Factors associated with physician decision-making in starting tube feeding.

Journal of Palliative Medicine
Christina BellPatricia Lanoie Blanchette

Abstract

Because tube-feeding decisions are sometimes difficult, we examined physician, institutional, and patient factors associated with these decisions. Primary care physicians (n = 388) likely to manage nursing home patients in Hawaii were surveyed. Respondents indicated the factors of great importance in tube feeding decisions based on a vignette of a poststroke patient failing to thrive and family disagreement with advance directives. chi(2) and multiple logistic regression analyses were used to examine associations between physician demographics and factors of importance to physicians and their decisions based on the vignette. Starting tube feeding (chosen by 31% of respondents) was associated with internal medicine specialty (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.4-4.6), and placing great importance on family preference (OR 5.4, 95% CI 3.0-9.8) and liability (OR 2.5, 95% CI 1.3-4.8). After 3 months without improvement, 58% chose to withdraw tube feeding. Continuing tube feeding was associated with placing great importance on family wishes (OR 3.0, 95% CI 1.8-5.1) and liability (OR 1.7, 95% CI 1.0-2.9). Placing great importance on the living will was associated with decreased likelihoods of starting (OR 0.1, 95% CI ...Continue Reading

References

Aug 1, 1990·The American Journal of Medicine·H S PerkinsJ D Schoolfield
Nov 3, 1989·JAMA : the Journal of the American Medical Association·K W DavidsonR S McCord
Mar 1, 1995·American Journal of Public Health·N A Christakis, D A Asch
Dec 29, 2000·Journal of the American Geriatrics Society·C E GessertB Frey
Feb 15, 2002·Journal of the American Geriatrics Society·K L BraunB Y Horiuchi
Apr 6, 2002·Journal of Medical Ethics·H HinkkaP Kellokumpu-Lehtinen
Jun 22, 2002·JAMA : the Journal of the American Medical Association·Joan M TenoTerrie Wetle
Jul 3, 2003·JAMA : the Journal of the American Medical Association·Susan L MitchellVincent Mor
Sep 3, 2003·Journal of General Internal Medicine·Gregg A WarshawLinda M Goldenhar
Oct 8, 2003·The American Journal of Hospice & Palliative Care·Jean A YatesNabil Ibrahim
Nov 1, 2003·BMJ : British Medical Journal·Trevor ThompsonLisa Schwartz
Jul 28, 2004·Archives of Internal Medicine·Steven B Hardin, Yasmin A Yusufaly
Sep 10, 2004·The Journal of the American Board of Family Practice·George C Xakellis
Feb 24, 2005·Aging & Mental Health·A M FairrowB J Messinger-Rapport
Apr 13, 2005·Journal of Interprofessional Care·Seiji YamadaMarlene Lindberg
Mar 15, 2006·Archives of Internal Medicine·Neil J FarberE Gil Boyer
Jul 18, 2006·Journal of the American Medical Directors Association·Paul R Katz, Jurgis Karuza
Aug 11, 2006·Sozial- Und Präventivmedizin·Susanne FischerUNKNOWN EURELD consortium
Feb 9, 2007·The New England Journal of Medicine·Farr A CurlinJohn D Lantos
Feb 16, 2007·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Kelley WithySeiji Yamada

❮ Previous
Next ❯

Citations

Dec 12, 2012·ISRN Gastroenterology·Fabrizio Cardin
Aug 25, 2012·Journal of Pain and Symptom Management·Cindy De GendtLuc Deliens
May 31, 2012·Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association·S Baker, C Thompson
Oct 15, 2013·Journal of the American Geriatrics Society·Yoshitoshi Kuroda, Riko Kuroda
Jun 29, 2010·Journal of the American Geriatrics Society·Satinderpal K SandhuMary S Dietrich
May 27, 2010·Journal of Clinical Nursing·Ruth Palan LopezNeville E Strumpf
Mar 20, 2016·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Marissa BurgermasterDavid S Seres
Jan 22, 2015·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Beth T HallDavid C Evans
Jun 17, 2009·Current Opinion in Supportive and Palliative Care·Velia A Löbbe
May 6, 2015·International Journal of Clinical Practice·J J Arevalo-MansoE Diez-Tejedor

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.