An explorative study design was used to describe the psychological and social impact of HPN using the Corbin and Strauss Chronic Illness Trajectory Framework. Fifty subjects completed four quantitative instruments and HPN Demographic Questionnaire by phone. Six subjects were interviewed. The selection of the quantitative instruments was guided by the Chronic Illness Framework concept of ‘work’ and descriptive reports of patient adjustment to HPN. The instruments included Ferrans and Powers Quality of Life Index (QLI), SF-36 Health Survey, Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI)). The HPN Demographic Questionnaire included specific questions concerning the underlying illness and the HPN daily infusion procedures. The subject’s trajectory phase and trajectory projection were determined from the demographic and HPN data. Subjects were in the stable (n=18), unstable (n=8), acute (n=9), comeback (n=11) and the downward phase (n=4) and the short-term (n=13), long-term (n=33), and palliative (n=4) trajectory projections. Results indicated quality of life, physical functioning, and sleep quality to be lower than the normal population but similar to other chronically ill populations. Surprisingly, the mental health scores were similar to healthy populations. The content analysis of the semi-structured interview data described physical limitations, social and family life disruptions, disrupted sleep and complaints of fatigue. Conclusions regarding the use of trajectory phasing and projections are hampered by the small groups. Utilizing the Chronic Illness Framework to guide instrument selection was very valuable. The results were viewed from the perspective of the ‘work’ of subjects on HPN, not HPN treatment outcome. Further research with a larger sample would be necessary to evaluate the use of the trajectory phasing and projections.
Session #1204 - Home Care
The 29th Annual MNRS Research Conference (April 1-4, 2005)