دورية أكاديمية
The Impact of Palliative Decompressive Gastrostomy Tube Placement on Patients and Their Caregivers: A Mixed Methods Analysis.
| العنوان: | The Impact of Palliative Decompressive Gastrostomy Tube Placement on Patients and Their Caregivers: A Mixed Methods Analysis. |
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| المؤلفون: | Roberson JL; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. Jeffrey.Roberson@pennmedicine.upenn.edu., Gasior JA; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Ginzberg SP; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.; Penn Center for Cancer Care Innovation, University of Pennsylvania, Philadelphia, PA, USA., Bakillah E; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA., Passman J; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA., Shreve L; Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA., Sharoky CE; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Nadolski G; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.; Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA., Courtright KR; Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.; Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA, USA., Kaufman EJ; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. |
| المصدر: | Annals of surgical oncology [Ann Surg Oncol] 2024 Jul 31. Date of Electronic Publication: 2024 Jul 31. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 9420840 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-4681 (Electronic) Linking ISSN: 10689265 NLM ISO Abbreviation: Ann Surg Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : New York, NY : Springer Original Publication: New York, NY : Raven Press, c1994- |
| مستخلص: | Background: Palliative decompressive gastrostomy tubes are intended to relieve the severe physical symptoms of malignant small bowel obstruction (SBO) near the end of life. The objective of this study was to assess the impact of palliative decompressive gastrostomy tube on patient and caregiver well-being. Patients and Methods: We prospectively enrolled patients with a malignant SBO and their caregivers at the time of informed consent for decompressive gastrostomy tube placement. We collected the Edmonton Symptom Assessment Scale (ESAS) and the Functional Assessment of Chronic Illness Therapy-Palliative (FACIT-Pal-14) surveys from patients at baseline and at 2-week post-procedure follow-up. The Caregiver Burden Scale survey was administered to caregivers at baseline. Survey scores were compared using paired t-tests. We also conducted semistructured interviews with patients and their caregivers at two-week follow-up until thematic saturation was reached. Content analysis was used to identify themes with two independent coders. Results: We enrolled 15 patient-caregiver dyads. Preprocedure, the median caregiver burden scale score was 37.5 (significant burden ≥ 21). Eight patients (53%) survived to 2 weeks; among these patients, median ESAS scores (51 versus 43.5, p < 0.001) and median FACIT-Pal-14 scores (22 versus 32, p = 0.015) were significantly improved at 2-week follow-up. Interviews revealed three major themes: improved symptom management, new stressors, and opportunities for better education and resources. Conclusions: Decompressive gastrostomy tubes effectively alleviated symptoms in patients with inoperable malignant SBOs. This palliative intervention may provide greater benefit if performed earlier, and caregivers and patients need improved resources and education for tube management to minimize added stressors. (© 2024. Society of Surgical Oncology.) |
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| فهرسة مساهمة: | Keywords: Decompressive gastrostomy; Malignancy; Palliative care; Quality of life |
| تواريخ الأحداث: | Date Created: 20240731 Latest Revision: 20240731 |
| رمز التحديث: | 20240801 |
| DOI: | 10.1245/s10434-024-15943-0 |
| PMID: | 39085545 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1534-4681 |
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| DOI: | 10.1245/s10434-024-15943-0 |