Poster Presentation
Wednesday, July 11, 2007
9:00 AM - 9:45 AM
Wednesday, July 11, 2007
2:45 PM - 3:30 PM
Right Technique! Wrong Place?Deconstructing the Scarce Use of Percutaneous Endoscopic Gastrostomy in Taiwan
Lily Yeh, PhD, student, RN, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan and Bih-Ching Shu, PhD, RN, Department of Nursing and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan, Tainan, Taiwan.
| Learning Objective #1: 1.Acknowledge the pattern of technology utilization is embedded in different cultures and societies, such as PEG use in western and eastern countries. |
| Learning Objective #2: 2.Realize the influential factors embedded in a particular context should be deconstructed and given attention before taking action to deal with the problem. |
Objectives: Percutaneous endoscopic gastrostomy (PEG) feeding, introduced in 1980, has been a common device used in western countries for more than twenty years. However, its use is not as popular in Taiwan. The purpose of this research was to explore the factors that influence PEG use in Taiwan nursing homes. Methods: In Tainan City, eight nursing homes were invited to participate in the research in which each fit the criteria of containing fifty care beds or more and have at least operated the institution for one year. To explore the factors that influence PEG use, tape recorded in-depth interviews were administered to each personnel who was in charge of the nursing home. Line by line qualitative content analysis of each transcription was reviewed by two researchers to explore categories of factors that influence PEG use. Moreover, characteristics of nursing home residents who need an enteral nutritional support were collected to depict the context.
Results: Preliminary results from four nursing homes showed that 78 residents (28%, N=279) need a long term enteral nutritional support and only 3 residents (3.8%) with PEG. Qualitative analysis of the verbatim transcription revealed that factors influence PEG use included; 1. Culture factor (1) Maintaining the integrity of body surface towards the end of life is highly valued in Chinese society (2) The multiple family caregivers phenomena inhibit the consensus of accepting PEG use. 2. Health care system factor—Lack of PEG knowledge and experience of a multidisciplinary team result in the inability to influence caregivers. Additionally, there is a lack of case management operation to mobilize the collaboration of multidisciplinary teams to suggest PEG use and a lack of resources to transfer those who need PEG device. Final results shall be available before the conference as data collection is scheduled in late December 2006.