臨床消化器病学ジャーナル

Percutaneous Endoscopic Gastrostomy: Opinions, Attitudes and Experiences of Patients, Care Takers and Health Workers at a Subsaharan Hospital

Abstract

Victoria Nkore , Francis Basimbe1 *, Othiniel Musana and Gorreti Nassali

Dysphagia has a high burden of disease with a global prevalence estimated to be at 43.8% and the highest prevalence rate was estimated in Africa at 64.2%. Many medical conditions have been associated with dysphagia including; stroke, Parkinson’s disease, dementia and traumatic brain injury. Dysphagia is associated with malnutrition and carries a significant risk of mortality in many patients. To ensure adequate nutritional intake, enteral nutrition is usually the method of choice in patients with a normally functioning gastrointestinal system. The (European Society on Parenteral Nutrition) ESPEN guidelines recommend Nasogastric tube feeding for short term enteral feeding and Percutaneous Endoscopic Gastrostomy (PEG) for long term feeding (>4 weeks). Despite this recommendation the uptake of PEG Tube feeding has been very low in our setting we therefore set out to explore the opinions, attitudes and experiences of patients, caretakers and health workers towards PEG Tube feeding.

Methods: This was a cross-sectional, exploratory qualitative study design conducted using semi-structured in-depth interviews to enable participant’s air out their opinions and describe their experiences. Opinions attitudes and experiences of patients, caretakers, health workers that manage patients with PEGs and interact with patients who may require PEG Tube feeding were explored

Results: Three major themes emerged from interviews with health worker and these were: positive experience; negative experiences and community care. “So the PEG has really improved their life in terms of weight gain. We used to rush to hospital because of aspiration pneumonia, but now we stopped and these events reduced in the frequency.” – Nurse The three main theses that emerged from the care takers and patients were, Need for PEG, Benefits of PEG and the challenges they have faced while with a PEG Tube for feeding and Coping mechanisms “When we went home, we were feeding the tube and the porridge is so good for him. You could see that he had become healthy and the skin at come back soon as and so smooth” – caregiver.

Conclusion: Our study found that the need for PEG was significant due to the increasing burden of dysphagia and its associated complications. It also noted that PEG has shown to have improved care and better patient outcomes in terms of health and nutrition. . However multiple challenges and set backs were noted and these included cost, lack of knowledge and resistance from patients and families.