Pain and discomfort in children with gastrostomy tubes - In the context of hematopoietic stem cell transplantation

J Pediatr Nurs. 2023 May-Jun:70:79-89. doi: 10.1016/j.pedn.2023.02.005. Epub 2023 Feb 26.

Abstract

Background: In children with malignant and severe non-malignant disorders undergoing hematopoietic stem cell transplantation (HSCT), treatment related pain and discomfort are common. Food consumption may become troublesome, making the use of a gastrostomy tube (G-tube) necessary and resulting in complications, why the purpose was to explore pain and discomfort during the transplantation and post-transplantation time.

Methods: This was a mixed methods study where data were collected along the child's total health-care process between 2018 and 2021. Questions with fixed answer options were used, simultaneously, semi-structured interviews were performed. In total, sixteen families participated. Descriptive statistics and content analysis were used to describe analysed data.

Findings: Intense pain was common during the post-surgery phase, especially in conjunction with G-tube care, which is why the children needed support to manage the situation. After the post-surgery phase when the skin has healed, most of the children experienced minor to no pain or bodily discomfort, why the G-tube became a well-functioning and supportive tool in daily life.

Conclusions: This study describes variations in and experiences of pain and bodily discomfort in conjunction with G-tube insertion in a unique sample of children who had undergone HSCT. In conclusion, the children's comfort in daily life after the post-surgery phase seemed to be only marginally affected by G-tube insertion. Children with severe non-malignant disorders seemed to experience a higher frequency and intensity of pain and bodily discomfort due to the G-tube than children with malignant disorders.

Practice implications: The paediatric care team need competence in assessing G-tube related pain and awareness that experiences may differ depending on the child's disorder.

Keywords: Children; Gastrostomy; Nursing; Nutrition; Stem cell transplantation.

MeSH terms

  • Child
  • Gastrostomy* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Pain / etiology