Applying the Timing It Right Framework to Caregiver Experiences and Needs in Adult Percutaneous Endoscopic Gastrostomy: A Longitudinal Qualitative Study

Xi Li,1,2 Xinru Zhang,1,2 Yu Guo,1 Weiqing Ruan1 1Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, People’s Republic of China; 2School of Nursing, Southern Medical University, Guangzhou, Guangdong, 510515, People’s Republic of ChinaCorrespondence: Weiqing Ruan, Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, People’s Republic of China, Tel +86 13533399913, Email [email protected]: Applying the Timing It Right (TIR) theoretical framework, we explored the evolving experiences and needs of caregivers supporting adult percutaneous endoscopic gastrostomy (PEG) patients during different cycles of PEG placement, within a Chinese cultural context.Patients and Methods: A descriptive phenomenological research design was used to select 12 family caregivers of PEG patients in a tertiary hospital in Guangzhou from December 2024 to June 2025 through purposive sampling combined with the maximum difference strategy. Based on the TIR framework, the PEG course was divided into five stages (diagnosis, stabilization, discharge preparation, adjustment, and adaptation). Semi-structured in depth interviews were conducted with caregivers at each stage. The Colaizzi 7-step method and NVivo V.17 software were used to analyze the data and extract themes.Results: The themes of the experiences and needs of PEG caregivers at different stages were as follows: 1. Diagnostic stage: anxiety and worry, lack of disease awareness, and passivity in medical decision-making. 2. Stabilization stage: coping with the postoperative comfort management needs of patients and sense of treatment benefit. 3. Discharge readiness stage: caregiving skills training needs and resource accessibility concerns. 4. Adjustment stage: continuity of care needs, daily care challenges (wound care needs, gastrostomy tube adjustment period), and caregiver socioeconomic role reconstruction. 5. Adaptation period: rehabilitation expectations, reality conflicts, and self-efficacy enhancement.Conclusion: The notable variations in the demands and experiences of PEG caregivers at various phases of caregiving highlighted how crucial it was to create a staged support system that was accurate and culturally sensitive to maximize healthcare resources and effectively empower caregivers.Keywords: experience and needs, percutaneous endoscopic gastrostomy, caregivers, timing it right theory, qualitative research