"I Wouldn't Ever Want It": A Qualitative Evaluation of Patient and Caregiver Perceptions Toward Enteral Tube Feeding in Hip Fracture Inpatients.

BACKGROUND: One in 2 hip fracture inpatients are malnourished on admission to hospital, with many experiencing nutrition decline during their length of stay. Despite this, enteral tube feeding (ETF) is rarely used in this population. As patient/caregiver viewpoints regarding the utility of ETF remain unclear, this study explored the perceptions of hip fracture inpatients and caregivers toward ETF use to assist recovery.

METHODS: An inductive qualitative research project was conducted within a tertiary hospital orthogeriatric ward. Individual semistructured interviews were undertaken with 13 purposively sampled, postsurgery hip fracture inpatients and 7 caregivers. Interviews were transcribed, hard-copy coded, and thematically analyzed.

RESULTS: The majority of inpatient participants did not wish to be tube fed. A novel, complex interrelationship of the following 3 main themes emerged: knowledge and understanding, perceived consequences and necessity of tube, contributed toward potential ETF acceptance and refusal. Theme interrelationship was indicated by subthemes (nutrition importance, attitude, and ability to cope) and driven by the following 3 key categories: value of nutrition, quality of life, and personal perception.

CONCLUSION: A number of factors impacted the likelihood of tube acceptance. This highlights the importance of food as a medicine, treatment intent, and shared decision making when considering ETF in acute hip fracture inpatients.