How are decisions made about the use of percutaneous endoscopic gastrostomy for long-term nutritional support?

被引:47
作者
Van Rosendaal, GMA [1 ]
Verhoef, MJ [1 ]
Kinsella, TD [1 ]
机构
[1] Univ Calgary, Calgary, AB, Canada
关键词
D O I
10.1016/S0002-9270(99)00581-X
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
OBJECTIVE: We sought to study the process by which decisions to commit individuals to long-term nutritional support via percutaneous endoscopic gastrostomy (PEG) are made. METHODS: A semistructured questionnaire was administered to surrogates and patients in 73 cases of persons undergoing PEG. RESULTS: Such decisions are often made with inadequate information regarding the PEG and its possible impact on the future clinical course, sometimes with an overly optimistic view of the prognosis. Several factors may influence this process. In cases in which the underlying illness was severe, 30% of surrogate decisionmakers expressed some uncertainty that a right decision was made. CONCLUSIONS: The decision to commit patients to long-term nutritional support via PEG is often difficult and the implications of such a commitment may have major implications for patients and their families. Strategies to optimize this decisionmaking process are recommended. (C) 1999 by Am. Cell. of Gastroenterology.
引用
收藏
页码:3225 / 3228
页数:4
相关论文
共 20 条
  • [1] ARTIFICIAL HYDRATION AND ALIMENTATION AT THE END OF LIFE - A REPLY TO CRAIG
    ASHBY, M
    STOFFELL, B
    [J]. JOURNAL OF MEDICAL ETHICS, 1995, 21 (03) : 135 - 140
  • [2] INFORMATION AND PARTICIPATION PREFERENCES AMONG CANCER-PATIENTS
    CASSILETH, BR
    ZUPKIS, RV
    SUTTONSMITH, K
    MARCH, V
    [J]. ANNALS OF INTERNAL MEDICINE, 1980, 92 (06) : 832 - 836
  • [3] ON WITHHOLDING NUTRITION AND HYDRATION IN THE TERMINALLY ILL - HAS PALLIATIVE MEDICINE GONE TOO FAR - A REPLY
    DUNLOP, RJ
    ELLERSHAW, JE
    BAINES, MJ
    SYKES, N
    SAUNDERS, CM
    [J]. JOURNAL OF MEDICAL ETHICS, 1995, 21 (03) : 141 - 143
  • [4] MEASURING PATIENTS DESIRE FOR AUTONOMY - DECISION-MAKING AND INFORMATION-SEEKING PREFERENCES AMONG MEDICAL PATIENTS
    ENDE, J
    KAZIS, L
    ASH, A
    MOSKOWITZ, MA
    [J]. JOURNAL OF GENERAL INTERNAL MEDICINE, 1989, 4 (01) : 23 - 30
  • [5] PERCUTANEOUS ENDOSCOPIC GASTROSTOMY - INITIAL PLACEMENT BY SINGLE ENDOSCOPIC TECHNIQUE AND LONG-TERM FOLLOW-UP
    GRANT, JP
    [J]. ANNALS OF SURGERY, 1993, 217 (02) : 168 - 174
  • [6] AGREEMENT BETWEEN PATIENTS AND THEIR SELF-SELECTED SURROGATES ON DIFFICULT MEDICAL DECISIONS
    HARE, J
    PRATT, C
    NELSON, C
    [J]. ARCHIVES OF INTERNAL MEDICINE, 1992, 152 (05) : 1049 - 1054
  • [7] TO PEG OR NOT TO PEG - THAT IS THE COSTLY QUESTION
    KIRBY, DF
    [J]. MAYO CLINIC PROCEEDINGS, 1992, 67 (11) : 1115 - 1117
  • [8] A CONTROLLED TRIAL TO IMPROVE CARE FOR SERIOUSLY ILL HOSPITALIZED-PATIENTS - THE STUDY TO UNDERSTAND PROGNOSES AND PREFERENCES FOR OUTCOMES AND RISKS OF TREATMENTS (SUPPORT)
    KNAUS, WA
    CONNORS, AF
    DAWSON, NV
    DESBIENS, NA
    FULKERSON, WJ
    GOLDMAN, L
    LYNN, J
    OYE, RK
    BERGNER, M
    DAMIANO, A
    HAKIM, R
    MURPHY, DJ
    TENO, J
    VIRNIG, B
    WAGNER, DP
    WU, AW
    YASUI, Y
    ROBINSON, DK
    KRELING, B
    DULAC, J
    BAKER, R
    HOLAYEL, S
    MEEKS, T
    MUSTAFA, M
    VEGARRA, J
    ALZOLA, C
    HARRELL, FE
    COOK, EF
    HAMEL, MB
    PETERSON, L
    PHILLIPS, RS
    TSEVAT, J
    FORROW, L
    LESKY, L
    DAVIS, R
    KRESSIN, N
    SOLZAN, J
    PUOPOLO, AL
    BARRETT, LQ
    BUCKO, N
    BROWN, D
    BURNS, M
    FOSKETT, C
    HOZID, A
    KEOHANE, C
    MARTINEZ, C
    MCWEENEY, D
    MELIA, D
    OTTO, S
    SHEEHAN, K
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1995, 274 (20): : 1591 - 1598
  • [9] PERCUTANEOUS ENDOSCOPIC GASTROSTOMY - INDICATIONS, SUCCESS, COMPLICATIONS, AND MORTALITY IN 314 CONSECUTIVE PATIENTS
    LARSON, DE
    BURTON, DD
    SCHROEDER, KW
    DIMAGNO, EP
    [J]. GASTROENTEROLOGY, 1987, 93 (01) : 48 - 52
  • [10] PATIENT INVOLVEMENT IN DECISION-MAKING IN SURGICAL AND ORTHOPEDIC PRACTICE - THE PROJECT PERIOPERATIVE RISK
    LARSSON, US
    SVARDSUDD, K
    WEDEL, H
    SALJO, R
    [J]. SOCIAL SCIENCE & MEDICINE, 1989, 28 (08) : 829 - 835