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is widely recognised that patients do need to make psychological and emotional adjustments following PEG placement.
Patients have identified a number of psychosocial issues that dietitians in clinical practice need to be aware of in order to provide the support pa- tients require. Table one summarises the issues raised, identifies some of the common causes and contributing factors to the issue. It also outlines the support that patients may find helpful in dealing with the issues they face.
Patient feelings and implications for clinical practice
The psychosocial issues undoubtedly contribute to the feelings patients expe- rience regarding PEG feeding: positive, negative and indifferent feelings. Positive feelings were associated with security and the relief from the pressure to eat at mealtimes and were associated with increasing body weight and an improved nutritional intake. Other patients explained that they had no particular feelings to- wards the PEG feeding. On the other hand negative feelings towards PEG feeding included depression, anger, frustration, relief and fear (1).
Practitioners are well placed to re- spond to and create opportunities to help patients and their families work out solutions to psychosocial prob- lems that arise from just getting on with everyday life.
Practitioners are well placed to respond to and create opportunities to help patients and their families work out solutions to psychosocial problems that arise
from just getting on with everyday life.
It may take a shift in focus to a greater consideration of the psychosocial im- pact of medical and clinical interven-
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NHDmag.com Aug/Sept '10 - issue 57
tions, but mere acknowledgement of and an attempt to understand every- day difficulties can be helpful. Although practitioners may not feel comfortable themselves offering solution focus in- terventions, they can offer time to listen and, if appropriate, signpost to other services or community resources. How- ever, practitioners who access training in solution focused approaches may realise wider benefits, not just for psy- chosocial issues.
Understanding the issues
Returning to attending the social event without eating and drinking, I had thought about how this may feel before I went to the christening, but I was totally unprepared for the re- sponses and reactions from the oth- ers at the celebration. I now appreci- ate why the patient challenged me to attend a social event without eating and drinking. Try it; your experiences will enhance your understanding of the issues your patients face on a daily basis.
References 1 Brotherton AM, Abbott J & Aggett P J (2006) The impact of percutaneous endoscopic gastrostomy feeding upon daily life in adults. J Hum Nutr Diet. 19, 355-367
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