1 The School of Health and Related Research (ScHARR), University of Sheffield, UK.
2 Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK.
JPEN J Parenter Enteral Nutr. 2017 Jul;41(5):837-843. doi: 10.1177/0148607115604114. Epub 2015 Aug 28.
Jejunostomy feeding tubes (JFTs) can be used to provide nutrition support to patients who have had surgery for esophagogastric cancer. Although previous research reports how patients cope with a gastrostomy tube, little is known about the impact of having a JFT. The aim of this qualitative study was to explore how patients and their informal caregivers experience living with a JFT in the first months following surgery.
Participants were purposively sampled from a cohort of patients recruited to a trial investigating home enteral nutrition vs standard care after esophagogastric surgery for cancer. The sampling framework considered age, sex, and marital status. Informal caregivers were also invited to participate. Interviews were audio recorded, transcribed verbatim, and anonymized. Inductive thematic analysis was used to identify key themes related to living with a JFT.
Fifteen patient interviews were conducted; 8 also included a family caregiver. Analysis of the data resulted in 2 main themes: "challenges" and "facilitators" when living with a JFT. While "physical effects," "worries" and "impact on routine" were the main challenges, "support," "adaptation" and "perceived benefit" were what motivated continuation of the intervention.
Findings suggest that participants coped well with a JFT, describing high levels of compliance with stoma care and the feeding regimen. Nonetheless, disturbed sleep patterns and stoma-related problems proved troublesome. A better understanding of these practical challenges, from the patient and family caregiver perspective, should guide healthcare teams in providing proactive support to avoid preventable problems.
空肠造口饲管 (JFT) 可用于为接受食管胃结合部癌手术的患者提供营养支持。尽管之前的研究报告了患者如何应对胃造口管，但对于使用 JFT 的影响知之甚少。本定性研究的目的是探讨患者及其非专业照护者在手术后的头几个月中使用 JFT 的体验。
从一项调查胃癌手术后家庭肠内营养与标准护理的试验中招募的患者队列中，通过目的性抽样选择参与者。抽样框架考虑了年龄、性别和婚姻状况。也邀请了非正式照护者参加。对访谈进行了录音、逐字转录和匿名处理。采用归纳主题分析来确定与使用 JFT 相关的主要主题。
进行了 15 次患者访谈；其中 8 次还包括了一名家属照护者。数据分析产生了 2 个主要主题：“使用 JFT 时的挑战”和“便利因素”。“身体影响”、“担忧”和“对日常生活的影响”是主要挑战，而“支持”、“适应”和“感知益处”则是继续干预的动力。
研究结果表明，参与者使用 JFT 情况良好，对造口护理和喂养方案的依从性较高。尽管如此，睡眠模式紊乱和造口相关问题仍然很麻烦。从患者和家属照护者的角度更好地了解这些实际挑战，应指导医疗保健团队提供积极的支持，以避免可预防的问题。
