Sandhu Rebekah, Elliott Treeva, Hussain Whitney, Engbers John, Kassam Rosemin
Dietitian Services Department, Fraser Health Authority, Surrey, British Columbia, Canada.
School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Nutr Clin Pract. 2025 Apr;40(2):368-388. doi: 10.1002/ncp.11225. Epub 2024 Oct 25.
Home enteral nutrition (HEN) provides nutrition through a tube to individuals at home who cannot meet their needs by mouth. Systematic reviews have explored the experiences of HEN subpopulations, such as those with head and neck cancers. Given HEN services care for adults with various underlying conditions, a synthesis of the experiences of all adults using HEN and their caregivers is warranted. The purpose of this study is to summarize the experiences of HEN adult users and their caregivers regardless of underlying condition. Medline, PsychINFO, EmBase and CINAHL were systematically searched in January 2024. Studies with qualitative results and adult participants and focused on HEN were included. Studies with participants in nursing facilities, results using word counts, or not in English were excluded. Study quality was assessed using the Johanna Briggs Institute (JBI) qualitative checklist. Study design and participants' details were extracted. Themes were collated using the JBI meta-aggregative method. Forty studies (n = 732) were included. Three synthesized findings were identified: positive experiences (very low ConQual score), negative experiences (low ConQual score), and facilitators and coping mechanisms (moderate ConQual score). Although more negative than positive experiences were reported, users and caregivers who developed coping mechanisms or accessed supports viewed HEN as a worthwhile experience. Those with few supports or coping mechanisms did not. Based on this review, it is proposed that before starting HEN, users and caregivers should be made aware of the available supports and coping mechanisms. As negative experiences arise, healthcare providers should help users and caregivers access supports to improve their experiences.
家庭肠内营养（HEN）通过管道为在家中无法通过口腔满足营养需求的个体提供营养。系统评价已经探讨了HEN亚群体的经历，比如头颈癌患者。鉴于HEN服务照顾的是患有各种基础疾病的成年人，综合所有使用HEN的成年人及其照顾者的经历是有必要的。本研究的目的是总结HEN成年使用者及其照顾者的经历，无论其基础疾病如何。2024年1月对Medline、PsychINFO、EmBase和CINAHL进行了系统检索。纳入了有定性结果、成年参与者且聚焦于HEN的研究。排除了参与者为护理机构人员、使用词频统计结果或非英文的研究。使用乔安娜·布里格斯学院（JBI）定性检查表评估研究质量。提取了研究设计和参与者细节。使用JBI元聚合方法整理主题。纳入了40项研究（n = 732）。确定了三个综合结果：积极经历（ConQual分数非常低）、消极经历（ConQual分数低）以及促进因素和应对机制（ConQual分数中等）。尽管报告的消极经历多于积极经历，但形成应对机制或获得支持的使用者和照顾者认为HEN是一次有价值的经历。而那些支持或应对机制较少的人则不这么认为。基于本综述，建议在开始HEN之前，应让使用者和照顾者了解可用的支持和应对机制。当出现消极经历时，医疗服务提供者应帮助使用者和照顾者获得支持，以改善他们的体验。
