Feeding tube use in Italian nursing homes: The role of cultural factors

Bellelli, Giuseppe; Frisoni, Giovanni B.; Trabucchi, Marco

doi:10.1016/j.jamda.2004.12.014

Cited by 8 publications

(8 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A small-scale study from Italy declared the prevalence of tube feeding to range between ! 2.0% up to 6.6% in a few nursing homes, but did not mention a mean or median prevalence [9] . On a global scale, there are several studies comparing the use and prevalence of tube feeding in nursing home residents with advanced dementia [24] , which unfortunately are not comparable to this study as our questionnaire was not restricted to residents with dementia.…”

Section: Discussionmentioning

confidence: 97%

“…Nevertheless, reliable data are lacking in Germany and other European countries regarding the prevalence and use of enteral feeding via PEG in nursing homes. Significant differences between countries are thought to exist [8,9] . PEG use in nursing homes is a field of high interest because critics of artificial nutrition in the elderly presume that this method is partly misused to ease care without any reasonable medical indication [10][11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of Percutaneous Endoscopic Gastrostomy in Nursing Home Residents – A Nationwide Survey in Germany

Wirth

Bauer

Willschrei³

et al. 2009

Gerontology

View full text Add to dashboard Cite

Background: Despite extensive discussion about percutaneous endoscopic gastrostomy (PEG) in nursing home residents, no prevalence data exist in most countries. Objective: This study aimed to determine the prevalence of PEG in German nursing homes, as well as nursing home characteristics that may influence this prevalence. Additionally, we documented the timing of PEG insertion, whether pre- or post-admission to the nursing home, and the proportion of residents receiving oral nutrition in addition to tube feeds. Methods: A 26-item questionnaire was sent to 6,995 German nursing homes. Responses were anonymous. Results: Of the 6,995 questionnaires sent out, 807 (11.5%) were completed and returned. Of the 66,507 total residents in the responding nursing homes, there were 4,390 residents with PEG (6.6%). The median PEG prevalence was 5.6% (5th–95th percentile 1.0–16.3%). Of all PEGs inserted, 55.3% were inserted before and 44.7% were inserted after nursing home admission. Oral beverage intake in addition to tube feeding was reported in 48.8% of residents with a PEG, and 43.5% of patients also received solid food. There were no significant differences in PEG prevalence between the federal states of Germany. The location (rural vs. urban) of the nursing home, its proprietor and food delivery method had no significant influence on PEG prevalence. With regard only to PEG tubes inserted after nursing home admission, all the factors stated above showed no significant influence on PEG prevalence. Weak positive correlations between PEG prevalence and the size of the nursing home as well as the number of total and certified nursing staff per resident could be detected, reflecting the heavy burden of care associated with residents requiring artificial nutrition. Conclusions: Compared to other countries, Germany can be assumed to have an average PEG prevalence in nursing home residents. No specific nursing home characteristics could be identified that affect PEG prevalence.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Prevalence of Percutaneous Endoscopic Gastrostomy in Nursing Home Residents – A Nationwide Survey in Germany

Wirth

Bauer

Willschrei³

et al. 2009

Gerontology

View full text Add to dashboard Cite

show abstract

“…Approximately 5-30% of the advanced dementia patients in nursing homes are on tube feeding in Europe and the USA; whereas, in Japan, approximately 50% of those are on tube feeding. [3][4][5][6] Thus, the percentage of tube feeding including PEG for dementia patients is higher in Japan than that in Western countries. However, recent studies have questioned the appropriateness of tube feeding in these patients.…”

Section: Introductionmentioning

confidence: 99%

Indications and practice for tube feeding in Japanese geriatricians: Implications of multidisciplinary team approach

Ogita

Utsunomiya

Akishita

et al. 2012

Geriatrics Gerontology Int

View full text Add to dashboard Cite

The results show that approximately half of the geriatricians prescribe tube feeding when the patient has dementia with loss of appetite or apraxia for eating. There is no consensus among Japanese geriatricians about the indication of tube feeding for demented people. We suggest that guidelines for tube feeding in the elderly should be established. Furthermore, a multidisciplinary approach would be desirable for decision making for tube feeding.

show abstract

“…Likely, the reduced use of feeding tubes in Italian nursing homes is due to the lack of education in the field of artificial nutrition, in addition to financial and environment‐specific factors and cultural background. Indeed, the Italian attitude toward end‐of‐life decisions is certainly less aggressive than that of other countries (United States or Netherlands) 33 . Also in our study, feeding tubes have a limited use (an average of 6.6% of NHRs).…”

Section: Discussionmentioning

confidence: 51%

“…A French multicentric study observed a significantly less prevalent use compared with the United States 32 . Recently Bellelli et al 33 conducted 2 surveys at different times in 1 nursing home in the province of Brescia and in 31 nursing homes in the province of Cremona (Lombardia Region, Italy). They found that the use of EN was low among Italian NHRs (the global use of tube feeding varied from less than 2% to 6.6%), was significantly lower than in U.S. facilities, and was not associated with common clinical or nursing home's characteristics.…”

Section: Discussionmentioning

confidence: 99%