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      Factors influencing decision regret regarding placement of a PEG among substitute decision-makers of older persons in Japan: a prospective study

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      BMC Geriatrics

      BioMed Central

      Decision regret, Decision conflict, Decision-making, Feeding tube, Older person

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          Abstract

          Background

          A tube feeding decision aid designed at the Ottawa Health Research Institute was specifically created for substitute decision-makers who must decide whether to allow placement of a percutaneous endoscopic gastrostomy (PEG) tube in a cognitively impaired older person. We developed a Japanese version and found that the decision aid promoted the decision-making process of substitute decision-makers to decrease decisional conflict and increase knowledge. However, the factors that influence decision regret among substitute decision-makers were not measured after the decision was made. The objective of this study was to explore the factors that influence decision regret among substitute decision-makers 6 months after using a decision aid for PEG placement.

          Methods

          In this prospective study, participants comprised substitute decision-makers for 45 inpatients aged 65 years and older who were being considered for placement of a PEG tube in hospitals, nursing homes and patients’ homes in Japan. The Decisional Conflict Scale (DCS) was used to evaluate decisional conflict among substitute decision-makers immediately after deciding whether to introduce tube feeding and the Decision Regret Scale (DRS) was used to evaluate decisional regret among substitute decision-makers 6 months after they made their decision. Normalized scores were evaluated and analysis of variance was used to compare groups.

          Results

          The results of the multiple regression analysis suggest that PEG placement ( P < .01) and decision conflict ( P < .001) are explanatory factors of decision regret regarding placement of a PEG among substitute decision-makers.

          Conclusions

          PEG placement and decision conflict immediately after deciding whether to allow PEG placement have an influence on decision regret among substitute decision-makers after 6 months.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12877-017-0524-2) contains supplementary material, which is available to authorized users.

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          Most cited references 19

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          Validation of a Decision Regret Scale

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            Rethinking the role of tube feeding in patients with advanced dementia.

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              Tube Feeding in Patients With Advanced Dementia

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                Author and article information

                Contributors
                y-noda@slcn.ac.jp
                nakayama@slcn.ac.jp
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                28 June 2017
                28 June 2017
                2017
                : 17
                Affiliations
                ISNI 0000 0001 0318 6320, GRID grid.419588.9, Graduate School of Nursing Science, , St. Luke’s International University, ; 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044 Japan
                Article
                524
                10.1186/s12877-017-0524-2
                5490187
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funding
                Funded by: MEXT KAKENHI
                Award ID: 25862123
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Geriatric medicine

                older person, feeding tube, decision-making, decision conflict, decision regret

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