Home parenteral nutrition for the short bowel syndrome

Gulledge, A. Dale; Gipson, W. Terry; Steiger, Ezra; Hooley, Ruth; Srp, Faith

doi:10.1016/0163-8343(80)90080-8

Cited by 30 publications

(6 citation statements)

References 15 publications

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“…The great majority of patients receiving HPN involved in our study reported some degree of anxiety and depression, and this was especially evident in those with a diagnosis of malignancy. The prevalence of anxiety and depression in our population was over three times that reported by others (21) in patients with benign conditions. After one month of HPN, anxiety and depression decreased significantly; however, the improvement in anxiety and depression appeared to be limited to patients with underlying malignancy.…”

Section: Discussionsupporting

confidence: 56%

Anxiety, Depression and Quality of Life Improve After One Month and Three Months of Home Parenteral Nutrition: A Pilot Study in a Canadian Population

Sánchez

Gadowsky

McKenzie

et al. 2018

Journal of the Canadian Association of Gastroenterology

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Background Patients receiving home parenteral nutrition (HPN) have a reduced quality of life (QoL), but it is unknown if this is associated with psychiatric comorbidities such as anxiety or depression. Aim The aim of this study was to assess anxiety, depression and QoL in patients transitioning from hospital to HPN. Methods We conducted a prospective study in adult patients receiving parenteral nutrition (PN) during transition from hospital to home. We assessed anxiety and depression (Hospital Anxiety and Depression Scale; HADS), health-related quality of life (HRQoL; SF-36) and health status (EQ-5D) before discharge and again later at one and three months after HPN was started. Results Of the 29 patients, 15 had an underlying malignancy. At baseline, 93% of patients with malignancy had anxiety or depression (HADS A and/or HADS D >7) or both, while of the patients without malignancy, 60% had anxiety, and 40% had depression. Questionnaires were completed by 21 patients at one month and by 15 at three months. Anxiety and depression scores decreased significantly after one month of HPN (mean difference [MD] anxiety: 4.3; 95% CI, 1.2–7.5, P = 0.004; MD depression: 4.0; 95% CI, 1.5–6.5, P = 0.001), and the decrease persisted at three months (MD anxiety: 35; 95% CI, 0.35–6.6, P = 0.02; MD depression: 2.5; 95% CI, 0.06–5.0, P = 0.04). Overall, patients reported an improvement in HRQoL (SF-36) after one month of HPN, and this improvement was maintained at three months in those patients who survived. Conclusion Home parenteral nutrition is associated with improvements in anxiety, depression and HRQoL at one month and three months after discharge from hospital. The improvements in Qol, anxiety and depression seem greater in patients with underlying malignancy.

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Section: Discussionsupporting

confidence: 56%

Anxiety, Depression and Quality of Life Improve After One Month and Three Months of Home Parenteral Nutrition: A Pilot Study in a Canadian Population

Sánchez

Gadowsky

McKenzie

et al. 2018

Journal of the Canadian Association of Gastroenterology

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“…However, disadvantages have also beeen reported, such as inability to cope created by role changes within the family, lack of professional and social support for the family, financial stress, and potential depression in family members (Gulledge et al, 1980). The problems commonly reported in studies of patients receiving TPN at home include anxiety related to learning technologic care, and intermittent nonpsychiatric depression (Malcolm et al, 1980).…”

Section: Literature Reviewmentioning

confidence: 99%

Responsibilities and Reactions of Family Caregivers of Patients Dependent on Total Parenteral Nutrition at Home

Smith¹,

Moushey

Ross

et al. 1993

Public Health Nursing

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This prospective study assessed the caregiving responsibilities and reactions of family members who provide home care to a relative who is dependent on total parenteral nutrition (TPN). A short, semistructured interview based on the Roy adaptation model was used to gather data about the caregiving experiences of 20 relatives of adult TPN-dependent patients. Data were content analyzed, and frequently occurring themes identified. Results indicated that altered family responsibilities as well as negative and positive psychologic reactions to caregiving do occur. The interviews suggested that caregivers master TPN technology but make little use of assistance from extended family or professionals. Although depression and fatigue were reported as common, these family members felt capable and successful in their caregiving roles. Further longitudinal research with larger samples should allow for comparison of caregivers on demographic differences, stress, and other variables pertinent to managing complex home care.

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“…Although HPN is an established method in the management of intestinal failure, it is a time-consuming and invasive procedure requiring the careful training of both patient and carer. Several factors may impose severe restrictions on daily life with regard to social activity (Price & Levine, 1979) as well as emotional function (Gulledge et al 1980). Many patients go through several emotional reactions for example disbelief, fear, anger or depression (McRitchie, 1978).…”

mentioning

confidence: 99%

A review of the instruments used to assess the quality of life of adult patients with chronic intestinal failure receiving parenteral nutrition at home

2005

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Home parenteral nutrition is an established method of supporting patients with intestinal failure, but this treatment may be life long and imposes severe restrictions on daily life. Impact on quality of life is an important outcome when considering the management of home parenteral nutrition patients. This paper reviews studies in which the quality of life of patients receiving home parenteral nutrition has been assessed. A systematic search of electronic databases and relevant publications was undertaken to identify generic or treatment-specific questionnaires used with home parenteral nutrition patients. Many of the thirty-four reports discovered were small studies. Nineteen used non-specific generic instruments, eight used non-validated questionnaires, four used a combination of both, and three did not use any formal tool. Few systematic patterns emerged. There are few available data on the quality of life of home parenteral nutrition patients, and there is a need for standardised, scientifically validated, treatment-specific instruments to measure quality of life in this population.

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Home parenteral nutrition for the short bowel syndrome

Cited by 30 publications

References 15 publications

Anxiety, Depression and Quality of Life Improve After One Month and Three Months of Home Parenteral Nutrition: A Pilot Study in a Canadian Population

Anxiety, Depression and Quality of Life Improve After One Month and Three Months of Home Parenteral Nutrition: A Pilot Study in a Canadian Population

Responsibilities and Reactions of Family Caregivers of Patients Dependent on Total Parenteral Nutrition at Home

A review of the instruments used to assess the quality of life of adult patients with chronic intestinal failure receiving parenteral nutrition at home

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