Evaluation of patient quality of life and satisfaction with home enteral feeding and oral nutrition support services: a cross-sectional study.

Abstract

Objective The aims of the present study, in home enteral nutrition (HEN) patients, were to assess patient satisfaction with the service and quality of life (QOL) scores, and to compare QOL scores in HEN patients with general Australian population values. Methods Self-administered voluntary questionnaires for the present cross-sectional study were mailed out to 322 eligible participants registered with HEN for >5 months. The questionnaires used included a patient satisfaction survey and a validated QOL questionnaire. Data analysis consisted of cross-tabulation, Chi-squared tests and t-tests. Results There were 112 participants. Patients reported satisfaction with information received before discharge (86%), support received after discharge (74%), expertise of the health professional (87%), access to health professionals experienced with HEN (74%), communication between health professionals (74%), costs of HEN supplies (52%) and delivery of HEN supplies (88%). QOL scores related to physical, psychological, social and environment domains were significantly lower in HEN patients than in the Australian reference population (P<0.001). There was no significant difference in QOL and health satisfaction across different clinical areas (0.737 and 0.316, respectively). Conclusion Overall, participants were satisfied with HEN services. Participants had lower QOL scores compared with the Australian general population. Improvements to the HEN service were suggested, including sooner follow-up after hospital discharge; more frequent reviews for long-term patients; and the availability of a multidisciplinary team to manage HEN patients. What is known about the topic? Malnutrition is a common problem in Australian hospitals. Many patients require nutrition support to maintain or improve their nutrition status because of inadequate oral intake, malabsorption of nutrients or because of a disease process. Nutrition support is commonly started in the in-patient setting and, because of faster patient discharge from hospital, HEN is a cost-effective and reliable way of treating patients who continue to need nutrition support after hospital discharge. Inconsistencies exist in service provision of HEN because there is no national or state-wide standardisation of services. Australian studies that have evaluated patient satisfaction with HEN services are lacking. This is of particular importance because HEN service use is increasing. What does this paper add? This study reveals that patients receiving HEN therapy are mostly satisfied with the service provided. Patients surveyed have expressed important aspects of the HEN service include follow-up and advice from health care professionals, low price and home delivery of supplies, emphasising the importance of adequate clinical services, supply and delivery of HEN. QOL is poorer in the HEN patient population compared with the general Australian population. What are the implications for practitioners? Standardisation of HEN services is important to ensure uniformity in service provision to HEN patients. Health services adhering to best practice guidelines for HEN will result in the provision of adequate quality of care, and subsequently improved patient satisfaction and adherence to HEN therapy. Adequate service provision and appropriate monitoring and review of HEN patients in the community may also contribute to better health outcomes and better QOL for patients.