title: A pilot study exploring the factors that influence the decision to have PEG feeding in patients with progressive conditions.
abstract: This original pilot study was conducted to explore and understand the factors that influence a patient's decision-making when considering percutaneous endoscopic gastrostomy placement for nonoral nutrition and hydration supplementation. Seven patients living with progressive dysphagic symptoms who had made a decision about percutaneous endoscopic gastrostomy placement were interviewed and their responses analyzed using the constant comparison method. All participants felt they had no option other than to accept the percutaneous endoscopic gastrostomy. The impact of visible physical deterioration and medical opinion were the most powerful influences on patients' decisions. Patients' perception of their involvement in the decision varied. This was linked to the amount and timing of information supplied and support they felt they received. Few patients have prior knowledge of tube feeding and rely heavily on medical advice. Effective communication by healthcare professionals can promote an environment that is supportive of patients' involvement in decisions. Adequate preparation time is vital if patients are to stop feeling uninvolved or peripheral to the decision-making process. Multidisciplinary teams need to address their working practices so that they do not intimidate patients, but rather empower patients in their decision-making.
authors.affiliation: Speech and Language Therapy Department, Trafford General Hospital, Davyhulme, Manchester M41 5SL, UK. speech.therapy@trafford.nhs.uk
authors.forename: Siobhan
authors.initials: S
authors.lastname: Vesey
authors.forename: Paula
authors.initials: P
authors.lastname: Leslie
authors.forename: Catherine
authors.initials: C
authors.lastname: Exley
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003657:Decision Making; D003679:Deglutition; D003680:Deglutition Disorders / Q000503:physiopathology* / Q000523:psychology; D004750:Enteral Nutrition / Q000379:methods* / Q000523:psychology; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010465:Perception; D010865:Pilot Projects; D036301:Qualitative Research