The impact of home parenteral nutrition on daily life - a review

Abstract

Background: Total parenteral nutrition (TPN) is a lifesaving therapy in patients with
severe intestinal failure that can be administered at home. However, patients have to face
complex technological nutritional support issues at home, which will influence their
personal life.
Objectives: This review aims to describe the implications of home parenteral nutrition
(HPN) on the quality of life, as experienced by patients, as well as to describe the
caregiver’s reactions regarding these notions.
Search strategy: A systematic review of the literature published between 1965 and 2005
was conducted. Cinahl, Medline, and Psychlit databases were searched. Systematic data
extraction and narrative data synthesis were performed.
Selection criteria: Papers were included if they described original research published in a
peer reviewed journal, with a focus on adult patients on HPN and/or their family
caregivers.
Data collection (and analysis): A standardised record was used for data extraction.
Main results: A total of 26 studies were included. The quality of life reported by patients
was moderate to good, but psychological problems, e.g. depression and anxiety, were
common. Social life was disturbed due to the venous access device, the time schedule for
HPN administration, the inability to have normal oral intake, gastrointestinal mobility
problems, and physical complaints. Frequently mentioned somatic problems included
fatigue, diarrhoea, pain, polyuria during infusion and sleep disruption.
Despite social restrictions, depression and fatigue, caregivers reported their overall QoL as similar to the norms for healthy populations.

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ORCID for L. Schoonhoven: orcid.org/0000-0002-7129-3766

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