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Attitudes of patients and nurses towards diarrhoea during enteral tube feeding

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Background: 

Diarrhoea is a common complication during enteral tube feeding (ETF) and, despite little empirical evidence, is said to be unpleasant for both patients and nurses (Whelan et al., 2007). The aspects of diarrhoea considered to be unpleasant among patients receiving ETF or among nurses caring for these patients has not previously been investigated. Therefore, the aim of the study was to investigate patients’ and nurses’ attitudes towards diarrhoea during ETF. Methods: 

A questionnaire was developed following an extensive literature review and was pre-tested for clarity. An interviewer-administered questionnaire survey was then conducted by the same interviewer, in patients receiving ETF and in nurses caring for patients receiving ETF. Seven different characteristics of diarrhoea (faecal colour, consistency, frequency, quantity, incontinence, odour, need to change underwear) were rated for their unpleasantness using a four-point Likert scale. Ratings were then ranked and a mean rank calculated for each group to determine the most and least unpleasant characteristic. Ranks were then compared within patients and within nurses using a Friedman test. Ethical approval was obtained from an NHS Research Ethics Committee. Results: 

In total, 22 patients (16 male, six female; mean age 58.5 ± 15.2 years) receiving ETF due to dysphagia, post-surgery, tracheostomy and inadequate nutritional intake and 57 nurses (16 male, 41 female) from respiratory, intensive therapy, elderly care and renal units were interviewed. There were differences in the rankings of the seven characteristics among patients (P < 0.001) and among nurses (P < 0.001). Patients rated incontinence and frequency as the most unpleasant characteristic of diarrhoea, whereas nurses rated odour and changing underwear as the most unpleasant characteristic of caring for patients with diarrhoea during ETF ( Table 1). Discussion: 

The characteristics of diarrhoea considered to be unpleasant by patients are not the same as for nurses. The importance of understanding the patient perspective of symptoms is increasingly recognised in practice and research. Conclusion: 

Faecal incontinence and frequency are considered to be the most unpleasant characteristics of diarrhoea by patients. These characteristics should be monitored by healthcare professionals and strategies developed to minimize their occurrence in hospitalised patients receiving ETF. Reference 

Whelan, K. (2007) Enteral-tube-feeding diarrhoea: manipulating the colonic microbiota with probiotics and prebiotics. Proc. Nutr Soc. 66, 299–306.
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Document Type: Research Article

Publication date: 2008-08-01

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