title: Psychosocial issues of nutritional support. A multidisciplinary interpretation.
abstract: In many cases, initiation of specialized nutritional support is a final attempt at medically managing illness for which other treatments have failed. Patients may have suffered for months or even years with their underlying diseases and are usually aware that poor response to nutritional support and concurrent therapies may lead to surgical intervention or more complex treatment. In some cases, there may be few alternatives left to pursue. For such patients, this paints a very stressful picture. If we as caregivers are empathetic to each patient's situation, we are better able to offer the support that these patients need. Health care professionals must keep patients informed of treatment plans and encourage participation in the planning process--during hospitalization, through the discharge phase, and after hospitalization. We need to pay close attention to those needs, whether nutritional support is short-term during hospitalization, prolonged, or permanent. The health care environment is demanding greater proficiency in cost containment and quality assurance in the delivery of care. Complex patient cases are becoming more difficult to manage as time constraints and resources become more restrictive. The ingenuity and imagination of health care providers trying to find ways to continue providing high-quality and safe care to patients are being tested daily. These worthwhile goals can be met only through cooperation, communication, and support among all levels and disciplines involved with the delivery of care. Feelings of helplessness, dependence, and loss of control can be diminished if health care providers maintain optimistic, confident attitudes, offer positive reinforcement for patients successes, and try to restore hope during this stressful period in patients' lives.
authors.affiliation: Cleveland Clinic Home Care Services, Cleveland Clinic Foundation, Ohio.
authors.forename: F
authors.initials: F
authors.lastname: Srp
authors.forename: E
authors.initials: E
authors.lastname: Steiger
authors.forename: A D
authors.initials: AD
authors.lastname: Gulledge
authors.forename: L E
authors.initials: LE
authors.lastname: Matarese
authors.forename: J
authors.initials: J
authors.lastname: Paysinger
authors.forename: T
authors.initials: T
authors.lastname: Roncagli
authors.forename: J
authors.initials: J
authors.lastname: Stebbins
authors.forename: M
authors.initials: M
authors.lastname: Sullivan
mesh_terms: D000328:Adult; D004750:Enteral Nutrition / Q000523:psychology*; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D008297:Male; D010289:Parenteral Nutrition, Total / Q000523:psychology*; D010348:Patient Care Team