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Patient and caregiver perspectives on feeding tube transitions: a qualitative interview study
Raman Chawla1,2, Lara Montgomery2,3, Lyndsay Mackay2,4
1Section of Pediatric Hospital Medicine, Alberta Children's Hospital, Calgary, AB, Canada.
Insights
Understanding patient and caregiver experiences during enteral feeding tube transitions is crucial. Involving families in decision-making and providing adequate preparation optimizes care for children with feeding disorders.
Area of Science:
- Pediatric Gastroenterology
- Patient-Centered Care
- Healthcare Transitions
Background:
- Enteral feeding is vital for children with paediatric feeding disorders.
- Various feeding tubes are used, necessitating transitions during a child's health journey.
- Understanding patient and caregiver experiences during these transitions is essential.
Purpose of the Study:
- To comprehensively understand patient and caregiver perspectives and experiences during enteral feeding tube transitions.
- To identify key factors influencing the decision-making, management, and training processes for tube transitions.
Main Methods:
- Qualitative study employing semi-structured interviews with 14 caregivers and 2 youth with feeding tubes.
- Interviews explored child/family context, transition experiences, and goals/expectations.
- Data analyzed using inductive thematic analysis.
Main Results:
- Decision-making for tube transitions requires family involvement and advocacy.
- Tube transitions necessitate adequate preparation and training.
- Children and caregivers have distinct hopes and expectations for tube transitions, with identified benefits and challenges for different tube types.
Conclusions:
- Feeding tube transitions are critical junctures for children, youth, and families.
- Integrating patient and caregiver perspectives is vital for optimal decision-making, management, and training.
- Shared decision-making, individualized timing, education, and expectations can optimize the transition process.
Objectives:
Enteral feeding provides nutrition for children with paediatric feeding disorders. Different types of tubes are used depending on the duration of enteral feeding and whether gastric or jejunal feeds are better tolerated. Many children move from one type of tube to another; these are important transitions in the health journey of a child. This study aimed to gain a thorough understanding of the patient and caregiver perspectives and experiences during enteral feeding transitions.
Methods:
This qualitative study included semi-structured interviews of 16 individuals, including 14 caregivers and 2 youth with feeding tubes from 2 tertiary care centres. Interviews were conducted exploring the following key topics: (1) child and family context; (2) experience transitioning to a different enteral feeding tube; and (3) goals and expectations before and during tube transitions. Data were analysed using inductive thematic analysis.
Results:
The following themes were identified: (1) The decision-making process for tube transitions requires family involvement and advocacy; (2) The tube transition itself must be supported by adequate preparation and training; and (3) Children and caregivers have their own hopes and expectations for tube transitions. To supplement these themes, a table of youth/caregiver identified benefits and challenges for nasogastric versus surgical tubes was created.
Conclusion:
Feeding tube transitions are important transition points for children, youth, and families. Integrating their perspectives is critical to optimal decision-making, management, and training around feeding tube transitions. Deliberate shared decision-making would optimize the transition process by individualizing the timing, education and expectations.
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