Health practitioners' practices, perceptions, and experiences regarding gastronomy placement in a paediatic setting

Master Thesis

2018

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Background Since its introduction in the 1980s, reports show an increase in the placement of gastrostomies in children, particularly in those with disabilities, due to its many benefits. To date, little has been reported on the practices, perceptions and experiences of the health care practitioners when engaging in the management of children with gastrostomies. Research aims This study aims to provide insight into the practices as well as the perceptions and experiences of the health care practitioners working with gastrostomies in a paediatric setting. Method A qualitative interpretative design was used. Eighteen healthcare practitioners, who form part of the multidisciplinary team working with paediatric gastrostomies, from one of the two prominent tertiary institutions in Cape Town, South Africa were recruited for this study. Semi structured interviews were conducted after which data analysis took place. Results Four themes emerged from the data collected; experience of better patient health evolving post gastrostomy despite complications, health care practitioners’ perceived change to a family’s quality of life, the gastrostomy process: just as you think it’s going right then something goes wrong; and experiencing multidisciplinary team work, and its influences on the management of patients with gastrostomies. Conclusion The health care practitioners reflected on their practices, perceptions and experiences of gastrostomy management as being a process. During the different stages of the process, they engaged with the advantages and disadvantages the gastrostomy has on the health of a child; the positive and negative influences on the quality of life for families and identified the importance of but also the lacking in the provision of education and ongoing support for caregivers. An effective multidisciplinary team is a requirement for the management of the gastrostomy; inadequacies within the team contributed to undesirable service delivery and poor health outcomes for the child. This study highlights the importance of and the need for the implementation of best practice guidelines for gastrostomy decision-making, placement and management in the paediatric setting.
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