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Martin, Allison (2014) FEEDING TUBE INTERVENTION: FACTORS INFLUENCING DECISION MAKING IN PATIENTS WITH ALS. Master's Thesis, University of Pittsburgh. (Unpublished)

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Eating and drinking are necessary and pleasurable events that take place every day in a person’s life. Individuals with a swallowing disorder, known as dysphagia, have difficulty swallowing food and drinks. This impairment can result in an unpleasant swallowing process or an inability to swallow and associated health issues. Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease which inhibits, and eventually destroys, motor nerve cells in the brainstem and/or spinal cord that control voluntary muscle movement. Patients with ALS will develop dysphagia at some point in the disease process. Some patients opt to use artificial feeding tubes to supplement intake when they cannot obtain adequate nutrition/hydration orally. There are many factors that could affect this decision. This study aims to identify these factors through patient interviews.
Six participants who attended an ALS specialty clinic were interviewed by a third party investigator. The question set used in the interview was based on six main topic areas (background, information, values, outside pressures, support, and reflection), which were also used in a “sister study” by Vesey, Leslie, and Exley in 2008. The de-identified interview transcripts were analyzed using a coding method. The transcripts were coded by the primary investigator based on themes generated in the participants’ responses. A second coder was used to check the primary coder’s interpretations and to confirm that the conclusions from the transcripts were reasonable.
Patient-generated themes and individual factors were derived from the interview transcripts. Major themes found across patients include information, influences, support, and independence. Some unique personal factors found include how the feeding tube affects an individual’s appearance, social restrictions, and weighing the risks and benefits of timing of feeding tube placement. Clinicians need to understand factors patients consider when making the decision to accept or to decline a feeding tube.
For clarity, male pronouns such as he/him/his will be used when discussing a patient or client. Female pronouns such as she/her/hers will be used when discussing the clinician.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Martin, Allisonajm135@pitt.eduAJM135
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorLeslie, Paulapleslie@pitt.eduPLESLIE
Committee MemberCoyle, James Ljcoyle@pitt.eduJCOYLE
Committee MemberVerdolini, Katherinekav25@pitt.eduKAV25
Committee MemberTerry, Marthamaterry@pitt.eduMATERRY
Date: 23 May 2014
Date Type: Publication
Defense Date: 28 January 2014
Approval Date: 23 May 2014
Submission Date: 15 April 2014
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 91
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Communication Science and Disorders
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Amyotrophic Lateral Sclerosis; Decision Making; Feeding Tube
Date Deposited: 23 May 2014 14:59
Last Modified: 15 Nov 2016 14:19


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