What are the attitudes and perceptions of Doctors to the informed consent process for patients receiving a Percutaneous Endoscopic Gastrostomy (PEG) following a Cerebral Vascular Accident (CVA)?

  • Elaine Elizabeth Trautner

    Student thesis: Master's ThesisMaster of Science by Research


    Patients post CVA can often suffer with dysphagia which means that they cannot take diet and fluids orally. These patients may require feed to be provided to them through a percutaneous endoscopic gastrostomy (PEG), in order for this procedure to be completed, doctors must first gain consent from the patient prior to the procedure taking place. In the UK it would appear that there is very little research into the perceptions of doctors around PEG consent post CVA and so I as the researcher identified that research was required to identify the perceptions of doctors around PEG consent post CVA.

    This research aims to explore the experiences of gastroenterologists and gerontologists (with experience of CVA) into PEG consent post CVA. A qualitative hermeneutical phenomenological was used in this research. Ten doctors of varied levels of experience were interviewed using unstructured interviews to collect data, each interview was then transcribed and analysed using thematic analysis. Ethical clearance was provided prior to the commencement of the research.

    The key findings of the research were displayed in four main themes. The first theme ‘task VS process’ identified that PEG consent post CVA is a process with several processes rather than a single task or piece of documentation. These processes include consideration of both the needs of the patient and the physical assessment of the patient prior to procedure. Theme two, ‘collaborative working’ considered the importance of a multidisciplinary approach to PEG consent to ensure specialist assessments and in-depth information was provided to patient, to ensure PEG placement was in their best interests. Theme three ‘process of interaction’. In particular the need to ascertain the capacity of the patient as part of the consent process was identified as essential and the difficulties in communicating with both 3 Elaine Trautner - 1226072 patients following a CVA and their families about PEG was discussed by the doctors interviewed. Finally, theme four ‘preparation to consent’ outlined that some junior doctors felt afraid to consent patients for a PEG post CVA due to lack of knowledge. Doctors interviewed outlined that they had received little or nil education around PEG consent or clinical nutrition and felt more education from nutrition teams was required.

    This research has identified that PEG consent post CVA is in fact a process which requires a multidisciplinary approach to ensure PEG is in the best interests of the patient. Junior doctors require training on how to consent for PEG and clinical nutrition as a whole in order to improve the outcome for the patient.
    Date of Award2014
    Original languageEnglish
    Awarding Institution
    • Coventry University
    SupervisorJean Astley-Cooper (Supervisor)

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