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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Geriatrics 1/2014

A decision aid regarding long-term tube feeding targeting substitute decision makers for cognitively impaired older persons in Japan: A small-scale before-and-after study

Zeitschrift:
BMC Geriatrics > Ausgabe 1/2014
Autoren:
Yumiko Kuraoka, Kazuhiro Nakayama
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2318-14-16) contains supplementary material, which is available to authorized users.

Competing interests

This work was supported by MEXT KAKENHI (Grant Number 22890189).

Authors’ contributions

YK was involved in all aspects of the research, including study design, informant recruitment, data analysis, and manuscript preparation. KN’s role in the study included assistance with study design, supervision of data collection, data analysis, and preparation of the manuscript. Both authors read and approved the final manuscript.

Abstract

Background

In Japan, there is no decision-making guide regarding long-term tube feeding that specifically targets individuals making decisions on behalf of cognitively impaired older persons (substitute decision makers). The objective of this study was to describe the development and evaluation of such a decision aid.

Methods

In this before-and-after study, participants comprised substitute decision makers for 13 cognitively impaired inpatients aged 65 years and older who were being considered for placement of a percutaneous endoscopic gastrostomy tube in acute care hospitals and mixed-care hospitals in Japan. Questionnaires were used to compare substitute decision makers’ knowledge, decisional conflict, and predisposition regarding feeding tube placement before and after exposure to a decision aid. The acceptability of the decision aid was also assessed. Paired t-tests were used to compare participants’ knowledge and decisional conflict scores before and after using the decision aid.

Results

Substitute decision makers showed significantly increased knowledge (P < .001) and decreased decisional conflict (P < .01) regarding long-term tube feeding after using the decision aid. All substitute decision makers found the decision aid helpful and acceptable.

Conclusions

The decision aid facilitated the decision-making process of substitute decision makers by decreasing decisional conflict and increasing knowledge.
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