Tube feeding preferences among nursing home residents.
OBJECTIVE
To determine the preferences of nursing home residents regarding the use of tube feedings and to characterize the clinical, functional, and psychosocial factors that are associated with preferences.


METHODS
In-person survey.


METHODS
Forty-nine randomly selected nursing homes.


METHODS
Three hundred seventy-nine randomly selected, decisionally capable, nursing home residents.


RESULTS
Thirty-three percent of participants would prefer tube feedings if no longer able to eat because of permanent brain damage. Factors positively associated with preferences for tube feedings include male gender. African-American race, never having discussed treatment preferences with family members or health care providers, never having signed an advance directive, and believing that tube feeding preferences will be respected by the nursing home staff. Twenty-five percent of the participants changed from preferring tube feedings to not preferring tube feedings on learning that physical restraints are sometimes applied during the tube feeding process.


CONCLUSIONS
Demographic and social factors are associated with preferences for tube feedings. The provision of information about the potential use of physical restraint altered a proportion of nursing home residents' treatment preferences.
O'Brien
L A
LA
Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, USA.
Siegert
E A
EA
Grisso
J A
JA
Maislin
G M
GM
LaPann
K
K
Evans
L K
LK
Krotki
K P
KP
D016223:Advance Directives; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases; D003657:Decision Making; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D019538:Health Care Surveys; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009735:Nursing Homes; D017060:Patient Satisfaction; D015143:Philadelphia; D012149:Restraint, Physical; D028761:Withholding Treatment