Depression and Anxiety in PEG Feeding Dissertation - 1

Depression and Anxiety in PEG Feeding - Dissertation Example Expand a few lines†¦ TABLE OF CONTENTS TABLE OF CONTENTS 3 LIST OF FIGURES Abstract This dissertation is about the social and psychological impact, including anxiety and depressed moods, on people who are artificially fed via a tube based on percutaneous endoscopic gastrostomy (PEG). The analysis is based on a framework that highlights two sides of sickness, â€Å"disease† underlying the placement of a feeding tube (biological malfunctions recorded as particular disease categories, e.g., cancer, neurological disorders, cardiac diseases, palsy) and the response to this by patients and their carers. This distinction between â€Å"disease† and â€Å"illness† provides a view of the social and psychological complexities involved. These are often overlooked when artificial feeding is adopted. The dissertation proceeds via a description of the literature search on PEG. The primary tools used in this search is the topical search (e.g., â€Å"socio-psychological imp acts of PEG feeding†) on the internet and the exploration of various databases, such as Cinahl, PubMed, Medline, Cochrane and Google Scholar. The literature used refers to reports of â€Å"new† (i.e. past decade) findings. In a very few cases only, when outlining â€Å"illness responses† to â€Å"disease† and the ensuing person-oriented framework, a few basic sources pre-dating 2000, are drawn upon. The accompanying review of relevant sources attempts to bring out the emphasis of â€Å"disease† and the omission of efforts to develop a framework or model and conceptual tools to grasp the social and psychological implications of artificial feeding due to disability. Such a model can, however, be of great value to nursing care and operating practice. Such a framework is available to us via a number of qualitative studies and a â€Å"narrative understanding of the illness experience†. The usefulness of this body of literature will be examined in the ensuing discussion. In the conclusion I will stress the value of a qualitative, person-oriented perspective (the â€Å"illness experience†) for a humanistic medical and nursing practice. Introduction This dissertation is based on a lengthy review of available literature on the social and psychological impact, including anxiety and depressed moods, on people who are artificially fed via a tube based on percutaneous endoscopic gastrostomy (PEG) This review allows me to examine the emotional costs involved in PEG tube feeding, especially with regard to experiences and the coping with the emotional (anxiety, depressed mood) and social costs of tube feeding before, during and after the placement of a PEG tube. This dissertation takes the patient’s point of view and reviews two groups of literature in depth: one of the two is person-and qualitatively-oriented and proposes a meaning-centred, qualitative and humanistic method/perspective. At the same time, one realizes tha t patients are found in a larger health care context where medical and health care professionals operate. Their and the perspective of medicine must be understood as well. Byron Good’s (2008) book on Medicine, Rationality and Experience provides a good introduction to their and the patient’s perspective. It is therefore meaningful to compare and contrast the views and perspectives of these professionals and the views that patients express, their way of coping with PEG tube feeding, their modes of reasoning, their various feeling-states (anxiety, depression) and the lives they live. I have chosen