Journal Articles

Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915

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Author: search.filters.author.Cook C

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    Insights into paediatric tube feeding dependency: A speech language pathology perspective
    Jones E; Southwood H; Cook C; Nicholson T
    Aim: To identify factors that contribute to pediatric tube dependency from the Speech Language Pathology (SLP) perspective. Tube dependency is characterised by the need to remain tube fed after the need for enteral feeding has ended. Most research relates to intervention programmes for tube withdrawal/weaning. However, there is limited research into factors contributing to tube feeding dependency. SLP perspectives about this morbidity have yet to be explored. Method: A sequential mixed methodology was utilised. In the quantitative phase, 43 SLPs completed an online survey. Ten participants were then interviewed for the quantitative phase. Findings from both phases were integrated at the final analysis. Result: There was four clear factors that contributed to tube dependency from the survey; medical condition, the tube fed child’s negative reaction to oral feeding, limited appetite, and insufficient clinical time to transition children to oral feeding. The interview data further explained the survey results. In addition, participants perceived the prolonged use of nasogastric tube (NGT) feeding; parental influence; service delivery issues and the challenges of school transition as contributing factors to tube dependency. Conclusion: SLPs identified that there were often multiple and often competing factors that resulted in tube dependency. Early and ongoing biomedical focus on weight gain continued to affect long-term goals for transitioning to oral feeding. Team goals were not shared or consistent in terms of priorities for the child. This lack of a shared vision led to parents receiving competing and conflicting messages prolonging tube feeding.
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    Palliative Care, Intimacy, and Sexual Expression in the Older Adult Residential Care Context: "Living until You Don't"
    (MDPI (Basel, Switzerland), 2022-10-12) Cook C; Henrickson M; Schouten V
    Commonly, frail older adults move to residential care, a liminal space that is their home, sometimes a place of death, and a workplace. Residential facilities typically espouse person-centred values, which are variably interpreted. A critical approach to person-centred care that focuses on social citizenship begins to address issues endemic in diminishing opportunities for intimacy in the end-of-life residential context: risk-averse policies; limited education; ageism; and environments designed for staff convenience. A person-centred approach to residents’ expressions of intimacy and sexuality can be supported throughout end-of-life care. The present study utilised a constructionist methodology to investigate meanings associated with intimacy in the palliative and end-of-life care context. There were 77 participants, including residents, family members and staff, from 35 residential facilities. Analysis identified four key themes: care home ethos and intimacy; everyday touch as intimacy; ephemeral intimacy; and intimacy mediated by the built environment. Residents’ expressions of intimacy and sexuality are supported in facilities where clinical leaders provide a role-model for a commitment to social citizenship. Ageism, restrictive policies, care-rationing, functional care, and environmental hindrances contribute to limited intimacy and social death. Clinical leaders have a pivotal role in ensuring person-centred care through policies and practice that support residents’ intimate reciprocity.