Robinovitch A E
JPEN J Parenter Enteral Nutr. 1981 Nov-Dec;5(6):522-5. doi: 10.1177/0148607181005006522.
Home total parenteral nutrition (TPN) usually necessitates major and probably permanent changes in the patient's major and probably changes in the patient's lifestyle. Among the nonmedical, nontechnological issues these patients face are the need to: (1) adhere to prescribed regimens to avoid crises and to control symptoms; (2) alter their self-perceptions; (3) modify their accustomed roles; (4) reorder their priorities and re-think their values; (5) deal with machine and medical center dependency; (6) assign a monetary value to their lives. The emotional and environmental pressures that are the chief issues for these patients include financial, employment, psychological, and interpersonal problems such as depression, anger, anxiety, relief, body image, and self-esteem. Patients on hom TPN are best treated with a clinical team that serves both the patient and family as individuals and as a social system. Services offered include: (1) medical diagnosis, treatment, and rehabilitation; (2) professional and technical support services including pharmacy, dietary, and nursing to teach, demonstrated and monitor self-care, nutrition, and use of the home TPN system; and (3) professional social work services to assist patients and families to deal with the feelings, relationships, environmental pressures, and advocacy needs associated with home TPN.
家庭全胃肠外营养（TPN）通常需要患者在生活方式上做出重大且可能是永久性的改变。在这些患者面临的非医学、非技术问题中，包括需要：（1）遵守规定的治疗方案以避免危机和控制症状；（2）改变自我认知；（3）调整习惯的角色；（4）重新排列优先事项并重新思考价值观；（5）应对对机器和医疗中心的依赖；（6）为自己的生命赋予金钱价值。这些患者面临的主要问题，即情感和环境压力，包括财务、就业、心理和人际关系问题，如抑郁、愤怒、焦虑、解脱、身体形象和自尊。接受家庭TPN治疗的患者最好由一个临床团队来治疗，该团队将患者及其家庭视为个体和社会系统来提供服务。提供的服务包括：（1）医学诊断、治疗和康复；（2）专业和技术支持服务，包括药房、饮食和护理服务，以教授、示范和监测自我护理、营养以及家庭TPN系统的使用；（3）专业社会工作服务，以协助患者及其家庭应对与家庭TPN相关的情感、人际关系、环境压力和维权需求。
