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That Won't Help The Meatballs: health care providers' perceptions of eating, drinking, and feeding as human experiences

Leslie, Paula (2017) That Won't Help The Meatballs: health care providers' perceptions of eating, drinking, and feeding as human experiences. Master's Thesis, University of Pittsburgh. (Unpublished)

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Eating, drinking, and feeding are individual acts signaling our values, our identity, our cultural alignment, and care giving. Humans need oxygen, a system to transport oxygen, and fuel (food and drink), but only with the last of these do we choose what, where and with whom. Swallowing difficulties (dysphagia) affect nine million adults in the United States. Health care providers report more discomfort with dysphagia decisions than other clinical interventions. Feeding is a unique form of clinical care because providers live in both worlds: eating, drinking and feeding as fundamentally and culturally part of 1) human experience and 2) clinical process.

To explore health care providers’ personal and professional attitudes to eating, drinking, and feeding focusing on the incongruities between the two perspectives.

Two focus groups occurred with speech-language pathologists (total n=15) from rehabilitation settings and two groups with non-SLP front line providers (total n=15) from an urban health care network. Participants considered: 1) eating/drinking/feeding as a) a human experience, and b) a biomechanical task in dysphagia care, and 2) why health care providers may deviate from practice guidelines. Dialogue was audio recorded, transcribed and studied using Thematic Analysis.

A list of 33 codes gave rise to 8 themes: we eat and drink for health and life; meanings of food and feeding; nutrition/hydration versus food/drink; reasons for practice patterns; professional collaboration; patient control; economic concerns; improving things. Participants voiced concern that a) patients lose control over a highly meaningful life process, and b) health care providers do not recognize their role in this problem. Participants expressed inner turmoil with feeding interventions/decisions.

Dysphagia intervention uniquely challenges and distresses people making decisions. Health care providers aim to do good but the definition of what “good” is should be broadened and addressed earlier in training. The telos (purpose) of eating and feeding is much more than the techne (doing) of medically framed nutrition. Addressing providers’ distress could reduce patient/family angst and support informed consent because more appropriate questions can be asked and clearer information provided, especially valuable in situations when caregivers have to make decisions.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Leslie, Paulapleslie@pitt.eduPLESLIE
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairTerry, Marthamaterry@pitt.edumaterry
Committee MemberHall, Danieldeh30@pitt.edudeh30
Committee MemberWright, Rollinrmw27@pitt.edurmw27
Date: 20 January 2017
Date Type: Publication
Defense Date: 4 November 2016
Approval Date: 20 January 2017
Submission Date: 3 December 2016
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 95
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Bioethics
Degree: MA - Master of Arts
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: bioethics, feeding, focus group, health care, human experience
Date Deposited: 20 Jan 2017 15:30
Last Modified: 21 Jan 2017 06:15


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