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Erschienen in: The journal of nutrition, health & aging 4/2017

09.07.2016

Perceptions of healthcare professionals on the usage of percutaneous endoscopic gastrostomy in a teaching hospital from a middle-income South East Asian country

verfasst von: M. H. Jaafar, S. Mahadeva, P. Subramanian, Maw Pin Tan

Erschienen in: The journal of nutrition, health & aging | Ausgabe 4/2017

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Abstract

Objective

To explore the perceptions of healthcare professionals’ (HCPs) in a South East Asian nation towards percutaneous endoscopic gastrostomy (PEG) feeding.

Design

Semi-structured, qualitative interviews.

Settings

A teaching hospital in Kuala Lumpur, Malaysia.

Participants

A total of 17 healthcare professionals aged 23-43 years, 82% women.

Results

Thematic analysis revealed five themes that represent HCPs’ perceptions in relation to the usage of PEG feeding: 1) knowledge of HCPs, 2) communication, 3) understanding among patients, and 4) financial and affordability.

Conclusion

The rationale for reluctance towards PEG feeding observed in this regions was explained by lack of education, knowledge, communication, team work, and financial support. Future studies should assess the effects of educational programmes among HCPs and changes in policies to promote affordability on the utilization of PEG feeding in this region.
Literatur
1.
Zurück zum Zitat Paciaroni M, Mazzotta G, Corea F, Caso V, Venti M, Milia P, et al. Dysphagia following Stroke. Eur Neurol; 2004; 51(3): 162–7.CrossRefPubMed Paciaroni M, Mazzotta G, Corea F, Caso V, Venti M, Milia P, et al. Dysphagia following Stroke. Eur Neurol; 2004; 51(3): 162–7.CrossRefPubMed
2.
Zurück zum Zitat Turley R, Cohen S. Impact of voice and swallowing problems in the elderly. Otolaryngol Head Neck Surg; 2009,140(1):33–6.CrossRefPubMed Turley R, Cohen S. Impact of voice and swallowing problems in the elderly. Otolaryngol Head Neck Surg; 2009,140(1):33–6.CrossRefPubMed
3.
Zurück zum Zitat Zaherah Mohamed Shah F, Suraiya HS, Poi PJ, Tan KS, Lai PS, Ramakrishnan K, et al. Long-term nasogastric tube feeding in elderly stroke patients—an assessment of nutritional adequacy and attitudes to gastrostomy feeding in Asians. J Nutr Health Aging;2012; 16(8): 701–6. Zaherah Mohamed Shah F, Suraiya HS, Poi PJ, Tan KS, Lai PS, Ramakrishnan K, et al. Long-term nasogastric tube feeding in elderly stroke patients—an assessment of nutritional adequacy and attitudes to gastrostomy feeding in Asians. J Nutr Health Aging;2012; 16(8): 701–6.
4.
Zurück zum Zitat Lin LC, Wu SC, Chen HS, Wang TG, Chen MY. Prevalence of impaired swallowing in institutionalized older people in taiwan. J Am Geriatr Soc; 2002; 50(6): 1118–23.CrossRefPubMed Lin LC, Wu SC, Chen HS, Wang TG, Chen MY. Prevalence of impaired swallowing in institutionalized older people in taiwan. J Am Geriatr Soc; 2002; 50(6): 1118–23.CrossRefPubMed
5.
Zurück zum Zitat Cabre M, Serra-Prat M, Palomera E, Almirall J, Pallares R, Clave P. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing; 2010; 39(1): 39–45.CrossRefPubMed Cabre M, Serra-Prat M, Palomera E, Almirall J, Pallares R, Clave P. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing; 2010; 39(1): 39–45.CrossRefPubMed
6.
7.
Zurück zum Zitat Serra-Prat M, Palomera M, Gomez C, Sar-Shalom D, Saiz A, Montoya JG, et al. Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study. Age Ageing; 2012; 41(3): 376–81.CrossRefPubMed Serra-Prat M, Palomera M, Gomez C, Sar-Shalom D, Saiz A, Montoya JG, et al. Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study. Age Ageing; 2012; 41(3): 376–81.CrossRefPubMed
8.
Zurück zum Zitat Middleton MH, Nazarenko G, Nivison-Smith I, Smerdely P. Prevalence of malnutrition and 12-month incidence of mortality in two Sydney teaching hospitals. Intern Med J; 2001; 31(8): 455–61.CrossRefPubMed Middleton MH, Nazarenko G, Nivison-Smith I, Smerdely P. Prevalence of malnutrition and 12-month incidence of mortality in two Sydney teaching hospitals. Intern Med J; 2001; 31(8): 455–61.CrossRefPubMed
9.
Zurück zum Zitat Kreymann KG, Berger MM, Deutz NEP, Hiesmayr M, Jolliet P, Kazandjiev G, et al. ESPEN Guidelines on Enteral Nutrition: Intensive care. Clin Nutr; 2006; 25(2): 210–23.CrossRefPubMed Kreymann KG, Berger MM, Deutz NEP, Hiesmayr M, Jolliet P, Kazandjiev G, et al. ESPEN Guidelines on Enteral Nutrition: Intensive care. Clin Nutr; 2006; 25(2): 210–23.CrossRefPubMed
11.
Zurück zum Zitat Dwolatzky T, Berezovski S, Friedmann R, Paz J, Clarfield AM, Stessman J, et al. A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people. Clin Nutr; 2001; 20(6): 535–40.CrossRefPubMed Dwolatzky T, Berezovski S, Friedmann R, Paz J, Clarfield AM, Stessman J, et al. A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people. Clin Nutr; 2001; 20(6): 535–40.CrossRefPubMed
12.
Zurück zum Zitat Sadasivan A, Faizal B, Kumar M. Nasogastric and percutaneous endoscopic gastrostomy tube use in advanced head and neck cancer patients: A comparative study. J Pain Palliat Care Pharmacother; 2012; 26(3): 226–32.CrossRefPubMed Sadasivan A, Faizal B, Kumar M. Nasogastric and percutaneous endoscopic gastrostomy tube use in advanced head and neck cancer patients: A comparative study. J Pain Palliat Care Pharmacother; 2012; 26(3): 226–32.CrossRefPubMed
13.
Zurück zum Zitat Hamidon BB, Abdullah SA, Zawawi MF, Sukumar N, Aminuddin A, Raymond AA. A prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with acute dysphagic stroke. Med J Malaysia; 2006; 61(1): 59–66.PubMed Hamidon BB, Abdullah SA, Zawawi MF, Sukumar N, Aminuddin A, Raymond AA. A prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with acute dysphagic stroke. Med J Malaysia; 2006; 61(1): 59–66.PubMed
14.
Zurück zum Zitat Kwong JPY, Stokes EJ, Posluns EC, Fitch MI, McAndrew A, Vandenbussche KA. The experiences of patients with advanced head and neck cancer with a percutaneous endoscopic gastrostomy tube: A qualitative descriptive study. Nutr Clin Pract; 2014; 29(4): 526–33.CrossRefPubMed Kwong JPY, Stokes EJ, Posluns EC, Fitch MI, McAndrew A, Vandenbussche KA. The experiences of patients with advanced head and neck cancer with a percutaneous endoscopic gastrostomy tube: A qualitative descriptive study. Nutr Clin Pract; 2014; 29(4): 526–33.CrossRefPubMed
15.
Zurück zum Zitat Kumagai R, Kubokura M, Sano A, Shinomiya M, Ohta S, Ishibiki Y, et al. Clinical evaluation of percutaneous endoscopic gastrostomy tube feeding in Japanese patients with dementia. Psychiatry Clin Neurosci; 2012; 66(5): 418–22.CrossRefPubMed Kumagai R, Kubokura M, Sano A, Shinomiya M, Ohta S, Ishibiki Y, et al. Clinical evaluation of percutaneous endoscopic gastrostomy tube feeding in Japanese patients with dementia. Psychiatry Clin Neurosci; 2012; 66(5): 418–22.CrossRefPubMed
16.
Zurück zum Zitat Gomes CA, Lustosa SA, Matos D, Andriolo RB, Waisberg DR, Waisberg J. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances. Cochrane Database Syst Rev; 2012;3:CD008096. Gomes CA, Lustosa SA, Matos D, Andriolo RB, Waisberg DR, Waisberg J. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances. Cochrane Database Syst Rev; 2012;3:CD008096.
17.
Zurück zum Zitat Lin LC, Li MH, Watson R. A survey of the reasons patients do not chose percutaneous endoscopic gastrostomy/jejunostomy (peg/pej) as a route for long-term feeding. J Clin Nurs 2011;20(5/6):802–10.CrossRefPubMed Lin LC, Li MH, Watson R. A survey of the reasons patients do not chose percutaneous endoscopic gastrostomy/jejunostomy (peg/pej) as a route for long-term feeding. J Clin Nurs 2011;20(5/6):802–10.CrossRefPubMed
18.
Zurück zum Zitat Jaafar MH, Mahadeva S, Tan KM, Tan MP. Attitudes of Health Care Professionals Towards Gastrostomy Feeding in Older Adults in Malaysia. Int J Gerontol; 2015; 9(1): 40–5.CrossRef Jaafar MH, Mahadeva S, Tan KM, Tan MP. Attitudes of Health Care Professionals Towards Gastrostomy Feeding in Older Adults in Malaysia. Int J Gerontol; 2015; 9(1): 40–5.CrossRef
19.
Zurück zum Zitat Madigan SM, Fleming P, McCann S, Wright ME, MacAuley D. General Practitioners involvement in enteral tube feeding at home: a qualitative study. BMC Fam Pract; 2007;8:29.CrossRefPubMedPubMedCentral Madigan SM, Fleming P, McCann S, Wright ME, MacAuley D. General Practitioners involvement in enteral tube feeding at home: a qualitative study. BMC Fam Pract; 2007;8:29.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Bjuresäter K, Larsson M, Nordström G, Athlin E. Cooperation in the care for patients with home enteral tube feeding throughout the care trajectory: nurses’ perspectives. J Clin Nurs; 2008; 17(22): 3021–9.CrossRefPubMed Bjuresäter K, Larsson M, Nordström G, Athlin E. Cooperation in the care for patients with home enteral tube feeding throughout the care trajectory: nurses’ perspectives. J Clin Nurs; 2008; 17(22): 3021–9.CrossRefPubMed
21.
Zurück zum Zitat Brotherton A, Abbott J. Clinical decision making and the provision of information in PEG feeding: an exploration of patients and their carers’ perceptions. J Hum Nutr Diet; 2009; 22(4): 302–9.CrossRefPubMed Brotherton A, Abbott J. Clinical decision making and the provision of information in PEG feeding: an exploration of patients and their carers’ perceptions. J Hum Nutr Diet; 2009; 22(4): 302–9.CrossRefPubMed
22.
Zurück zum Zitat Bryon E, Gastmans C, de Casterle BD. Nurse-physician communication concerning artificial nutrition or hydration (ANH) in patients with dementia: a qualitative study. J Clin Nurs; 2012;21(19pt20):2975–84.CrossRefPubMed Bryon E, Gastmans C, de Casterle BD. Nurse-physician communication concerning artificial nutrition or hydration (ANH) in patients with dementia: a qualitative study. J Clin Nurs; 2012;21(19pt20):2975–84.CrossRefPubMed
23.
Zurück zum Zitat Polit DF, Beck CT. Essentials of Nursing Research: Appraising evidence for nursing practice. Burns CC, Reilly D, editors. Philadelphia, PA.: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2010; 512 p. Polit DF, Beck CT. Essentials of Nursing Research: Appraising evidence for nursing practice. Burns CC, Reilly D, editors. Philadelphia, PA.: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2010; 512 p.
24.
Zurück zum Zitat Gubrium JF, Holstein JA. The New Language of Qualitative Method. 198 Madison Avenue, New York: Oxford University Press, Inc. 1997;256 p. Gubrium JF, Holstein JA. The New Language of Qualitative Method. 198 Madison Avenue, New York: Oxford University Press, Inc. 1997;256 p.
25.
Zurück zum Zitat Yeh L, Lo L, Fetzer S, Chen C. Limited PEG tube use: the experience of long-term care directions. J Clin Nurs; 2010;19(19/20):2897–906.CrossRefPubMed Yeh L, Lo L, Fetzer S, Chen C. Limited PEG tube use: the experience of long-term care directions. J Clin Nurs; 2010;19(19/20):2897–906.CrossRefPubMed
26.
Zurück zum Zitat Adams KM, Kohlmeier M, Powell M, Zeisel SH. Nutrition in medicine: nutrition education for medical students and residents. Nutr Clin Pract; 2010; 25(5): 471–80.CrossRefPubMedPubMedCentral Adams KM, Kohlmeier M, Powell M, Zeisel SH. Nutrition in medicine: nutrition education for medical students and residents. Nutr Clin Pract; 2010; 25(5): 471–80.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Todd V, van Rosendaal G, Duregon K, Verhoef M. Percutaneous endoscopic gastrostomy (PEG): the role and perspective of nurses. J Clin Nurs; 2005; 14(2): 187–94.CrossRefPubMed Todd V, van Rosendaal G, Duregon K, Verhoef M. Percutaneous endoscopic gastrostomy (PEG): the role and perspective of nurses. J Clin Nurs; 2005; 14(2): 187–94.CrossRefPubMed
28.
Zurück zum Zitat Healy S, McNamara E. Tube feeding controversial patients: what do dietitians think? J Hum Nutr Diet; 2002; 15(6): 445–53.CrossRefPubMed Healy S, McNamara E. Tube feeding controversial patients: what do dietitians think? J Hum Nutr Diet; 2002; 15(6): 445–53.CrossRefPubMed
29.
Zurück zum Zitat Yip K, Rai V, Wong K. Evaluation of delivery of enteral nutrition in mechanically ventilated Malaysian ICU patients. BMC Anesthesiol; 2014; 14(1): 1–5.CrossRef Yip K, Rai V, Wong K. Evaluation of delivery of enteral nutrition in mechanically ventilated Malaysian ICU patients. BMC Anesthesiol; 2014; 14(1): 1–5.CrossRef
30.
Zurück zum Zitat Xu XL, Zhou JC, Pan KH, Zhao HC, Ying KJ. Attitudes toward the American nutrition guidelines for the critically ill patients of Chinese intensive care physicians. Asia Pac J Clin Nutr; 2015; 24(2): 347–58.PubMed Xu XL, Zhou JC, Pan KH, Zhao HC, Ying KJ. Attitudes toward the American nutrition guidelines for the critically ill patients of Chinese intensive care physicians. Asia Pac J Clin Nutr; 2015; 24(2): 347–58.PubMed
31.
Zurück zum Zitat Wei J, Chen W, Zhu M, Cao W, Wang X, Shi H, et al. Guidelines for parenteral and enteral nutrition support in geriatric patients in China. Asia Pac J Clin Nutr; 2015; 24(2): 336–46.PubMed Wei J, Chen W, Zhu M, Cao W, Wang X, Shi H, et al. Guidelines for parenteral and enteral nutrition support in geriatric patients in China. Asia Pac J Clin Nutr; 2015; 24(2): 336–46.PubMed
32.
Zurück zum Zitat Kobayashi N. Guidelines for the use of parenteral and enteral nutrition. Nihon Rinsho; 2001;59 Suppl 5:45–8.PubMed Kobayashi N. Guidelines for the use of parenteral and enteral nutrition. Nihon Rinsho; 2001;59 Suppl 5:45–8.PubMed
33.
Zurück zum Zitat Propp KM, Apker J, Zabava Ford WS, Wallace N, Serbenski M, Hofmeister N. Meeting the complex needs of the health care team: identification of nurse-team communication practices perceived to enhance patient outcomes. Qual Health Res; 2010; 20(1): 15–28.CrossRefPubMed Propp KM, Apker J, Zabava Ford WS, Wallace N, Serbenski M, Hofmeister N. Meeting the complex needs of the health care team: identification of nurse-team communication practices perceived to enhance patient outcomes. Qual Health Res; 2010; 20(1): 15–28.CrossRefPubMed
34.
Zurück zum Zitat Carmel S. Life-sustaining treatments: what doctors do, what they want for themselves and what elderly persons want. Soc Sci Med; 1999; 49(10): 1401–8.CrossRefPubMed Carmel S. Life-sustaining treatments: what doctors do, what they want for themselves and what elderly persons want. Soc Sci Med; 1999; 49(10): 1401–8.CrossRefPubMed
35.
Zurück zum Zitat McDonagh JR, Elliott TB, Engelberg RA, Treece PD, Shannon SE, Rubenfeld GD, et al. Family satisfaction with family conferences about end-of-life care in the intensive care unit: increased proportion of family speech is associated with increased satisfaction. Crit Care Med; 2004; 32(7): 1484–8.CrossRefPubMed McDonagh JR, Elliott TB, Engelberg RA, Treece PD, Shannon SE, Rubenfeld GD, et al. Family satisfaction with family conferences about end-of-life care in the intensive care unit: increased proportion of family speech is associated with increased satisfaction. Crit Care Med; 2004; 32(7): 1484–8.CrossRefPubMed
36.
Zurück zum Zitat Oberle K, Hughes D. Doctors’ and nurses’ perceptions of ethical problems in end-oflife decisions. J Adv Nurs; 2001; 33(6): 707–15.CrossRefPubMed Oberle K, Hughes D. Doctors’ and nurses’ perceptions of ethical problems in end-oflife decisions. J Adv Nurs; 2001; 33(6): 707–15.CrossRefPubMed
37.
Zurück zum Zitat Puntillo KA, McAdam JL. Communication between physicians and nurses as a target for improving end-of-life care in the intensive care unit: challenges and opportunities for moving forward. Crit Care Med; 2006;34(11 Suppl):S332–40.CrossRefPubMed Puntillo KA, McAdam JL. Communication between physicians and nurses as a target for improving end-of-life care in the intensive care unit: challenges and opportunities for moving forward. Crit Care Med; 2006;34(11 Suppl):S332–40.CrossRefPubMed
38.
Zurück zum Zitat Cahill NE, Murch L, Cook D, Heyland DK. Barriers to feeding critically ill patients: A multicenter survey of critical care nurses. J Crit Care; 2012; 27(6): 727–34.CrossRefPubMed Cahill NE, Murch L, Cook D, Heyland DK. Barriers to feeding critically ill patients: A multicenter survey of critical care nurses. J Crit Care; 2012; 27(6): 727–34.CrossRefPubMed
39.
Zurück zum Zitat Claramita M, Nugraheni MD, van Dalen J, van der Vleuten C. Doctor-patient communication in Southeast Asia: a different culture? Adv Health Sci Educ Theory Pract; 2013; 18(1): 15–31.CrossRefPubMed Claramita M, Nugraheni MD, van Dalen J, van der Vleuten C. Doctor-patient communication in Southeast Asia: a different culture? Adv Health Sci Educ Theory Pract; 2013; 18(1): 15–31.CrossRefPubMed
40.
Zurück zum Zitat Baker R, Wu AW, Teno JM, Kreling B, Damiano AM, Rubin HR, et al. Family satisfaction with end-of-life care in seriously ill hospitalized adults. J Am Geriatr Soc. May; 2000;48(5 Suppl):S61–9.CrossRef Baker R, Wu AW, Teno JM, Kreling B, Damiano AM, Rubin HR, et al. Family satisfaction with end-of-life care in seriously ill hospitalized adults. J Am Geriatr Soc. May; 2000;48(5 Suppl):S61–9.CrossRef
41.
Zurück zum Zitat Mitchell SL, Berkowitz RE, Lawson FM, Lipsitz LA. A cross-national survey of tube-feeding decisions in cognitively impaired older persons. J Am Geriatr Soc.Apr; 2000; 48(4): 391–7.CrossRef Mitchell SL, Berkowitz RE, Lawson FM, Lipsitz LA. A cross-national survey of tube-feeding decisions in cognitively impaired older persons. J Am Geriatr Soc.Apr; 2000; 48(4): 391–7.CrossRef
42.
Zurück zum Zitat Conron M, Phuah S, Steinfort D, Dabscheck E, Wright G, Hart D. Analysis of multidisciplinary lung cancer practice. Intern Med J; 2007; 37(1): 18–25.CrossRefPubMed Conron M, Phuah S, Steinfort D, Dabscheck E, Wright G, Hart D. Analysis of multidisciplinary lung cancer practice. Intern Med J; 2007; 37(1): 18–25.CrossRefPubMed
43.
Zurück zum Zitat Lamb BW, Jalil RT, Sevdalis N, Vincent C, Green JS. Strategies to improve the efficiency and utility of multidisciplinary team meetings in urology cancer care: a survey study. BMC Health Serv Res; 2014;14:377.CrossRefPubMedPubMedCentral Lamb BW, Jalil RT, Sevdalis N, Vincent C, Green JS. Strategies to improve the efficiency and utility of multidisciplinary team meetings in urology cancer care: a survey study. BMC Health Serv Res; 2014;14:377.CrossRefPubMedPubMedCentral
44.
Zurück zum Zitat Mahadeva S, Khoo B-L, Khoo P-S, Malik A, Hilmi I, Qua C-S, et al. Clinical impact and risk factors for percutaneous gastrostomy wound infections due to resistant organisms. Int J Infect Dis; 2008;12(6):e149–e50.CrossRefPubMed Mahadeva S, Khoo B-L, Khoo P-S, Malik A, Hilmi I, Qua C-S, et al. Clinical impact and risk factors for percutaneous gastrostomy wound infections due to resistant organisms. Int J Infect Dis; 2008;12(6):e149–e50.CrossRefPubMed
45.
Zurück zum Zitat Subramaniam S. Private healthcare facilities and services (private hospitals and other private healthcare facilities)(amendment) order 2013. Malaysia: Attorney General’s Chambers, 2013. Subramaniam S. Private healthcare facilities and services (private hospitals and other private healthcare facilities)(amendment) order 2013. Malaysia: Attorney General’s Chambers, 2013.
46.
48.
Zurück zum Zitat Smith T. Annual BANS Report, 2011: Artificial Nutrition Support in the UK 2000-2011. Redditch, Worcs: BAPEN, 2011. Smith T. Annual BANS Report, 2011: Artificial Nutrition Support in the UK 2000-2011. Redditch, Worcs: BAPEN, 2011.
49.
Zurück zum Zitat Elia M. An international perspective on artificial nutritional support in the community. Lancet; 1995; 345(8961): 1345–9.CrossRefPubMed Elia M. An international perspective on artificial nutritional support in the community. Lancet; 1995; 345(8961): 1345–9.CrossRefPubMed
50.
Zurück zum Zitat Tangcharoensathien V, Patcharanarumol W, Ir P, Aljunid SM, Mukti AG, Akkhavong K, et al. Health-financing reforms in southeast Asia: challenges in achieving universal coverage. Lancet; 2011; 377(9768): 863–73.CrossRefPubMed Tangcharoensathien V, Patcharanarumol W, Ir P, Aljunid SM, Mukti AG, Akkhavong K, et al. Health-financing reforms in southeast Asia: challenges in achieving universal coverage. Lancet; 2011; 377(9768): 863–73.CrossRefPubMed
51.
Zurück zum Zitat Rechel B, Grundy E, Robine J-M, Cylus J, Mackenbach JP, Knai C, et al. Ageing in the European Union. Lancet; 2013; 381(9874): 1312–22.CrossRefPubMed Rechel B, Grundy E, Robine J-M, Cylus J, Mackenbach JP, Knai C, et al. Ageing in the European Union. Lancet; 2013; 381(9874): 1312–22.CrossRefPubMed
Metadaten
Titel
Perceptions of healthcare professionals on the usage of percutaneous endoscopic gastrostomy in a teaching hospital from a middle-income South East Asian country
verfasst von
M. H. Jaafar
S. Mahadeva
P. Subramanian
Maw Pin Tan
Publikationsdatum
09.07.2016
Verlag
Springer Paris
Erschienen in
The journal of nutrition, health & aging / Ausgabe 4/2017
Print ISSN: 1279-7707
Elektronische ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-016-0774-2

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