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    Discharging women with advanced ovarian cancer on home parenteral nutrition: making and implementing the decision

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    Authors
    Sowerbutts, AM
    Lal, S
    Sremanakova, J
    Clamp, Andrew R
    Jayson, Gordon C
    Teubner, A
    Hardy, L
    Todd, C
    Raftery, Anne-Marie
    Sutton, E
    Burden,S
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    Affiliation
    Faculty of Medicine, Biology and Health, and Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester M13 9PL, UK
    Issue Date
    2020
    
    Metadata
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    Abstract
    Increasingly, patients with advanced ovarian cancer in bowel obstruction are receiving home parenteral nutrition (HPN). Little is known about making and implementing the decision. This study explored the decision-making process for HPN and investigated the barriers and facilitators to implementation. This was a qualitative study underpinned by phenomenology involving 93 longitudinal in-depth interviews with 20 patients, their relatives and healthcare professionals, over 15 months. Participants were interviewed a maximum of four times. Interview transcripts were analysed thematically as per the techniques of Van Manen. We found variance between oncologists and patients regarding ownership of the HPN decision. The oncologists believed they were engaging in a shared decision-making process. However, patients felt that the decision was oncologist-driven. Nevertheless, they were content to have the treatment, when viewing the choice as either HPN or death. In implementing the decision, the principal mutable barrier to a timely discharge was communication difficulties across professional disciplines and organisations. Facilitators included developing a single point-of-contact between organisations, improving communication and implementing standardised processes. Oncologists and patients differ in their perceptions of how treatment decisions are made. Although patients are satisfied with the process, it might be beneficial for healthcare professionals to check patients' understanding of treatment.
    Citation
    Sowerbutts AM, Lal S, Sremanakova J, Clamp AR, Jayson GC, Teubner A, et al. Discharging Women with Advanced Ovarian Cancer on Home Parenteral Nutrition: Making and Implementing the Decision. Nutrients. 2020;12(1).
    Journal
    Nutrients
    URI
    http://hdl.handle.net/10541/622750
    DOI
    10.3390/nu12010166
    PubMed ID
    31936057
    Additional Links
    https://dx.doi.org/10.3390/nu12010166
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.3390/nu12010166
    Scopus Count
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