Development Of Management Scheme For Adults With Home Enteral Tube Feeding

ObjectivesTo establish a systematic,normative,and clinical applicable management scheme for adults with home enteral tube feeding,which will provide a reference for the safe implementation and management of home-based nutrition intervention.Methods1.We systematically searched the relevant literature of adults with home enteral tube feeding,analyzed the included researches by the literature analysis method,then extracted the critical content and links.2.According to the principles of phenomenological methodology,we used the purpose sampling method to select11 patients,10 caregivers and 10 health care professionals for semi-structured interviews to clarify the needs and advices of management scheme for adults with home enteral tube feeding.Colaizzi’s seven-step analysis method was used to analyze the data.3.Combined with the results of literature analysis,semi-structured interview and expert meetings,established a preliminary draft.The draft of management scheme for adults with home enteral tube feeding was consulted and revised according to a tow-round Delphi method,finally the management scheme for adults with home enteral tube feeding had been established.Results1.A total of 37 articles were coded and analyzed by the literature analysis method.There were 6 aspects and 26 items about management of adults with home enteral tube feeding,including organization and management,screening,assessment,plan,implement and monitoring2.Based on the perspective of the service object and the service provider,we summarized 4 themes and 9 subthemes:Information needs(Information needs of enteral tube feeding,Smooth information channels),Security needs(Symptom management,Home medical services),Organization management(Teamwork,Assessment and monitoring,Quality improvement of nutrition service)and Social support(Support network,Support system)3.After two rounds of Delphi expert consultations,the opinions tended to be consistent.There were 44 and 42 experts participated in the first and second Delphi expert consultations.The questionnaire recovery rate of two rounds were 88%and 94.45%,the proportion of experts who put forward opinions were 54.55%and 28.57%,the expert authority coefficients were 0.891 and 0.890.The coefficients of variation of items was 0 to 0.17,and the coordination coefficients the of primary,secondary-level and third-level were 0.314,0.211 and 0.129 respectively(P<0.001).Finally,management scheme of home enteral tube feeding covering organization and management,screening and assessment,plan,implement,monitoring and evaluation,quality improvement was formed.It includes 6 primary items,19 secondary-level items and 52 third-level items.ConclusionsThis research fully clarified the key content and links of management scheme through the analysis of literature,combined with the requirements and suggestions of stakeholder group,and formed a clinical practice-oriented family enteral tube through the expert correspondence method,which will provide a reference for development of systematic and professional family enteral tube feeding nutrition practice.