Tags

Type your tag names separated by a space and hit enter

Tube feeding in patients with advanced dementia: knowledge and practice of speech-language pathologists.
J Pain Symptom Manage. 2011 Sep; 42(3):366-78.JP

Abstract

CONTEXT

Speech-language pathologists (SLP) are often called on to evaluate eating difficulties in patients with dementia.

OBJECTIVES

To assess factors associated with SLPs' knowledge and recommendations about feeding tubes in patients with advanced dementia.

METHODS

A mail survey was administered to a probability sample of 1500 SLPs from the American Speech-Language-Hearing Association mailing list; 731 usable surveys were received (response rate=53.7%). Self-perceived preparedness, knowledge, and care recommendations were measured. Knowledge items were scored as "evidence based" or not according to the best evidence in the literature.

RESULTS

Only 42.1% of SLP respondents felt moderately/well prepared to manage dysphagia. Only 22.0% of respondents recognized that tube feeding is unlikely to reduce risk of aspiration pneumonia whereas a slight majority understood that tube feeding would not likely prevent an uncomfortable death (50.2%), improve functional status (54.5%), or enhance quality of life (QOL) (63.2%). A majority (70.0%) was willing to consider recommending oral feeding despite high risk of aspiration. Logistic regression analyses indicated that those willing to consider this recommendation gave the most evidence-based responses to knowledge questions about tube feeding outcomes: aspiration pneumonia (odds ratio [OR]=1.75, 95% confidence interval [CI]=1.07-2.87), functional status (OR=1.43, 95% CI=1.0-2.06), QOL (OR=2.19, 95% CI=1.52-3.17), and prevent uncomfortable death (OR=1.97, 95% CI=1.37-2.88). Logistic regression analyses also indicated that those with more experience evaluating patients with dementia gave the most evidence-based response to two knowledge questions: aspiration pneumonia (OR=2.64, 95% CI=1.48-4.72) and prevent uncomfortable death (OR=2.03, 95% CI=1.35-3.05) whereas those with higher self-perceived preparedness in managing dysphagia in dementia had less knowledge in two areas: aspiration pneumonia (OR=0.57, 95% CI=0.38-0.84) and QOL (OR=0.72, 95% CI=0.51-1.01).

CONCLUSION

Misperceptions among SLPs about tube feeding in advanced dementia are common, especially in relation to risk of aspiration. Knowledge about tube feeding outcomes was positively associated with experience and inversely associated with self-perceived higher preparedness in evaluating patients with dementia.

Authors+Show Affiliations

Division of Geriatric Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA. cavitale@umich.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21454044

Citation

Vitale, Caroline A., et al. "Tube Feeding in Patients With Advanced Dementia: Knowledge and Practice of Speech-language Pathologists." Journal of Pain and Symptom Management, vol. 42, no. 3, 2011, pp. 366-78.
Vitale CA, Berkman CS, Monteleoni C, et al. Tube feeding in patients with advanced dementia: knowledge and practice of speech-language pathologists. J Pain Symptom Manage. 2011;42(3):366-78.
Vitale, C. A., Berkman, C. S., Monteleoni, C., & Ahronheim, J. C. (2011). Tube feeding in patients with advanced dementia: knowledge and practice of speech-language pathologists. Journal of Pain and Symptom Management, 42(3), 366-78. https://doi.org/10.1016/j.jpainsymman.2010.11.017
Vitale CA, et al. Tube Feeding in Patients With Advanced Dementia: Knowledge and Practice of Speech-language Pathologists. J Pain Symptom Manage. 2011;42(3):366-78. PubMed PMID: 21454044.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tube feeding in patients with advanced dementia: knowledge and practice of speech-language pathologists. AU - Vitale,Caroline A, AU - Berkman,Cathy S, AU - Monteleoni,Carol, AU - Ahronheim,Judith C, Y1 - 2011/03/31/ PY - 2010/8/17/received PY - 2010/11/14/revised PY - 2010/11/23/accepted PY - 2011/4/2/entrez PY - 2011/4/2/pubmed PY - 2011/12/17/medline SP - 366 EP - 78 JF - Journal of pain and symptom management JO - J Pain Symptom Manage VL - 42 IS - 3 N2 - CONTEXT: Speech-language pathologists (SLP) are often called on to evaluate eating difficulties in patients with dementia. OBJECTIVES: To assess factors associated with SLPs' knowledge and recommendations about feeding tubes in patients with advanced dementia. METHODS: A mail survey was administered to a probability sample of 1500 SLPs from the American Speech-Language-Hearing Association mailing list; 731 usable surveys were received (response rate=53.7%). Self-perceived preparedness, knowledge, and care recommendations were measured. Knowledge items were scored as "evidence based" or not according to the best evidence in the literature. RESULTS: Only 42.1% of SLP respondents felt moderately/well prepared to manage dysphagia. Only 22.0% of respondents recognized that tube feeding is unlikely to reduce risk of aspiration pneumonia whereas a slight majority understood that tube feeding would not likely prevent an uncomfortable death (50.2%), improve functional status (54.5%), or enhance quality of life (QOL) (63.2%). A majority (70.0%) was willing to consider recommending oral feeding despite high risk of aspiration. Logistic regression analyses indicated that those willing to consider this recommendation gave the most evidence-based responses to knowledge questions about tube feeding outcomes: aspiration pneumonia (odds ratio [OR]=1.75, 95% confidence interval [CI]=1.07-2.87), functional status (OR=1.43, 95% CI=1.0-2.06), QOL (OR=2.19, 95% CI=1.52-3.17), and prevent uncomfortable death (OR=1.97, 95% CI=1.37-2.88). Logistic regression analyses also indicated that those with more experience evaluating patients with dementia gave the most evidence-based response to two knowledge questions: aspiration pneumonia (OR=2.64, 95% CI=1.48-4.72) and prevent uncomfortable death (OR=2.03, 95% CI=1.35-3.05) whereas those with higher self-perceived preparedness in managing dysphagia in dementia had less knowledge in two areas: aspiration pneumonia (OR=0.57, 95% CI=0.38-0.84) and QOL (OR=0.72, 95% CI=0.51-1.01). CONCLUSION: Misperceptions among SLPs about tube feeding in advanced dementia are common, especially in relation to risk of aspiration. Knowledge about tube feeding outcomes was positively associated with experience and inversely associated with self-perceived higher preparedness in evaluating patients with dementia. SN - 1873-6513 UR - https://www.unboundmedicine.com/medline/citation/21454044/Tube_feeding_in_patients_with_advanced_dementia:_knowledge_and_practice_of_speech_language_pathologists_ DB - PRIME DP - Unbound Medicine ER -