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Caring for the child with intestinal failure on home parenteral nutrition: A scoping review
Mary Beth Hovda Davis1, Valerie Boebel Toly2, Erin Weber3
1University of Iowa College of Nursing, Iowa City, Iowa, USA.
Insights
Caring for children with intestinal failure at home significantly burdens family caregivers, impacting their well-being. Enhanced training and support programs are crucial for improving caregiver preparedness and family outcomes.
Area of Science:
- Pediatric Gastroenterology
- Caregiver Support
- Home Healthcare
Background:
- Children with intestinal failure require complex homecare, placing a substantial burden on family caregivers.
- This caregiving role often leads to increased stress, anxiety, and depression among family members.
- Understanding caregiver experiences is vital for healthcare providers to better prepare families for home-based care.
Purpose of the Study:
- To explore the experiences of family caregivers providing home parenteral nutrition to children with intestinal failure.
- To identify gaps in the literature regarding caregiver preparedness, well-being, and daily experiences.
Main Methods:
- A scoping review was conducted following the Arksey and O'Malley methodology.
- Searches were performed across major databases (PubMed, CINAHL, Scopus, Embase) for relevant literature.
- Data from 15 included studies were extracted and analyzed thematically.
Main Results:
- The review identified 15 relevant studies focusing on various aspects of the caregiving experience.
- Key themes included caregiver quality of life (5 studies), discharge preparedness (5 studies), and caregiver well-being (3 studies).
- Two studies specifically addressed the daily experiences of providing home care.
Conclusions:
- While preparing families for home care can enhance preparedness, it significantly increases the caregiver burden.
- Developing comprehensive training, support systems, and interventions is essential.
- Such programs can alleviate caregiver stress and improve health outcomes for both children and their families.
Background:
Children with intestinal failure have significant long-term medical needs that require continual complex procedures provided by the family caregiver in the home. This contributes to a high burden of care, leading to increased stress, anxiety, and depression. Understanding caregivers' perceptions of the homecare experience will augment healthcare providers' knowledge of how to prepare a family to provide care in the home setting.
Methods:
This study focused on the caregiving experience by examining the current literature. A scoping review was conducted using the Arksey and O'Malley methodology. Comprehensive searches on the caregiver of a child with intestinal failure receiving home parenteral nutrition were conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Embase. Two reviewers screened the abstracts by title and abstract. One reviewer extracted then descriptively and thematically analyzed data to map the current evidence.
Results:
The initial search yielded 313 total articles. After inclusion and exclusion criteria were applied, a total of 15 relevant articles were included. Of the 15 studies, 5 studies described the caregiver's quality of life, 5 studies described caregiver's discharge preparedness, 3 studies discussed caregiver well-being (stress, anxiety, and depression), and 2 studies described the caregiver daily experience of providing care.
Conclusion:
Preparing families to care for children with intestinal failure in the home may bolster caregiver preparedness but also impose a significant burden. Developing programs that offer optimal training, support, and interventions for caregivers can help alleviate stress and improve outcomes for both children and their families.
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