Mothers\" Process of Decision Making for Gastrostomy Placement

Qualitative Health Research 22(5) 587 –594 ? The Author(s) 2012 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/1049732311423841 http://qhr.sagepub.com Articles Children who experience prolonged dysphasia and are unable to achieve an adequate nutritional intake orally are often considered suitable for artificial nutritional support via a gastrostomy tube. The clinical benefits of gastrostomy feeding are well recognized (Ramelli, Aloysius, King, Davis, & Muntoni, 2007; Sullivan et al., 2005), and arguably gastrostomy feeding leads to an improvement in the child’s quality of life (Rogers, 2004; Samson-Fang, Butler, & O’Donnell, 2003). Gastrostomy feeding is therefore often considered effective in correcting malnutrition that is attributable to feeding problems, but at what cost? The impact of percutaneous endoscopic gastrostomy (PEG) feeding goes beyond clinical and nutritional issues; when mothers first encounter the suggestion that PEG feeding might be required for their child, they face a plethora of conflicting tensions. It has been reported that the mere suggestion of a gastrostomy tube “sets up a conflict whereby mothers are faced with the complex task of renegotiating the meaning of ‘good’ mothering and finding new ways of relating to their child, constructed through the medium of feeding” (Craig & Scambler, 2006, p. 1116). Once in situ, the gastrostomy tube is the cause of further parental stress, created by the caring for a