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.
Background Nutrition by enteral tube is a complex therapy requiring significant management to ensure safe, timely delivery of nutrients and avoidance of complications. In the home setting, people with enteral tubes and their carers are required to self‐manage the therapy, including the need to cope with problems that arise. Whilst previous studies have conveyed experiences of people with enteral tubes, few have described views on enteral tube problems. Aims and objectives Drawing on the findings of a previously reported study (Journal of Human Nutrition and Dietetics, 2019), this paper aims to describe in‐depth the experiences of people with enteral tubes and their carers of living with the tube day to day and managing problems that arise. Design A qualitative descriptive design using semi‐structured in‐depth interviews was employed. Methods A purposive sample of 19 people with enteral tubes and 15 carers of people with tubes participated. Interviews were recorded and transcribed. Using a thematic analysis approach, codes were defined and applied; themes developed and refined. Five themes with associated subthemes were generated, of which one, “living with the tube,” is reported in‐depth. The COREQ checklist was used. Results Participants described the tube affecting both physical and psychosocial being and revealed it had resulted in significant changes to their daily living, necessitating adaptation to a new way of life. Participants reported spending much time and effort to manage tube problems, at times without support from healthcare practitioners knowledgeable in tube management. Discomfort associated with the tube was commonly described. Conclusions Living with an enteral tube impacts significantly on daily life requiring adaptations to normal routine. People with tubes and their carers use a range of strategies to manage common complications. Relevance to clinical practice Knowledge and understanding of how people with enteral tubes live with their tube and manage issues as they arise will enable healthcare practitioners to provide better support.
Patients with cancer can easily become overloaded with information about diagnosis, prognosis, treatments and side effects. One of a nurse's most important roles is to help patients and their families make sense of this, providing support and information through their cancer journey. However, many barriers exist, including the nurse's own knowledge limitations, time constraints and the patient's engagement with the nurse. This paper uses critical reflection to evaluate an incident from clinical practice involving a patient with prostate cancer suffering from a distressing side effect of treatment: urinary incontinence following a transurethral resection of the prostate (TURP). The paper examines nurse-patient communication, and evaluates how nurses can use communication strategies to minimise patient distress. Practical approaches to managing urinary incontinence are also discussed. This paper demonstrates that critical reflection is a valuable learning process that can alter clinical nursing practice to provide the best care for people with cancer.
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