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Mou J, Sun J, Zhang R, Yang Y, Yang W, Zhao X. Experiences and needs of home caregivers for enteral nutrition: A systematic review of qualitative research. Nurs Open 2022; 9:11-21. [PMID: 34273248 PMCID: PMC8685892 DOI: 10.1002/nop2.990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/28/2021] [Accepted: 06/14/2021] [Indexed: 11/11/2022] Open
Abstract
AIMS To systematically identify, evaluate and synthesize the qualitative evidence on enteral nutrition of home caregivers. DESIGN A qualitative evidence synthesis using the Sandelowski and Barroso methodology. DATA SOURCES We reviewed articles from eight databases: CINAHL, Embase, PubMed, Web of Science, Cochrane, CNKI, Wanfang Data and CSTJ. Qualitative, peer-reviewed, original studies published in English or Chinese before April 2020 on home caregivers' experience and needs for enteral nutrition were included. The studies were selected by screening titles, abstracts and full texts, and the quality of each study was assessed by two researchers independently. REVIEW METHODS Two researchers independently used qualitative assessment and review tools for quality assessment and thematic synthesis for data analysis. RESULTS This review included 10 articles. The themes identified included balance the enteral nutrition, the experiences and feelings in practice and the recommendations to meet challenge. CONCLUSION Home caregivers reported that they played an important role and faced greater pressure. Future studies should establish a systematic and standardized follow-up schedule to improve home caregivers' physical and mental health. IMPACT The findings established that home caregivers experienced not only changes in their roles and concerns but also spiritual changes. Home caregivers develop different coping strategies to adapt to enteral nutrition without standardized training and support. Although home caregivers make much account of enteral nutrition and feeding issues, they lack of information and support services. Understanding existing problems from a caregiver's perspective can allow interventions to be more clearly developed and well-established training standards established in the future.
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Affiliation(s)
- Jingjing Mou
- The First Hospital of Jilin UniversityChangchunJilin ProvinceChina
| | - Jianan Sun
- The First Hospital of Jilin UniversityChangchunJilin ProvinceChina
| | - Rui Zhang
- The First Hospital of Jilin UniversityChangchunJilin ProvinceChina
| | - Yang Yang
- The First Hospital of Jilin UniversityChangchunJilin ProvinceChina
| | - Wenwen Yang
- The First Hospital of Jilin UniversityChangchunJilin ProvinceChina
| | - Xiaosu Zhao
- The First Hospital of Jilin UniversityChangchunJilin ProvinceChina
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Sezer RE, Talas MS. In Home Caregivers' Experiences With Percutaneous Endoscopic Gastrostomy Patients: A Qualitative Review. Gastroenterol Nurs 2021; 44:268-277. [PMID: 34176890 DOI: 10.1097/sga.0000000000000541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/27/2020] [Indexed: 11/26/2022] Open
Abstract
In home caregivers of patients with percutaneous endoscopic gastrostomy face physical, social, and psychological problems. The results of qualitative studies play a key role in determining in home caregivers' percutaneous endoscopic gastrostomy-related problems, attitudes, views, and experiences. The aim of this review was to survey the literature to assess the problems faced by in home caregivers of percutaneous endoscopic gastrostomy patients and identify solutions to these problems. PubMed, Cochrane, and Web of Science databases were screened using the key words qualitative research, percutaneous endoscopic gastrostomy, enteral nutrition, and mixed method for relevant articles published between 1945 and November 2019. The literature search yielded 446 scholarly articles. Their titles and abstracts were screened for possible inclusion in this review. Fifteen articles that met the inclusion criteria were included in the study. The quality of the included qualitative articles were assessed using the Critical Appraisal Skills Programme Qualitative Research Checklist, whereas mixed-methods articles were assessed using the Mixed Methods Appraisal Tool. Five major themes were developed: percutaneous endoscopic gastrostomy tube problems, training requirement, health support system, effect on life, and tube necessity. We believe that determining caregivers' physical and psychosocial problems around managing patients' percutaneous endoscopic gastrostomy tubes and developing support systems can help solve those problems and improve both patients' and caregivers' quality of life.
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Affiliation(s)
- Rana Elcin Sezer
- Rana Elcin Sezer, MSN, is PhD student, and Research Assistant, Surgical Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
- Melek Serpil Talas, PhD, is Associate Professor, Surgical Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Melek Serpil Talas
- Rana Elcin Sezer, MSN, is PhD student, and Research Assistant, Surgical Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
- Melek Serpil Talas, PhD, is Associate Professor, Surgical Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
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Arends J, Strasser F, Gonella S, Solheim TS, Madeddu C, Ravasco P, Buonaccorso L, de van der Schueren MAE, Baldwin C, Chasen M, Ripamonti CI. Cancer cachexia in adult patients: ESMO Clinical Practice Guidelines ☆. ESMO Open 2021; 6:100092. [PMID: 34144781 PMCID: PMC8233663 DOI: 10.1016/j.esmoop.2021.100092] [Citation(s) in RCA: 199] [Impact Index Per Article: 66.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/09/2021] [Accepted: 02/24/2021] [Indexed: 12/15/2022] Open
Abstract
•This ESMO Clinical Practice Guideline provides key recommendations for managing cancer-related cachexia. •It covers screening, assessment and multimodal management of cancer cachexia. •All recommendations were compiled by a multidisciplinary group of experts. •Recommendations are based on available scientific data and the author's expert opinion.
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Affiliation(s)
- J Arends
- Department of Medicine I, Medical Center - University of Freiburg Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - F Strasser
- Integrated Cancer Rehabilitation and Cancer Fatigue Clinic, Klinik Gais/Kliniken Valens; Clinic Medical Oncology and Hematology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - S Gonella
- Direction of Health Professions, Azienda Ospedaliero Universitaria Città della Salute e della Scienza of Turin, University of Turin, Turin, Italy; Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - T S Solheim
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Cancer Clinic, Trondheim University Hospital, Trondheim, Norway
| | - C Madeddu
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Cagliari, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - P Ravasco
- Immuno-Hemotherapy and Oncology, University Hospital of Santa Maria, CHULN, Lisbon, Portugal; Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Lisbon, Portugal; University of Lisbon, Portugal
| | - L Buonaccorso
- Psycho-Oncology Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - M A E de van der Schueren
- Department of Nutrition, Dietetics and Life Style, School of Allied Health, HAN University of Applied Sciences, Nijmegen, The Netherlands; Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - C Baldwin
- Department of Nutritional Sciences, King's College London, London, UK
| | - M Chasen
- Department of Medicine, University of Toronto, Toronto, Canada; Department of Family Medicine, McMaster University, Hamilton, Canada; William Osler Health Services, Brampton, Canada
| | - C I Ripamonti
- Oncology-Supportive Care in Cancer Unit, Department of Onco-Haematology, Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Milan, Italy
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Barrimore S, Davey M, Pulle RC, Crouch A, Bell JJ. Why Don't We Tube Feed Hip Fracture Patients? Findings from the Implementation of an Enteral Tube Feeding Decision Support Tool. Geriatrics (Basel) 2021; 6:geriatrics6010012. [PMID: 33540618 PMCID: PMC7930976 DOI: 10.3390/geriatrics6010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
Background: This study aimed to report (i) the prevalence of enteral tube feeding (ETF), (ii) investigate whether implementing a decision support tool influenced ETF rates, and (iii) understand reasons influencing decisions to offer ETF. Methods: A pre/post evaluation included consecutive patients admitted to a hip fracture unit. Following baseline data collection, a published ETF Decision Support Tool was implemented by the multidisciplinary team to determine the necessity and influencing reasons for offering ETF. Results: Pre-post groups (n = 90,86) were well matched for age (83 vs. 84.5 years; p = 0.304) and gender (females 57 vs. 57; p = 0.683). ETF rates remained low across groups (pre/post n = 4,2; p = 0.683) despite high malnutrition prevalence (41.6% vs. 50.6%; p = 0.238). Diverse and conflicting reasons were identified regarding decisions to offer ETF. Conclusion: A complex interplay of factors influences the team decision-making process to offer ETF to nutritionally vulnerable patients. These demands are individualised, rather than algorithmic, involving shared decision-making and informed consent processes.
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Affiliation(s)
- Sally Barrimore
- The Prince Charles Hospital, Chermside, QLD 4032, Australia; (S.B.); (R.C.P.); (A.C.)
| | - Madeleine Davey
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia;
| | | | - Alisa Crouch
- The Prince Charles Hospital, Chermside, QLD 4032, Australia; (S.B.); (R.C.P.); (A.C.)
| | - Jack J. Bell
- The Prince Charles Hospital, Chermside, QLD 4032, Australia; (S.B.); (R.C.P.); (A.C.)
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD 4067, Australia
- Correspondence: ; Tel.: +61-7-3139-6172; Fax: +61-7-3139-6147
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Bell JJ, Geirsdóttir ÓG, Hertz K, Santy-Tomlinson J, Skúladóttir SS, Eleuteri S, Johansen A. Nutritional Care of the Older Patient with Fragility Fracture: Opportunities for Systematised, Interdisciplinary Approaches Across Acute Care, Rehabilitation and Secondary Prevention Settings. PRACTICAL ISSUES IN GERIATRICS 2021. [DOI: 10.1007/978-3-030-48126-1_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AbstractNutritional care of the older patient with fragility fracture is complex. Diagnostic difficulties, multi-morbidities and interdependencies and social complexities all contribute to the wicked problem of malnutrition. Whilst many settings have attempted to address malnutrition through highly specialised care, increasing evidence supports the role of systematised, interdisciplinary approaches across acute care, rehabilitation and secondary prevention settings. Consequently, this chapter is devoted to highlighting why a SIMPLE approach to malnutrition should underpin the nutritional care of the older patient with fragility fracture, regardless of setting or healthcare provider.S Screen for nutrition riskI Interdisciplinary assessmentM Make the diagnosis (es)P Plan with the patientL impLement interventionsE Evaluate ongoing care requirements
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You Q, Li X, Ma Y, Shi L, Hu W. A retrospective analysis on epidemiological characteristics of home enteral nutrition: results from a Chinese tertiary hospital in 2018. Eur J Clin Nutr 2020; 75:473-479. [PMID: 32939039 DOI: 10.1038/s41430-020-00755-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 07/31/2020] [Accepted: 09/05/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The use of home enteral nutrition (HEN) has increased enormously. HEN has been shown to decrease length of stays, improve clinical outcomes, and increase quality of life. Literature on HEN epidemiology has also sprouted recently. Nevertheless, studies on Chinese HEN users are hardly seen. The objective of this study was thus to describe the epidemiological characteristics of HEN users from a Chinese tertiary hospital in 2018. METHODS Data were retrospectively analyzed using the personal patient profiles we created upon each HEN initiation. In the year of 2018, 2007 patients and a cumulative total of 3375 episodes were recorded. RESULTS The median age was 61 (IQR 46-75) years, and 63 (IQR 49-75) for males and 55 (IQR 43-72) for females. The most frequent indication for HEN implementation was oncological diseases (35.8%), followed by digestive diseases (13.4%), and neurological diseases (9.0%). Overall, 90.0% of the episodes were prescribed for oral nutrition supplement (ONS) and 9.5% for tube feeding (TF). Majority (70.8%) of the episodes comprised standard commercial formula. CONCLUSIONS Our study revealed some fundamental epidemiological characteristics of Chinese HEN patients. This preliminary single-center study has multiple limitations but still possesses revelatory and referential significance for other Chinese practitioners in the field of HEN. In future, multicenter studies and qualified HEN registries are widely needed in China.
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Affiliation(s)
- Qian You
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China
| | - Xuemei Li
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China
| | - Ya Ma
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Shi
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China
| | - Wen Hu
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China.
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Zamanillo Campos R, Colomar Ferrer MT, Ruiz López RM, Sanchís Cortés MP, Urgelés Planella JR. Specific Quality of Life Assessment by the NutriQoL® Questionnaire Among Patients Receiving Home Enteral Nutrition. JPEN J Parenter Enteral Nutr 2020; 45:490-498. [PMID: 32459026 PMCID: PMC8048598 DOI: 10.1002/jpen.1852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 04/14/2020] [Indexed: 12/13/2022]
Abstract
Background Home enteral nutrition (HEN), including tube feeding and oral supplementation, can improve or worsen quality of life (QoL). The specific assessment of factors affecting QoL may identify the inherent problems associated with HEN. The aim of this study was to evaluate whether the validated NutriQoL® questionnaire is useful for assessing the QoL and the factors influencing it in patients receiving HEN. Methods A total of 78 patients receiving HEN completed both the NutriQoL and the SF‐12 questionnaires during their routine visits to nutrition service at the hospital. Results Ninety percent of patients receiving HEN had cancer, 58% received oral supplements, and 42% received tube feeding. At recruitment, the mean score ± SD of the NutriQoL was 66 ± 14, whereas that of the SF‐12 was 40 ± 9. A positive correlation between NutriQoL and SF‐12 scores (ρ = 0.5; P < .001) was found. Multivariate analysis showed that HEN type (oral vs tube) (odds ratio [OR], 5.6; 95% CI 2.0–15.3; P = .001) and the absence of secondary effects (OR, 3.0; 95% CI, 1.2–7.9; P = .024) were both variables explaining NutriQoL results adjusted by sex and age. The SF‐12 results did not show associations with nutrition factors. On visit 2, we observed significant improvements in NutriQoL results. Conclusion The NutriQoL questionnaire identifies specific problems that affect the QoL of patients receiving HEN, whereas SF‐12 does not. The route of entry and the occurrence of complications influence specific QoL. NutriQoL is a useful tool to identify the factors that worsen the QoL in patients receiving HEN.
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Affiliation(s)
- Rocío Zamanillo Campos
- Department of Endocrinology and Nutrition, Son Espases University Hospital, Balearic Islands, Spain.,Department of Health, Valencian International University (VIU), Valencia, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Balearic Islands, Spain
| | | | - Rosa María Ruiz López
- Department of Endocrinology and Nutrition, Son Espases University Hospital, Balearic Islands, Spain
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