Abstract
In dysphagia, it is presumed that there are about 260,000 patients with a gastrostomy in Japan and that the number has increased rapidly in the last decade. In gastrostomy, many reports have indicated the prevalence, trouble, prognosis and so on. In particular, the reports have focused on the care of patients with gastrostomy in healthcare centers and elderly facilities. However, there are few reports of findings from gastrostomy practitioners and from the patientsʼ side. The purpose of this study was to assess the current status of gastrostomy patients in two situations：those living with their families, and those in healthcare centers and elderly facilities. Furthermore, we discuss the contributing factors for effective gastrostomy care and the real problems of gastrostomy patients. We surveyed gastrostomy patients (including in hospital and in-home) in 833 clinics of the Japan National Health Insurance Clinics and Hospitals Association, in 138 long-term care insurance facilities (LTC) and in 485 intended facilities or clinics under direct management (IF). The results showed a decrease (53.1%) of patients with gastrostomy in the IF (on a declining trend in the past 3 years). However, there was a decrease (20.3%) in the LTCs, and there was a difference between the opinions of gastrostomy practitioners and of the patients. The patientsʼ degree of satisfaction was only-obtained with an explanation of the drawbacks and advantages of gastrostomy from related parties (not including medical doctor). The main causes of satisfaction were that patients could receive treatment in the home and they could live normally for three years from the initiation of gastrostomy.
