Construction Of Home Enteral Nutrition Management Scheme For Adults With Inflammatory Bowel Disease

Objective:This study aims to foothold the needs in home enteral nutrition therapy for adult patients with inflammatory bowel disease,on the basis of Nutrition Care Process and model,drawing on domestic and foreign practical experiences,combined with specialist disease characteristics,to construct a suitable management scheme of home enteral nutrition for adult patients with inflammatory bowel disease.Methods:1.Qualitative interview A phenomenological approach was used to conduct semi-structured interviews with adult patients with inflammatory bowel disease to gain insight into their real experience and actual need for home enteral nutrition therapy.2.Literature review Through the analysis of relevant literature at home and abroad,combined with the results of previous qualitative interviews,and based on the Nutrition Care Process and model,the framework and content of home enteral nutrition management scheme for adult patients with inflammatory bowel disease were preliminarily constructed3.Delphi method Through 2 ～ 3 rounds of expert consultations,the Delphi method was adopted to invite experts to evaluate each item and solicit opinions,which were revised and improved by group discussion according to the results of correspondence and expert opinions.Results:1.Qualitative interview A total of 14 patients with inflammatory bowel disease were interviewed.Attitudes,experiences and need about home enteral nutrition therapy were distilled into 3 categories.A total of 5 themes including different attitudes,positive experiences,negative experiences,information needs,and health resource needs were included.A total of 14 subthemes including decision support needs,need for treatment-related information,and need for specialized knowledge and skill guidance,etc.2.Literature review A total of 27 literatures were included for analysis,including14 Chinese and 13 English literatures.Those included 5 guidelines,2 expert consensus,1 clinical practice standard and 2 safe practice recommendations for enteral nutrition therapy.3.Delphi method Through two rounds of Delphi expert consultations,the management scheme were revised and improved.Finally,a management scheme was formed,containing 6 first-level indicators,12 second-level indicators and 50 third-level indicators.The positive coefficients of experts in two rounds were 83.33% and 95%,and the definitive coefficients were 0.908 and 0.891,respectively.After two rounds of consultations,the coordination coefficients were 0.276 and 0.127,and the coefficients of items from 0.00 to 0.19.The differences were statistically significant.Conclusions:The study constructed the home enteral nutrition management scheme for adults with inflammatory bowel disease,which covered key links in the management pathway from team organization,monitoring and evaluation,documentation,and so on.That could provide reference for the continuous nutritional nursing practice of adult patients with inflammatory bowel disease.