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Abstract
Children with serious chronic medical conditions may develop severe feeding problems.
In some of these children feeding through an enteral feeding tube may be necessary, and for long-term enteral feeding a gastrostomy may be the best choice. There are still few reports on parents’ assessment of outcome of gastrostomy.
The aims of the thesis were to assess parent reported outcome after gastrostomy placement in terms of factors affecting child health, gastrostomy complications, parents’ reports of meal situation, and changes in maternal psychological distress after gastrostomy placement, by reviewing medical records, performing semistructured interviews and using self-report questionnaires.
Parental satisfaction was high following gastrostomy placement, and most of the parents would, given the choice, have chosen a gastrostomy again. Parents also reported that their child’s overall situation had improved.
Vomiting was reduced in 40 %, and half of the children increased their oral intake of food according to the parents. Half of the children increased their weight-for-height percentile, and 20 % became obese.
Parents reported improved meal situations regarding both child and parent stress and satisfaction, and improved parent-child communication during meals.
Mothers reported lower levels of psychological distress, and symptoms of intrusive stress were significantly reduced.
Early postoperative complications were seen in 12 %. However, during long-term follow-up most children (more than 70%) experienced minor peristomal complications such as leakage, minor infections and hypergranulation.
Overall, despite frequent minor complications, placement of a gastrostomy had a positive impact on both the child and their parents, and gastrostomy may be useful in chronically ill children with major feeding problems.