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Home Total Parenteral Nutrition: A Psycho‐Social Viewpoint
Author(s) -
Robinovitch Arlene E.
Publication year - 1981
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607181005006522
Subject(s) - parenteral nutrition , feeling , anxiety , medicine , anger , social support , rehabilitation , interpersonal communication , nursing , psychiatry , psychology , intensive care medicine , physical therapy , psychotherapist , social psychology
Home total parenteral nutrition (TPN) usually necessitates major and probably permanent changes in the patient's lifestyle. Among the nonmedical, nontechnological issues these patients face are the need to: (1) adhere to prescribed regimens to avoid crises and to control symptoms; (2) alter their self‐perceptions; (3) modify their accustomed roles; (4) reorder their priorities and re‐think their values; (5) deal with machine and medical center dependency; and (6) assign a monetary value to their lives. The emotional and environmental pressures that are the chief issues for these patients include financial, employment, psychological, and interpersonal problems such as depression, anger, anxiety, relief, body image, and self‐esteem. Patients on home TPN are best treated with a clinical team that serves both the patient and family as individuals and as a social system. Services offered include: (1) medical diagnosis, treatment, and rehabilitation; (2) professional and technical support services including pharmacy, dietary, and nursing to teach, demonstrate and monitor self‐care, nutrition, and use of the home TPN system; and (3) professional social work services to assist patients and families to deal with the feelings, relationships, environmental pressures, and advocacy needs associated with home TPN.