NASOGASTRIC TUBE FEEDING IN STROKE CARE: A CROSS-SECTIONAL ASSESSMENT OF CAREGIVER KNOWLEDGE AND TECHNIQUE AT A TERTIARY HOSPITAL IN PESHAWAR, PAKISTAN
DOI:
https://doi.org/10.71000/ddq5vg62Keywords:
Caregivers; Deglutition Disorders; Enteral Nutrition; Health Knowledge, Attitudes, Practice; Intubation, Gastrointestinal; Patient Safety; Stroke.Abstract
Background: Stroke-related dysphagia often necessitates nasogastric tube feeding to maintain nutrition, hydration, and medication delivery. In resource-constrained hospitals, family caregivers frequently perform this task with limited supervision after discharge. Unsafe positioning, inadequate flushing, poor hygiene, and failure to verify tube placement may expose patients to preventable complications. Evidence regarding caregivers’ knowledge and feeding technique in Pakistan remains limited, making assessment of competence and its determinants important for planning practical, targeted education within routine stroke care services.
Objective: To assess caregiver knowledge and technique in nasogastric feeding after stroke and identify factors associated with adequate knowledge and safe practice.
Methods: This cross-sectional study included 280 caregivers of stroke patients receiving nasogastric feeding at Hayatabad Medical Complex, Peshawar. A structured questionnaire and observational checklist assessed five knowledge and five technique items. Scores of at least 4/5 indicated adequate knowledge or safe technique. Chi-square tests and multivariable logistic regression identified associated factors, reported as adjusted odds ratios with 95% confidence intervals.
Results: Caregiver age was 39.0 ± 10.0 years, and 119 (42.5%) had prior training. Mean knowledge and technique scores were 67.0% ± 28.0% and 59.5% ± 30.2%. Adequate knowledge was found in 145 caregivers (51.8%), while 115 (41.1%) demonstrated safe technique. Higher education predicted adequate knowledge (aOR 7.80, 95% CI 3.99–15.26; p<0.001), whereas rural residence reduced the odds (aOR 0.31, 95% CI 0.18–0.56; p<0.001). Prior training predicted adequate knowledge (aOR 2.14, 95% CI 1.23–3.74; p=0.007) and safe technique (aOR 3.82, 95% CI 2.15–6.81; p<0.001). High confidence predicted safe technique (aOR 2.71, 95% CI 1.39–5.29; p=0.003). Feeding difficulties or complications occurred in 130 caregivers (46.4%) and were more frequent with inadequate knowledge (59.3% vs 34.5%; p<0.001).
Conclusion: Caregiver competence remained insufficient, especially among less-educated, rural, and untrained participants. Structured pre-discharge instruction with return-demonstration may strengthen feeding safety.
Keywords: Caregivers; Deglutition Disorders; Enteral Nutrition; Health Knowledge, Attitudes, Practice; Intubation, Gastrointestinal; Patient Safety; Stroke.
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Copyright (c) 2025 Rizwanullah, Usman Khan, Muhammad Usman Bari, Zarafshan Hameed Khattak, Faizan Ahmad, Nazir Shah (Author)
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