The experiences and support needs of people living at home with an enteral tube: a qualitative interview study.


Journal

Journal of human nutrition and dietetics : the official journal of the British Dietetic Association
ISSN: 1365-277X
Titre abrégé: J Hum Nutr Diet
Pays: England
ID NLM: 8904840

Informations de publication

Date de publication:
10 2019
Historique:
pubmed: 23 4 2019
medline: 6 10 2020
entrez: 23 4 2019
Statut: ppublish

Résumé

The number of people with an enteral tube (ET) living at home is increasing globally and services to support them to manage this complex and life-changing intervention vary across regions. The present study aimed to gain an understanding of the experiences of people living at home with an ET and their carers, as well as to explore their views of supporting services and ET-related hospital admissions. A qualitative inductive descriptive design was employed. Semi-structured, face-to-face interviews with a purposive sample of people with an ET living at home and carers were undertaken. Interviews were transcribed, initial codes were assigned for salient constructs, and these were then grouped and developed into themes and sub-themes. Nineteen people with ETs and 15 carers of people with ETs were interviewed. Five themes were generated: home better than hospital, feelings about the tube, living with the tube, help when you need it and cost for health service. Participants indicated the ET significantly influenced daily life. Participants described becoming used to coping with the ET at home over time and developing strategies to manage problems, avoid hospital admission and reduce resource waste. Variation in supporting services was described. People with ETs and their carers need considerable support from knowledgeable, responsive healthcare practitioners during the weeks following initial placement of the ET. Twenty-four hour services to support people with ETs should be designed in partnership with the aim of reducing burden, negative experience, waste and hospital admissions. National frameworks for home enteral nutrition could set the standard for support for people with ETs.

Sections du résumé

BACKGROUND
The number of people with an enteral tube (ET) living at home is increasing globally and services to support them to manage this complex and life-changing intervention vary across regions. The present study aimed to gain an understanding of the experiences of people living at home with an ET and their carers, as well as to explore their views of supporting services and ET-related hospital admissions.
METHODS
A qualitative inductive descriptive design was employed. Semi-structured, face-to-face interviews with a purposive sample of people with an ET living at home and carers were undertaken. Interviews were transcribed, initial codes were assigned for salient constructs, and these were then grouped and developed into themes and sub-themes.
RESULTS
Nineteen people with ETs and 15 carers of people with ETs were interviewed. Five themes were generated: home better than hospital, feelings about the tube, living with the tube, help when you need it and cost for health service. Participants indicated the ET significantly influenced daily life. Participants described becoming used to coping with the ET at home over time and developing strategies to manage problems, avoid hospital admission and reduce resource waste. Variation in supporting services was described.
CONCLUSIONS
People with ETs and their carers need considerable support from knowledgeable, responsive healthcare practitioners during the weeks following initial placement of the ET. Twenty-four hour services to support people with ETs should be designed in partnership with the aim of reducing burden, negative experience, waste and hospital admissions. National frameworks for home enteral nutrition could set the standard for support for people with ETs.

Identifiants

pubmed: 31006929
doi: 10.1111/jhn.12656
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

646-658

Subventions

Organisme : Department of Health
ID : CAT CL-2013-04-014
Pays : United Kingdom

Informations de copyright

© 2019 The British Dietetic Association Ltd.

Références

Ojo O (2015) The challenges of home enteral tube feeding: a global perspective. Nutrients 7, 2524-2538.
Gramlich L, Hurt RT, Jin J et al. (2018) Home enteral nutrition: towards a standard of care. Nutrients 10, 1020.
Rogers SN, Thomson R, O'Toole P et al. (2007) Patients experience with long-term percutaneous endoscopic gastrostomy feeding following primary surgery for oral and oropharyngeal cancer. Oral Oncol 43, 499-507.
Mayre-Chilton KM, Talwar BP & Goff LM (2011) Different experiences and perspectives between head and neck cancer patients and their care-givers on their daily impact of a gastrostomy tube. J Hum Nutr Diet 24, 449-459.
Bjuresäter K, Larsson M & Athlin E (2015) Patients' experiences of home enteral tube feeding (HETF) - a qualitative study. J Res Nurs 20, 552-565.
Boland K, Maher N, O'Hanlon C et al. (2017) Home enteral nutrition recipients: patient perspectives on training, complications and satisfaction. Frontline Gastroenterol 8, 79-84.
Williams GF, White H, Sen M et al. (2018) Patients' experience of enteral feeding following (chemo) radiotherapy for head and neck cancer: a qualitative study. Clin Nutr Jun 21. pii: S0261-5614(18)31177-4. https://doi.org/10.1016/j.clnu.2018.06.958. [Epub ahead of print].
Jukic NP, Gagliardi C, Fagnani D et al. (2017) Home enteral nutrition therapy: difficulties, satisfactions and support needs of caregivers assisting older patients. Clin Nutr 36, 1062-1067.
Bjuresäter K, Larsson M & Athlin E (2012) Struggling in an inescapable life situation: being a close relative of a person dependent on home enteral tube feeding. J Clin Nurs 21, 1051-1059.
Jordan S, Philpin S, Warring J et al. (2006) Percutaneous endoscopic gastrostomies: the burden of treatment from a patient perspective. J Adv Nurs 56, 270-281.
Howard P, Jonkers-Schuitema C, Furniss L et al. (2006) Managing the patient journey through enteral nutritional care. Clin Nutr 25, 187-195.
NICE (2012) Nutrition Support in Adults. Quality standard [QS24]. Manchester: National Institute for Health and Clinical Excellence.
Boullata JI, Carrera AL, Harvey L et al. (2017) ASPEN safe practices for enteral nutrition therapy. J Parenter Enteral Nutr 41, 15-103.
Kurien M, White S, Simpson G et al. (2012) Managing patients with gastrostomy tubes in the community: can a dedicated enteral feed dietetic service reduce hospital readmissions? Eur J Clin Nutr 66, 757-760.
Drake R, Ozols A, Nadeau WJ et al. (2017) Hospital inpatient admissions with dehydration and/or malnutrition in medicare beneficiaries receiving enteral nutrition: a cohort study. J Parenter Enteral Nutr 42, 730-738.
Correa JA, Fallon SC, Murphy KM et al. (2014) Resource utilization after gastrostomy tube placement: defining areas of improvement for future quality improvement projects. J Pediatr Surg 49, 1598-1601.
Wong A, Goh G, Banks MD et al. (2018) A systematic review of the cost and economic outcomes of home enteral nutrition. Clin Nutr (Edinburgh, Scotland) 37, 429-442.
Majka AJ, Wang Z, Schmitz KR et al. (2014) Care coordination to enhance management of long-term enteral tube feeding: a systematic review and meta-analysis. J Parenter Enteral Nutr 38, 40-52.
Green S, Dinenage S, Gower M et al. (2013) Home enteral nutrition: organisation of services. Nursing Older People. 25, 14-18.
ACI (2012) ACI Nutrition Network Guidelines for Home Enteral Nutrition (HEN) Services. Chatswood, NSW: Agency for Clinical Innovation, August 2012. Report No.
Cresswell J (2013) Qualitative Inquiry and Research Design,. 3rd edn. London: SAGE Publications.
Britten N (2006) Qualitative interviews. In: Qualitative Research in Healthcare. pp. 12-24 [Pope C & Mays N, editors]. London: BMJ Books.
Sandelowski M (1995) Sample size in qualitative research. Res Nurs Health 18, 179-183.
Burr J (2005) ‘On the shoulder of giants': putting the quality into qualitative research. In: Researching Health Care Consumers. pp. 112-128 [Burr J & Nicholson P, editors]. Basingstoke: Palgrave Macmillan.
Welch A & Jirojwong S (2014) Data Collection: Qualitative Research. In: Research Methods in Nursing and Midwifery. pp. 121-139 [Jirojwong S, Johnson M & Welch A, editors]. Melbourne: Oxford University Press.
Holloway I & Wheeler S (2010) Qualitative Research in Nursing and Healthcare. Oxford: Blackwell.
Braun V & Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3, 77-101.
Robson C (2002) Real World Research. Oxford: Blackwell Publishing.
Whitehead L (2014) Qualitative data analysis. In: Research Methods in Nursing and Midwifery. 2nd edn, pp. 140-161. [Jirojwong S, Johnson M & Welch A, editors]. Melbourne: Oxford University Press.
White CWK, Ritchie J & Ormston R (2014) Writing up qualitative research. In: Qualitative Research Practice. 2nd edn, pp. 367-396. [Ritchie JLJ, McNaughton Nicholls C & Ormston R, editors]. London: SAGE.
O'Brien BC, Harris IB, Beckman TJ et al. (2014) Standards for reporting qualitative research: a synthesis of recommendations. Acad Med 89, 1245-1251.
National Nurses Nutrition Group (2016) Changing of a Balloon Gastrostomy Tube (BGT) into the Stomach for Adults and Children. Available at: http://www.nnng.org.uk/download-guidelines/ Accessed 01/04/19
Roberge C, Tran M, Massoud C et al. (2000) Quality of life and home enteral tube feeding: a French prospective study in patients with head and neck or oesophageal cancer. Br J Cancer 82, 263-269.
Brotherton AM, Abbott J, Hurley MA et al. (2007) Home percutaneous endoscopic gastrostomy feeding: perceptions of patients, carers, nurses and dietitians. J Adv Nurs 59, 388-397.
Brotherton A & Abbott J (2009) Clinical decision making and the provision of information in PEG feeding: an exploration of patients and their carers' perceptions. J Hum Nutr Diet 22, 302-309.
Martin L, Blomberg J & Lagergren P (2012) Patients' perspectives of living with a percutaneous endoscopic gastrostomy (PEG). BMC Gastroenterol 12, 126-133.
Stavroulakis T, Baird WO, Baxter SK et al. (2016) The impact of gastrostomy in motor neurone disease: challenges and benefits from a patient and carer perspective. BMJ Support Palliat Care 6, 52-59.
Kwong JPY, Stokes EJ, Posluns EC et al. (2014) The experiences of patients with advanced head and neck cancer with a percutaneous endoscopic gastrostomy tube: a qualitative descriptive study. Nutr Clin Pract 29, 526-533.
McDonald J, McKinlay E, Keeling S et al. (2017) The ‘wayfinding' experience of family carers who learn to manage technical health procedures at home: a grounded theory study. Scand J Caring Sci 31, 850-858.
Wei-Kuo C, Ning-Chi W, Wei-Ming W et al. (2014) Prospective evaluation of peristomal cutaneous changes among patients with long-term percutaneous endoscopic gastrostomy. Adv Skin Wound Care 27, 260-267.
Halliday V, Baker M, Thomas AL et al. (2017) Patient and family caregivers' experiences of living with a Jejunostomy feeding tube after surgery for esophagogastric cancer. JPEN J Parenter Enteral Nutr 41, 837-843.
Yeo ALR, Keegan J, Ward K et al. (2014) Qualitative Research Practice, 2nd edn. London: SAGE.
Lim ML, Yong BYP, Mar MQM et al. (2018) Caring for patients on home enteral nutrition: reported complications by home carers and perspectives of community nurses. J Clin Nurs 27, 2825-2835.
Jaafar MH, Mahadeva S, Morgan K et al. (2016) Review: systematic review of qualitative and quantitative studies on the attitudes and barriers to percutaneous endoscopic gastrostomy feeding. Clin Nutr 35, 1226-1235.
BAPEN (2016) Home Enteral Nutrition Redditch: British Association for Parenteral and Enteral Nutrition. https://www.bapen.org.uk/nutrition-support/enteral-nutrition/home-enteral-nutrition (accessed October 2018).
Strollo BP, McClave SA & Miller KR (2017) Complications of home enteral nutrition: mechanical complications and access issues in the home setting. Nutr Clin Pract 32, 723-729.
Dinenage S, Gower M, Van Wyk J et al. (2015) Development and evaluation of a home enteral nutrition team. Nutrients 7, 1607-1617.
Ojo O (2011) Balloon gastrostomy tubes for long-term feeding in the community. Br J Nurs (Mark Allen Publishing) 20, 34-38.

Auteurs

S M Green (SM)

School of Health Sciences, University of Southampton, Highfield, Southampton, UK.
Solent NHS Trust, Hampshire, UK.

K Townsend (K)

School of Health Sciences, University of Southampton, Highfield, Southampton, UK.

N Jarrett (N)

School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.

M Fader (M)

School of Health Sciences, University of Southampton, Highfield, Southampton, UK.

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