The PATCH program for caregivers of children with gastrostomy tubes: promoting and teaching confidence for the home
Lopez, Maria Isabella
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The PATCH Program: Promoting and Teaching Confidence for the Home is a distinct approach developed to address the problem of high emergency department visit (8.6%) and hospital readmission rates (3.9%) associated with pediatric gastrostomy tube (GT) placement (Goldin et al., 2016). Recent literature regarding negative outcomes associated with pediatric GT placement identified the failure of current GT education and training practices to properly prepare caregivers to manage care in the home (Berman et al., 2017; Franklin & Rodger, 2003; Russell, Jewell, Poskey, & Russell, 2018). Developed by an occupational therapist, the PATCH Program offers an innovative approach to reducing facility rates of negative pediatric GT-related outcomes through family-centered education and self-efficacy enhancing components. Theory-based and evidence-driven, the PATCH Program integrates problem-solving training, formal education, and interactive skills practice to empower caregivers in developing the skills and self-efficacy needed to manage their children’s GT care. Adopting an occupational therapy perspective, the PATCH Program acknowledges that effective home management of a child’s GT care is the product of careful integration of familial context, skills, resources, and support systems. This doctoral project (1) summarizes the theory and evidence base supporting the PATCH Program’s development, (2) describes the PATCH Program curriculum and approaches, and (3) outlines future directions for PATCH Program implementation, including evaluation, dissemination, and funding. The PATCH Program demonstrates the value occupational therapy offers to supporting families in successfully managing a child’s medically complex condition, to reducing post-surgical emergency department visits and hospital readmissions, and to promoting health and wellness among caregivers and families.
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