Patient Compliance with a Home Parenteral Nutrition Program

Abstract

ABSTRACT. A systematic study of patient compliance to home parenteral nutrition (HPN) was done by an independent nurse who visited 10 patients and families at varying periods after HPN had been started. A compliance scale was based on assessment of aseptic technique, sequènce of steps followed, safety precautions, proper use of equipment, and knowledge of complications. Compliance percentiles ranged from 73 to 97, with a median of 95. Seven of the 10 patients scored 90% or more in overall compliance. The only category that clearly showed a deficiency was patient knowledge of potential complications of HPN. Factors that correlated positively with a high compliance score were male sex, absence of children in the home, and wives who were enthusiastic about HPN and who offered the most moral support. This study shows that patients with chronic disabling diseases of the small bowel and severe malnutrition can be managed safely at home with HPN if they are properly trained and supervised.

Get full access to this article

View all access options for this article.

References

Broviac JW , Scribner BH : Prolonged parenteral nutrition in the home. Surg Gynecol Obstet 139:24–28, 1974.

Fleming CR , McGill DB , Berkner S : Home parenteral nutrition as primary therapy in patients with extensive Crohn's disease of the small bowel and malnutrition. Gastroenterology 73:1077–1081, 1977.

Jeejeebhoy KN , Langer B , Tsallas G et al: Total parenteral nutrition at home: studies in patients surviving 4 months to 5 years. Gastroenterology 71:943–953,1976.

Shils ME : A program for total parenteral nutrition at home. Am J Clin Nutr 28:1429–1435, 1975.

Shils ME: Personal communication, 1978

Abram HS : The “uncooperative” hemodialysis patient: a psychiatrist's viewpoint and a patient's commentary. IN Living or Dying: Adaptation to Hemodialysis, NB Levy (ed), Charles C Thomas, Publisher, Springfield, Illinois, 1974., pp 50–61.