Biopsychosocial, Behavioural Aspects and Quality of Life with Home Enteral Nutrition

Abstract

Artificial nutrition (AN) has become a therapeutic option that is used to considerably prolong the life of patients who were previously doomed to malnutrition. Enteral nutrition (EN) is often a choice treatment for patients at home with chronic diseases, who require artificial nutrition as they cannot be mouth fed. The recent biopsychosocial approach promoted by the World Health Organization wants us to consider the person from a ‘global’ perspective, taking into account the physiological, psychological and social implications of any treatment administered. Such a vision demands that the wellness of patients treated with AN and, especially, with home enteral nutrition (HEN) be considered from a general standpoint that evaluates both routine medical outcomes and the subjective stand of patients and caregivers, if any. It considers the effect of therapy on the so-called quality of life of the person. This chapter discusses and enlarges on the effects of HEN on the health-related quality of life (QoL) of patients and their primary caregivers. The biopsychosocial model we use reveals that certain aspects that were traditionally deemed as ‘positive’ and desirable by health-care professionals (i.e. the possibility of providing home care) lack a straightforward correspondence in the emotional framework of patients who are administered HEN. They also have a psychosocial impact on their lives. Often, the subjective perception of health-related quality of life (QoL) is lower than expected, when compared to matching groups of subjects.