Introduction Home parenteral nutrition (HPN) has been shown in previous studies to reduce the quality of life1of those receiving it. An essential part of life that provides meaning, financial security and community is occupation. The effect of HPN on a recipient’s occupation has not been looked at in detail before. This study sets out to ascertain the effect of HPN on occupation and the factors that influence a patient’s occupational status on HPN.
Method We developed a questionnaire with questions about occupational status before and after starting HPN, type of work, motivation for returning to work and if HPN had impacted on their ability to work. This was completed at the outpatient clinic and also sent to patients to complete as a web-based questionnaire. The information was then compiled onto a database. The questionnaire has, so far, been carried out among patients from St Marks Hospital in London and Glasgow Royal Infirmary.
Results There were 70 respondents in total (M:F 32:38, mean age 55 [20–80] years). Before starting HPN 73% patients were working, 11% were unemployed and 16% were retired; however, on HPN only 34% remained in work. The type of work was also different among those who did work with 79% in full time employment prior to HPN as well as 18% part time and 3% volunteering. Post HPN there was 42% in full time, 33% part time and 25% volunteering. The most common reason given for HPN treatment to impinge on the ability to work was ‘time needed to be on it’ (36%), ‘restricts how far from apparatus they can go’ (19%), ‘tiring’ (14%), ‘risk of complications’ (10%) and 12% stated it had ‘no impact’. For patients over 45, 91% worked prior to HPN and 49% afterwards (excluding those already retired). In patients under45, 71% worked before (bearing in mind some were under 18 before HPN) and 57% worked afterwards. In regard to gender, 43% of men (excluding those already retired) worked after HPN and only 39% of women.
Conclusion Whilst HPN is an exceptionally successful treatment it does undoubtedly limit a person’s ability to work. The extent to which HPN restricts the ability to work is more pronounced in some groups such as the over 45s. How it limits the ability to work differs greatly in patients and is very subjective to the individual patient. However, identifying more common areas of difficulty opens up the opportunity to discuss these with patients and endeavour to take measures that counteract these difficulties.
Disclosure of interest None Declared.
Winkler MF. Quality of life in adult home parenteral nutrition patients. J Parent Enteral Nutr. 2005;29(3):162–70. http://www.ncbi.nlm.nih.gov/pubmed/15837775(accessed 23rd April 2014)