Surrogates’ perceptions about feeding tube placement decisions

(1) To determine surrogates perceptions about who made the decision to place the feeding tube and who they would have preferred to have made the decision. (2) To determine surrogates’ perceptions of the information they received to make this decision. Structured interviews with 246 surrogate decisio...

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Bibliographic Details
Published in:Patient education and counseling 2006-05, Vol.61 (2), p.246-252
Main Authors: Lewis, Carmen L., Hanson, Laura C., Golin, Carol, Garrett, Joanne M., Cox, Christopher E., Jackman, Anne, Phifer, Nancy, Carey, Timothy S.
Format: Article
Language:English
Subjects:
Activities of Daily Living
Attitude to Health
Choice Behavior
Cooperative Behavior
Decision Making
Enteral Nutrition - psychology
Female
Gastrostomy
Gastrostomy - psychology
Health Services Needs and Demand
Humans
Living Wills
Male
North Carolina
Nursing
Patient Advocacy
Patient agent
Patient Selection
Physician's Role - psychology
Professional-Family Relations
Proxy
Proxy - psychology
Role
Self Concept
Surveys and Questionnaires
Third-Party Consent
Tube feeding
Uncertainty
Withholding Treatment
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Summary:(1) To determine surrogates perceptions about who made the decision to place the feeding tube and who they would have preferred to have made the decision. (2) To determine surrogates’ perceptions of the information they received to make this decision. Structured interviews with 246 surrogate decision-makers. Fifty-five percent of surrogates felt that the decision was made primarily by the surrogate, but 75% would prefer that the decision be shared with the physician. Surrogates reported that they discussed the benefits (80%) and the risks (72%) of feeding tube placement and discussed what life would be like with the feeding tube (65%) and without the feeding tube (67%). They also reported being asked if they understood the information (85%) and their thoughts about placement (56%). Despite receiving this information, 28 to 41% reported wanting more information about these aspects. Surrogates would have preferred greater physician participation in decisions about feeding tube placement and many reported that their informational needs were not completely met. These results suggest that physicians may be justified in taking a more active role in feeding tube decisions with surrogates and that many surrogates desire more information than is required by standards of informed decision making.
ISSN:0738-3991
1873-5134
DOI:10.1016/j.pec.2005.04.012