Review article: psychological aspects of home parenteral nutrition, abnormal illness behaviour and risk of self‐harm in patients with central venous catheters

Stern, Julian; Jacyna, Nicola

doi:10.1111/j.1365-2036.2008.03646.x

Cited by 14 publications

(16 citation statements)

References 34 publications

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“…It is possible that patients receiving HPN may use their central venous catheters in various ways to engage in selfharm (18). However, no such incidents were seen in the present cases.…”

Section: Discussioncontrasting

confidence: 52%

Home Parenteral Nutrition Therapy in Seven Patients with Anorexia Nervosa: The Role and Indications

Hotta

Araki

Urano³

et al. 2014

Intern. Med.

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Home parenteral nutrition (HPN) is a well-established intervention to sustain life in malnourished patients at home. Because it is difficult for patients with anorexia nervosa (AN) to gain weight or stop purging, such patients require repeated hospitalizations. Although HPN has not been commonly used for AN patients in Japan, we utilized this approach to treat seven AN patients. We herein present the clinical course and outcome of these seven patients, the application criteria for HPN in our institution, and the potential problems associated with HPN. Despite its complications, HPN may be a useful measure to help patients with persistent AN avoid multiple hospitalizations.

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“…It is possible that patients receiving HPN may use their central venous catheters in various ways to engage in selfharm (18). However, no such incidents were seen in the present cases.…”

Section: Discussioncontrasting

confidence: 52%

Home Parenteral Nutrition Therapy in Seven Patients with Anorexia Nervosa: The Role and Indications

Hotta

Araki

Urano³

et al. 2014

Intern. Med.

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“… There should be a delay to restorative surgery in Type 2 IF patients, and when possible they should be discharged home prior to surgery. For this to be possible the following may need to be addressed: ○home PN; ○venous access care and aseptic connection of PN; ○complex wound care; ○distal feeding; ○education on optimal oral intake; ○resolution of dental issues ; ○psychological problems ; ○robust arrangements for outpatient monitoring with a 24‐h support line; ○supervision of home care by a specialized IF centre; ○correction/control of underlying disease (e.g. inflammatory bowel disease) (Level of Evidence 5). …”

Section: Resultsmentioning

confidence: 99%

European Society of Coloproctology consensus on the surgical management of intestinal failure in adults

et al. 2016

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Intestinal failure (IF) is a debilitating condition of inadequate nutrition due to an anatomical and/or physiological deficit of the intestine. Surgical management of patients with acute and chronic IF requires expertise to deal with technical challenges and make correct decisions. Dedicated IF units have expertise in patient selection, operative risk assessment and multidisciplinary support such as nutritional input and interventional radiology, which dramatically improve the morbidity and mortality of this complex condition and can beneficially affect the continuing dependence on parenteral nutritional support. Currently there is little guidance to bridge the gap between general surgeons and specialist IF surgeons. Fifteen European experts took part in a consensus process to develop guidance to support surgeons in the management of patients with IF. Based on a systematic literature review, statements were prepared for a modified Delphi process. The evidence for each statement was graded using Oxford Centre for Evidence-Based Medicine Levels of Evidence. The current paper contains the statements reflecting the position and practice of leading European experts in IF encompassing the general definition of IF surgery and organization of an IF unit, strategies to prevent IF, management of acute IF, management of wound, fistula and stoma, rehabilitation, intestinal and abdominal reconstruction, criteria for referral to a specialist unit and intestinal transplantation.

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“…Patients are required to develop the knowledge and skills to cope with the demands of using complex medical equipment, observing strict hygiene procedures to minimize the risk for catheter complications, adherence to feeding schedules, and often restrictions of food and drink intake . Patients often experience significant psychosocial strains due to the associated lifestyle changes, functional limitations, role changes, body image disturbance, isolation, and a sense of loss of control and personal agency . Lifestyle changes include being restricted by the practicalities of PN, waiting in for deliveries, the amount of storage space required in the home, and having to plan travel, work, and social activities around the timings of connection and disconnection to PN .…”

Section: Introductionmentioning

confidence: 99%

Poor Social Support and Unemployment Are Associated With Negative Affect in Home Parenteral Nutrition–Dependent Patients With Chronic Intestinal Failure

Ablett

Vasant

Taylor

et al. 2018

J Parenter Enteral Nutr

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Background: Home parenteral nutrition (HPN) provides life‐sustaining treatment for people with chronic intestinal failure (CIF). Poor quality of life is reported in association with the burden of HPN and the underlying condition leading to intestinal failure (IF). However, levels of negative affect (NA), incorporating anxiety and depression, have not been reported in CIF. This study examined the occurrence and risk factors for NA in a large CIF population using the validated Hospital Anxiety & Depression Scale (HADS) and Multidimensional Scale of Perceived Social Support (MSPSS) questionnaires. Methods: A survey pack including HADS and MSPSS were distributed to patients managed by a specialist IF center. Data from these measures were analyzed against factors including underlying disease, length of time receiving HPN, employment status, and demographics. Results: Of 85 patients who completed this study, 56% had clinical levels of anxiety and/or depression. Linear regression analysis confirmed significant correlations between social support and HADS scores, with poorer perceived social support associated with higher levels of NA (−0.26 MSPSS + 33.24; R2 = 0.29; P < .0001). There were also significant associations between unemployment and higher anxiety (P = .004), depression (P = .008), and NA scores (P = .003). By contrast, there were no significant associations between patient age, duration of time receiving parenteral nutrition, pathophysiological mechanisms of CIF, and NA levels. Conclusions: Clinical anxiety and depression are common, affecting more than half of patients with CIF. Patients with poor social networks and those of working age who have ceased employment are particularly vulnerable and should be prioritized for psychological support because of their elevated risk.

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Review article: psychological aspects of home parenteral nutrition, abnormal illness behaviour and risk of self‐harm in patients with central venous catheters

Cited by 14 publications

References 34 publications

Home Parenteral Nutrition Therapy in Seven Patients with Anorexia Nervosa: The Role and Indications

Home Parenteral Nutrition Therapy in Seven Patients with Anorexia Nervosa: The Role and Indications

European Society of Coloproctology consensus on the surgical management of intestinal failure in adults

Poor Social Support and Unemployment Are Associated With Negative Affect in Home Parenteral Nutrition–Dependent Patients With Chronic Intestinal Failure

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