Parent perceptions of nasogastric tube insertion in adolescents with eating disorders: a qualitative study

To explore parental perceptions of nasogastric tube (NGT) insertion for adolescents who have received inpatient treatment for an eating disorder and to identify factors shaping a positive or negative experience.

Qualitative observational study using semistructured interviews with parents of adolescent patients who underwent NGT insertion during eating disorder treatment.

Participants' children had received care in eight hospitals across Australia. Videoconferencing software was used, with all participants completing their interview from home. One participant's child was a hospital inpatient at the time of interview.

Sixteen interviews were conducted: 3 with young people, 12 with parents and 1 joint interview with parent and child. Due to the small sample of patients, only the 13 parent interviews were analysed (including the joint interview).

Five key themes emerged: (1) inconsistencies in hospital protocols and rigidity in their application, (2) unit culture and staff attitudes, (3) perception of autonomy and consent, (4) the psychological impact of NGT insertion and (5) the physical discomfort and pain of NGT insertion. While no quantitative measures apply, the consistency across multiple hospitals and participants underscores the robustness of these findings.

Participants reported substantial variations in protocols and processes across hospitals, including discrepancies in indications for NGT insertion and removal, and approaches to group mealtimes. These differences had a marked impact on patient and parent experience. Our findings provide important insight into the physical and psychological experience of NGT insertion for young people and their parents and identify areas for improvement in future clinical practice.