Cultural Considerations in Tube Feeding Decision-Making

2014 ◽  
Vol 21 (2) ◽  
pp. 63-73 ◽  
Author(s):  
Nori Watson ◽  
Christina Bell
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Tube Feeding ◽  
Cultural Influences ◽  
Cultural Factors ◽  
Feeding Problems ◽  
Healthcare Teams ◽  
Assessment Skills ◽  
Institutional Differences ◽  
Feeding Decision

Tube feeding is a common intervention considered in the care of older adults. The objective of this paper is to provide an overview of the current literature on the relationship between cultural factors and tube feeding in older adults, to help prepare speech-language pathologists (SLPs) to consider these cultural factors in communicating with their patients and families who may be faced with a tube feeding decision. Although evidence indicates that this intervention lacks benefit in advanced dementia, the decision to provide tube feeding can be complicated and challenging. SLPs are often consulted to provide assistance in the evaluation of an older adult with eating and feeding problems, and have an important role in tube feeding decision-making. SLPs and the healthcare teams they work with need to be aware of regional, national, international, ethnic, cultural, and institutional differences in tube feeding decision-making and utilization. SLPs and their healthcare teams need culturally sensitive communication and assessment skills to gently elicit and address cultural influences in this decision.

scholarly journals The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linda Serwaa Agyemang ◽  
Claire Foster ◽  
Chris McLean ◽  
Deborah Fenlon ◽  
Richard Wagland
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cultural Influences ◽  
Language Barriers ◽  
Treatment Decision ◽  
Cultural Factors ◽  
Structured Interviews ◽  
Financial Barriers ◽  
Essential Information ◽  
Treatment Decision Making

Abstract Background Socio-cultural factors may influence the uptake of breast cancer treatments. This study aimed to explore these socio-cultural influences on treatment decision-making for women in Ghana. Method An ethnographic approach was adopted. Observation was conducted of women newly diagnosed with breast cancer, nominated relatives, nurses and doctors at a breast clinic in Ghana. Semi-structured interviews followed participant observation. Thematic analysis was employed. Findings Over 16 weeks (July 2017–November 2017), 31 participants were observed and 29 took part in semi-structured interviews. Three overarching themes were identified: (1) unequal power relationships; (2) Language barriers and (3) structural constraints. Following a breast cancer diagnosis, essential information necessary for treatment decision making is ‘hidden’ from women due to an unequal patient-provider relationship. Patients acknowledged cultural behaviours of deference to experts. Doctors deliberately misrepresented treatment information to women to encourage them to undergo surgical treatment. Structural issues such as the lack of privacy during consultations hindered quality patient engagement with decision-making. High treatment costs and the lack of resources to assist women with fertility after treatment impeded open discussions around these issues. Language barriers included a lack of terms in the local Twi language to explain cancer and its treatment. There was also an absence of appropriate information materials. Conclusion Findings highlight the need for health professionals to be aware of the socio-cultural factors that limit access to quality information which is needed for informed treatment decision making. Policies that aim to provide adequate logistics; increase staffing levels; improve staff cultural awareness training and remove financial barriers are recommended.

scholarly journals The adaptation of older adults’ transition to residential care facilities and cultural factors: a meta-synthesis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Changxian Sun ◽  
Yaping Ding ◽  
Yan Cui ◽  
Shuqin Zhu ◽  
Xianwen Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Older People ◽  
Residential Care ◽  
Nursing Staff ◽  
Cultural Factors ◽  
Qualitative Studies ◽  
Decision Making Process ◽  
Residential Care Facilities ◽  
Care Facilities

Abstract Background The transition to residential care facilities can be stressful for older people, entailing numerous challenges. Many qualitative studies focused on the adjustment and the experiences associated with older adults’ admission to residential care facilities. However, there have been few studies to synthesize qualitative studies and pay attention to the cultural factors influencing adaptation. The aim is to appraise the adaptation of older people’ s transition to the residential care facilities. Methods We followed the method of Preferred Reporting Items of Systematic Review and Meta-Analysis (PRISMA). Six databases (CINHAL, Cochrane, Embase, Pubmed, PsycInfo, and Web of Science) were searched systematically from their inception until April 2020 using Medical Subject Headings (MSH) or Subject Headings plus free-text words. The CASP evaluation for qualitative studies was used for quality appraisal and meta-aggregation was used in the data analysis. Results Ten studies (from 7 countries on 3 continents) were included in this review. We synthesized two main findings: the impacts of culture on adaptation and the transition process. Conclusions Understanding the cultural factors helps nursing staff to gain new insight into older adults’ transition to residential care facilities. The consideration of cultural factors might be incorporated into tailored interventions for residents during transition. Nursing staff is advised to pay attention to the decision-making process before residents’ admission to the residential care facilities, and care plans are best made by residents, family members, and staff members together at the beginning of the decision-making process.

Decision-Making Processes Associated With Use of Nutrition Facts Panels by Younger and Older Adults

2011 ◽  
Author(s):  
Lisa M. S. Miller ◽  
Diana L. Cassady ◽  
Gina Lim ◽  
Doanna T. Thach ◽  
Tanja N. Gibson
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Decision Making Processes

Too much choice: Older adults' decision making related to Medicare part D

2007 ◽  
Author(s):  
Betty E. Tanius ◽  
Stacey Wood ◽  
Yaniv Hanoch ◽  
Thomas Rice ◽  
Martina Ly ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Medicare Part D ◽  
Medicare Part ◽  
Part D

Age-Related Differences in Motivational Integration and Cognitive Control

2019 ◽  
Author(s):  
Debbie Marianne Yee ◽  
Sarah L Adams ◽  
Asad Beck ◽  
Todd Samuel Braver
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Cognitive Control ◽  
Task Performance ◽  
Cognitive Task ◽  
Monetary Reward ◽  
Potential Candidate ◽  
Younger Adults ◽  
Age Related ◽  
Cognitive Task Performance

Motivational incentives play an influential role in value-based decision-making and cognitive control. A compelling hypothesis in the literature suggests that the brain integrates the motivational value of diverse incentives (e.g., motivational integration) into a common currency value signal that influences decision-making and behavior. To investigate whether motivational integration processes change during healthy aging, we tested older (N=44) and younger (N=54) adults in an innovative incentive integration task paradigm that establishes dissociable and additive effects of liquid (e.g., juice, neutral, saltwater) and monetary incentives on cognitive task performance. The results reveal that motivational incentives improve cognitive task performance in both older and younger adults, providing novel evidence demonstrating that age-related cognitive control deficits can be ameliorated with sufficient incentive motivation. Additional analyses revealed clear age-related differences in motivational integration. Younger adult task performance was modulated by both monetary and liquid incentives, whereas monetary reward effects were more gradual in older adults and more strongly impacted by trial-by-trial performance feedback. A surprising discovery was that older adults shifted attention from liquid valence toward monetary reward throughout task performance, but younger adults shifted attention from monetary reward toward integrating both monetary reward and liquid valence by the end of the task, suggesting differential strategic utilization of incentives. Together these data suggest that older adults may have impairments in incentive integration, and employ different motivational strategies to improve cognitive task performance. The findings suggest potential candidate neural mechanisms that may serve as the locus of age-related change, providing targets for future cognitive neuroscience investigations.

Sign in / Sign up

Export Citation Format

Share Document