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    Patients’ experiences with home parental nutrition: A grounded theory study

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    Wood_Clinical_Nutrition_ESPEN.pdf (589.5Kb)
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    Publication date
    2018-04
    Author
    Wong, C.
    Lucas, Beverley J.
    Wood, Diana
    Keyword
    Home parenteral nutrition; Intestinal failure; Patient experience; Quality of life
    Rights
    © 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved. Reproduced in accordance with the publisher's self-archiving policy. This manuscript version is made available under the CC-BY-NC-ND 4.0 license.
    Peer-Reviewed
    Yes
    
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    Abstract
    Background & aims Parenteral nutrition (PN) provides nourishment and hydration as an intravenous infusion to patients with intestinal failure (IF). The aim of the study is to generate theory that explains the experiences of adult patients living with home parenteral nutrition (HPN) and complex medication regimens. Methods A grounded theory methodology was used to explore the experiences of twelve patients receiving HPN. A semi-structured interview was conducted and recorded in each participant's home setting. Each interview was transcribed verbatim. The simultaneous process of data collection and analysis was followed reflecting the principles of the constant comparative approach. Results A total of 15 patients gave written consent, with 12 of them agreeing to be interviewed. All the participants had previously undergone surgery as a result of chronic ill health or sudden illness. Analysis revealed two core categories: stoma and HPN, and these were supported by the subcategories: maintaining stoma output, access to toilets, managing dietary changes, maintaining the HPN infusion routine, access to technical help to set up an HPN infusion, mobility with HPN equipment and general health changes. The strategy of living with loss was demonstrated by all the participants, and this was supported by the action strategies of maintaining daily activities and social interactions. Conclusions This study generates new understanding and insight into the views and experiences of patients receiving HPN in the UK. The findings from these participants have been shown to resonate with the Kubler-Ross Model [1] of the five stages of grief. The theory of living with loss was generated by the use of a grounded theory methodology. This small scale exploratory study reveals opportunities for improvements in practice to be considered by the nutrition support team (NST) and other healthcare professionals involved in the patient's hospital stay prior to discharge on HPN.
    URI
    http://hdl.handle.net/10454/15440
    Version
    Accepted Manuscript
    Citation
    Wong C, Lucas B and Wood D (2018) Patients’ experiences with home parental nutrition: A grounded theory study. Clinical Nutrition ESPEN. 24: 100-108.
    Link to publisher’s version
    https://doi.org/10.1016/j.clnesp.2018.01.005
    Type
    Article
    Collections
    Life Sciences Publications
    Health Studies Publications

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