Napupuno, Hindi Nabubusog: Filipino Elderly and Nasogastric Tube Feeding

Carla Krishan A. Cuadro, MRS-SP, CSP-PASP

Janel Alexis O. Herrera, BS-SLP, CSP-PASP
Thomas L. Quiros, BS-SLP, CSP-PASP

Background: The use of nasogastric tubes (NGTs) forms part of the standard treatment of
patients with neurogenic dysphagia. While NGTs guarantee the unimpeded delivery of nutrients
into a body, complaints about its discomfort and aftercare are rife. Providing continuous
nutritional support takes precedence over NGTs’ infection and aspiration risks.
In a society that views eating well as a sign of good health, the psychosocial effects of
dysphagia are exacerbated by the unorthodox motions of tube-feeding. NGTs bring to the fore
what constitutes the older Filipino’s concept of being fed well. This project is an interrogation of
the role of tube-feeding in the older Filipino patient’s recovery from illness, and what is amiss in
the process that makes kabusugan unachievable.

Methods: In-depth episodic interviews were held among 10 older Filipinos aged 60+ years who
were using or had used NGTs. These personal narratives were audio-recorded, transcribed
verbatim, and subjected to qualitative data analysis. The data was coded, categorized, underwent
reordering and clustering to identify patterns or recurrent themes.

Results: Themes on the NGT and difficulties living with it, is an obstruction, and is necessary to
‘eat’ dominated these narratives. Recurring themes included NGT feeding as redefining what is
gutom to a person feeding via a tube, how taste contributed to satiation, and the disparity
between napuno vs. nabusog.

Conclusions: Concepts about the NGT as necessary for bodily nutrition but dissociates fullness
from satiation may be common among older Filipinos on the tube. Understanding these
perspectives may guide clinicians in dysphagia treatment planning and counseling.

keywords: nasogastric tubes, dysphagia, artificial tube feeding, speech-language pathology