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- Bjuresäter, Kaisa, 1970-
(author)
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Home enteral tube feeding - from patients’, relatives’ and nurses’ perspectives
- 2010
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Doctoral thesis (other academic/artistic)abstract
- Changes in the health-care system during the past decades have led to an increased transfer of health care to the home environment which also concerns patients treated with home enteral tube feeding (HETF). Research is scarce about how HETF care is functioning. Therefore, the overall aim with this thesis was to describe and explore HETF care and treatment from patients', relatives' and nurses' perspectives. Three qualitative and one quantitative study were used. The findings showed that the HETF treatment and care had a great impact on daily life for both patients and their relatives and implied many practical, emotional and social problems in their daily life, which they strived to manage. Side effects were common and the patients' reported low HRQL and general health. The amount and quality of received guidance and support from the health care, not least before discharge, turned out to have impact on the patients' and the relatives' daily life and how they could manage their situation. Lack of guidance and support meant insecurity, worries and distress. Cooperation in the care trajectory was found to be decisive for how well the care was running. Nurses' knowledge about tube feeding and discharge planning procedures, their commitment to the patients' care, as well as clarity regarding responsibility of HETF care were factors of crucial importance on how the cooperation worked, and the quality of the HETF care. This thesis shows the need of improvements regarding the care of HETF patients and their relatives.
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- Bjuresäter, Kaisa, 1970-, et al.
(author)
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Patients’ experiences of home enteral tube feeding (HETF) : a qualitative study
- 2015
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In: Journal of research in nursing. - : Sage Publications. - 1744-9871 .- 1744-988X. ; 20:7, s. 552-565
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Journal article (peer-reviewed)abstract
- Use of home enteral tube feeding (HETF) has increased in Western countries but research is scarce, especially about patients’ experiences of daily life when being treated with HETF. This study aimed to explore what it means to live with HETF and how the situation can be managed. A qualitative method was carried out according to Grounded Theory. In total, 22 interviews were performed with 11 patients treated with HETF for between 8 weeks and 2 years, using open-ended questions. Sampling, data collection and data analysis were carried out simultaneously. To be treated with HETF was experienced as positive as it meant survival, but the most prominent finding told about experiences of restrictions, practical problems and distress in the patients’ daily lives. How daily life turned out seemed to depend on the patient’s ability to manage problems, but was also strongly related to the amount and quality of information and support they received from health professionals. Lacking preparation before discharge as well as lacking support at home meant insecurity and uncertainty. The findings stress the need for comprehensive preparation and support from health professionals, and improvements are needed to facilitate HETF patients’ daily life.
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- Bjuresäter, Kaisa, 1970-, et al.
(author)
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Patients Living with Home Enteral Tube Feeding : Side effects, health-related quality of life and nutritional care
- 2014
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In: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 2:3, s. 64-75
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Journal article (peer-reviewed)abstract
- The aim of the study was to examine patients’ perceptions of side effects, health-related quality of life (HRQL), generalhealth, and nutritional care among patients receiving home enteral tube feeding (HETF) at two occasions after dischargefrom hospital. Three questionnaires, one study-specific, the Short Form 12 (SF-12) and the Health Index (HI), were sent topatients with HETF (n=62) twice, two weeks after discharge from hospital and two months later. Forty patients respondedtwo weeks after discharge and out of these 29 patients also responded after two months. Data were collected in centralSweden from March 2006 to January 2010. Side effects were common at both points of data collection (70% of thepatients after two weeks and 72% after two month). Patients using bolus feeding reported significantly fewer side effectsthan patients using intermittent feeding. HRQL and HI scores for the total group were low at both points of data collection.The bolus feeding group reported significantly higher physical HRQL and emotional HI than the intermittent feedinggroup did. Most patients were satisfied with the information and support they received from the health care team. Thisstudy has revealed that patients treated with HETF experienced side effects limiting their daily life to a great extent.Differences in HRQL related to feeding methods were found. Individualized support and regular controls are needed inorder to meet patient needs. Bolus feeding may be a suitable feeding method to improve well-being.
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- Bjuresäter, Kaisa, 1970-, et al.
(author)
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Struggling in an inescapable life situation : being a close relative of a person dependent on home enteral tube feeding
- 2012
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In: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 21:7-8, s. 1051-1059
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Journal article (peer-reviewed)abstract
- Aim. To explore what it means to be a close relative of a person dependent on home enteral tube feeding (HETF) and how they can manage this situation. Background. Previous studies have shown that the situation of close relatives in home care in general can be burdensome and difficult. Research is scarce about experiences of close relatives when patients are treated with HETF. Design. A qualitative design was used, in accordance with grounded theory ( GT). Methods. Twelve close relatives were interviewed twice, using open- ended questions. Five were relatives of patients supported by home care services or advanced home care teams. Using the GT method, sampling, data collection and data analysis were carried out simultaneously. Results. One core category, ` Struggling in an inescapable life situation' and eight categories were found. The situation led to involuntary changes in the lives of the close relatives, something they could do little about. Their lives had become completely upturned and restricted by the HETF. Togetherness and pleasure was lost and they felt lonely. The relatives faced a new role of being informal caregivers and they had to adjust their daily life accordingly. They felt forced to take on a heavy responsibility for which they lacked support. The close relatives struggled to manage and to make the best of their new situation. Conclusions. This study highlighted the demands and vulnerability which is embedded in the role of being a close relative of a patient with HETF. It also pointed out their need for comprehensive support from the health care system.
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