TY - JOUR

T1 - Percutaneous venting gastrostomy/gastrojejunostomy for malignant bowel obstruction: a qualitative study

AU - Singh Curry, Rebecca

AU - Evans, Elizabeth

AU - Raftery, Anne-Marie

AU - Hiscock, Julia

AU - Poolman, Marlise

PY - 2019/12/3

Y1 - 2019/12/3

N2 - Malignant Bowel Obstruction (MBO) is a complication of advanced malignancy and is associated with a short prognosis. MBO can infrequently be reversed by surgery or stenting, however the focus of treatment is usually symptomatic management, of which percutaneous venting gastrostomy/gastrojejunostomy (PVG) is one consideration. There is little data considering the impact of PVG on quality of life, and we therefore aimed to explore this. We identified patients with PVG inserted for MBO and those who consented to participate were interviewed. The interviews were audio-recorded, transcribed and analysed using Framework. Alongside patient interviews, a data collection tool was designed and utilised to record patient demographics and medical information, enabling us to contextualise individual patients’ experiences. 11 patients were interviewed and 10 patients’ data was analysed (1 patient withdrew). No patients regretted having a PVG and many benefitted symptomatically and psychosocially. Challenges encountered included practical issues, pain and PVG tube complications. The analysis provided a detailed insight into the impact of PVG insertion and demonstrated that each patients’ experience is shaped by a complex interplay of individual factors, thereby highlighting the need to improve referral criteria and individualise patient selection. Other service improvements include enhancing information provision for patients and training for Healthcare Professionals’, thus aiming to mitigate the challenges experienced.Our study is the first to explore in-depth patients’ experiences of PVG at a tertiary cancer centre. Ensuring that the insights from this study are fed back to guide future service provision is critical in enhancing patient experiences.

AB - Malignant Bowel Obstruction (MBO) is a complication of advanced malignancy and is associated with a short prognosis. MBO can infrequently be reversed by surgery or stenting, however the focus of treatment is usually symptomatic management, of which percutaneous venting gastrostomy/gastrojejunostomy (PVG) is one consideration. There is little data considering the impact of PVG on quality of life, and we therefore aimed to explore this. We identified patients with PVG inserted for MBO and those who consented to participate were interviewed. The interviews were audio-recorded, transcribed and analysed using Framework. Alongside patient interviews, a data collection tool was designed and utilised to record patient demographics and medical information, enabling us to contextualise individual patients’ experiences. 11 patients were interviewed and 10 patients’ data was analysed (1 patient withdrew). No patients regretted having a PVG and many benefitted symptomatically and psychosocially. Challenges encountered included practical issues, pain and PVG tube complications. The analysis provided a detailed insight into the impact of PVG insertion and demonstrated that each patients’ experience is shaped by a complex interplay of individual factors, thereby highlighting the need to improve referral criteria and individualise patient selection. Other service improvements include enhancing information provision for patients and training for Healthcare Professionals’, thus aiming to mitigate the challenges experienced.Our study is the first to explore in-depth patients’ experiences of PVG at a tertiary cancer centre. Ensuring that the insights from this study are fed back to guide future service provision is critical in enhancing patient experiences.

KW - malignant bowel obstruction

KW - patient experience

KW - percutaneous venting gastrostomy

KW - qualitative

U2 - 10.1136/bmjspcare-2019-001866

DO - 10.1136/bmjspcare-2019-001866

M3 - Article

VL - 9

SP - 381

EP - 388

JO - BMJ Supportive and Palliative Care

JF - BMJ Supportive and Palliative Care

SN - 2045-435X

IS - 4

ER -