School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia.
Orthogeriatric Unit, The Prince Charles Hospital, Brisbane, Queensland, Australia.
JPEN J Parenter Enteral Nutr. 2019 May;43(4):526-533. doi: 10.1002/jpen.1444. Epub 2018 Sep 10.
One in 2 hip fracture inpatients are malnourished on admission to hospital, with many experiencing nutrition decline during their length of stay. Despite this, enteral tube feeding (ETF) is rarely used in this population. As patient/caregiver viewpoints regarding the utility of ETF remain unclear, this study explored the perceptions of hip fracture inpatients and caregivers toward ETF use to assist recovery.
An inductive qualitative research project was conducted within a tertiary hospital orthogeriatric ward. Individual semistructured interviews were undertaken with 13 purposively sampled, postsurgery hip fracture inpatients and 7 caregivers. Interviews were transcribed, hard-copy coded, and thematically analyzed.
The majority of inpatient participants did not wish to be tube fed. A novel, complex interrelationship of the following 3 main themes emerged: knowledge and understanding, perceived consequences and necessity of tube, contributed toward potential ETF acceptance and refusal. Theme interrelationship was indicated by subthemes (nutrition importance, attitude, and ability to cope) and driven by the following 3 key categories: value of nutrition, quality of life, and personal perception.
A number of factors impacted the likelihood of tube acceptance. This highlights the importance of food as a medicine, treatment intent, and shared decision making when considering ETF in acute hip fracture inpatients.
每两个髋部骨折住院患者中就有一个在入院时存在营养不良，许多患者在住院期间会出现营养状况恶化。尽管如此，该人群中很少使用肠内管饲（ETF）。由于患者/照护者对 ETF 效用的看法仍不清楚，本研究旨在探讨髋部骨折住院患者和照护者对 ETF 使用以辅助康复的看法。
在一家三级医院骨科病房进行了一项归纳性定性研究项目。对 13 名接受过择期髋部手术后的住院患者和 7 名照护者进行了有针对性抽样的半结构式访谈。访谈记录被转录为文字，然后进行硬拷贝编码和主题分析。
大多数住院患者都不想接受管饲。出现了以下 3 个主要主题的新的、复杂的相互关系：知识和理解、对管饲的感知后果和必要性，这些都促成了潜在的 ETF 接受和拒绝。主题之间的相互关系由子主题（营养重要性、态度和应对能力）表示，并由以下 3 个关键类别驱动：营养的价值、生活质量和个人认知。
许多因素影响着接受管饲的可能性。这突出了将食物作为药物、治疗意图以及在考虑急性髋部骨折住院患者使用 ETF 时进行共同决策的重要性。
