TY - JOUR
T1 - Between Choice, Necessity, and Comfort: Deciding on Tube Feeding in the Acute Phase After a Severe Stroke
AU - Frey, Isabel
AU - De Boer, Marike E.
AU - Dronkert, Leonie
AU - Pols, A. Jeannette
AU - Visser, Marieke C.
AU - Hertogh, Cees M. P. M.
AU - Depla, Marja F. I. A.
N1 - Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by The Netherlands Organization for Health Research and Development (grant number 844001305). Publisher Copyright: © The Author(s) 2020. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - This is an ethnographic study of decision-making concerning tube feeding in the acute phase after a severe stroke. It is based on 6 months of ethnographic research in three stroke units in the Netherlands, where the decision-making on life-sustaining treatment was studied in 16 cases of severe stroke patients. Data were collected through participant observation and interviews. For this article, the analysis was narrowed down to the decision whether or not the patient should receive tube feeding. The data on tube feeding were assembled and coded according to different modes of dealing with this decision in clinical practice, which we refer to as “repertoires.” We discerned three different repertoires: choice, necessity, and comfort. Each repertoire structures clinical practice differently: It implies distinctive ethical imperatives, central concerns, sources of information, and temporalities. We hope our findings can improve decision-making by uncovering its underlying logics in clinical practice.
AB - This is an ethnographic study of decision-making concerning tube feeding in the acute phase after a severe stroke. It is based on 6 months of ethnographic research in three stroke units in the Netherlands, where the decision-making on life-sustaining treatment was studied in 16 cases of severe stroke patients. Data were collected through participant observation and interviews. For this article, the analysis was narrowed down to the decision whether or not the patient should receive tube feeding. The data on tube feeding were assembled and coded according to different modes of dealing with this decision in clinical practice, which we refer to as “repertoires.” We discerned three different repertoires: choice, necessity, and comfort. Each repertoire structures clinical practice differently: It implies distinctive ethical imperatives, central concerns, sources of information, and temporalities. We hope our findings can improve decision-making by uncovering its underlying logics in clinical practice.
KW - end-of-life decision-making
KW - ethnographic research
KW - palliative care
KW - qualitative research; The Netherlands
KW - severe stroke
KW - tube feeding
UR - http://www.scopus.com/inward/record.url?scp=85084786788&partnerID=8YFLogxK
U2 - https://doi.org/10.1177/1049732320911370
DO - https://doi.org/10.1177/1049732320911370
M3 - Article
C2 - 32418501
SN - 1049-7323
VL - 30
SP - 1114
EP - 1124
JO - Qualitative health research
JF - Qualitative health research
IS - 7
ER -