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Caring for patients on home enteral nutrition: Reported complications by home carers and perspectives of community nurses

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  • Mei Ling Lim
  • Bei Yi Paulynn Yong
  • Mei Qi Maggie Mar
  • Shin Yuh Ang
  • Mei Mei Chan
  • Madeleine Lam
  • Ngian Choo Janet Chong
  • Violeta Lopez

Abstract

Aims and objectives To explore the experiences of community nurses and home carers, in caring for patients on home enteral nutrition. Background The number of patients on home enteral nutrition is on the increase due to advancement in technology and shift in focus of providing care from acute to community care settings. Methods A mixed‐method approach was adopted. (i) A face‐to‐face survey design was used to elicit experience of carers of patients on home enteral nutrition. (ii) Focus group interviews were conducted with community nurses. Results Ninety‐nine carers (n = 99) were recruited. Patient's mean age that they cared for was aged 77.7 years (SD = 11.2), and they had been on enteral feeding for a mean of 29 months (SD = 23.0). Most were bed‐bound (90%) and required full assistance with their feeding (99%). Most were not on follow‐up with dietitians (91%) and dentists (96%). The three most common reported gastrointestinal complications were constipation (31%), abdominal distension (28%) and vomiting (22%). Twenty community nurses (n = 20) were recruited for the focus group interviews. Four main themes emerged from the analysis: (i) challenge of accessing allied health services in the community; (ii) shorter length of stay in the acute care setting led to challenges in carers' learning and adaptation; (iii) transition gaps between hospital and home care services; and (iv) managing expectations of family. Conclusion To facilitate a better transition of care for patients, adequate training for carers, standardising clinical practice in managing patients with home enteral nutrition and improving communication between home care services and the acute care hospitals are needed. Relevance to clinical practice This study highlighted the challenges faced by community home care nurses and carers. Results of this study would help to inform future policies and practice changes that would improve the quality of care received by patients on home enteral nutrition.

Suggested Citation

  • Mei Ling Lim & Bei Yi Paulynn Yong & Mei Qi Maggie Mar & Shin Yuh Ang & Mei Mei Chan & Madeleine Lam & Ngian Choo Janet Chong & Violeta Lopez, 2018. "Caring for patients on home enteral nutrition: Reported complications by home carers and perspectives of community nurses," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(13-14), pages 2825-2835, July.
    • Handle: RePEc:wly:jocnur:v:27:y:2018:i:13-14:p:2825-2835
    DOI: 10.1111/jocn.14347
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    References listed on IDEAS

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    1. Kaisa Bjuresäter & Maria Larsson & Elsy Athlin, 2012. "Struggling in an inescapable life situation: being a close relative of a person dependent on home enteral tube feeding," Journal of Clinical Nursing, John Wiley & Sons, vol. 21(7‐8), pages 1051-1059, April.
    2. IngBritt Rydeman & Lena Törnkvist, 2006. "The patient's vulnerability, dependence and exposed situation in the discharge process: experiences of district nurses, geriatric nurses and social workers," Journal of Clinical Nursing, John Wiley & Sons, vol. 15(10), pages 1299-1307, October.
    3. Li‐Chan Lin & Mei‐Hui Li & Roger Watson, 2011. "A survey of the reasons patients do not chose percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) as a route for long‐term feeding," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(5‐6), pages 802-810, March.
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    1. Shin Yuh Ang & Mei Ling Lim & Xin Ping Ng & Madeleine Lam & Mei Mei Chan & Violeta Lopez & Siew Hoon Lim, 2019. "Patients and home carers' experience and perceptions of different modalities of enteral feeding," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(17-18), pages 3149-3157, September.
    2. Sue M. Green & Kay Townsend & Nikki Jarrett & Catherine Westoby & Mandy Fader, 2019. "People with enteral tubes and their carers' views of living with a tube and managing associated problems: A qualitative interview study," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(19-20), pages 3710-3720, October.

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