Fostering coping skills and resilience in home enteral nutrition consumers

Home enteral nutrition (HEN) is a lifesaving source of nutrition for many individuals; however, reliance upon this therapy is associated with numerous medical and psychosocial challenges. The purpose of this qualitative study was to understand the characteristics, skills, behaviors, and external resources that HEN consumers used to successfully cope and ultimately thrive with this therapy. Information was also gathered to learn how health-care providers (HCPs) could enhance HEN education programs by incorporating strategies that foster effective coping and nurture individuals' resilient assets. The Transactional Model of Stress and Coping and the metatheory of resilience and resiliency served as the theoretical frameworks for this research. Twelve adult HEN consumers self-selected for this study and met the criterion of resilience based on their Resilience Scale scores. They participated in a series of two in-depth interviews where semistructured, open-ended interview questions were asked in person, by telephone, or e-mail. Data were then coded and analyzed using grounded theory methodology.;One overarching theme and five main categories emerged from the data, revealing that these individuals utilize an attitude of personal responsibility to accept new life conditions, take charge of their health, seek and accept support, maximize independence and normality, and focus on the positive. In addition, these participants used a variety of problem- and emotion-focused coping strategies and shared several resilient characteristics such as self-efficacy and perseverance. Suggestions to improve the HEN education and monitoring processes were discussed by a focus group of 13 HCPs. Recommendations for clinical practice and HEN consumer education were developed.