cannula
Nasal Cannulas
A nasal cannula is a lightweight tube split into two prongs placed in the nostrils,...