title: The complex gastrointestinal patient and Jean Watson's Theory of Caring in nutrition support.
abstract: The care of the patient with gastrointestinal disease is complex and challenging. The reasons for the complexity are varied and different for each patient. Any of these variables can affect the nutritional health of the patient, an essential element of care that supports healing, recovery, and improved quality of life. A nutritional assessment, an evaluation of the patient's nutritional status, can be used to establish the patient's weight history, dietary habits, tolerances, and likes and dislikes. Intake and output values from this assessment provide information relating to the patient's ability to meet his or her nutritional requirements orally or whether alternate methods for nutrition support need be considered, such as a feeding tube or a central intravenous catheter. Parenteral nutrition is the intravenous nutrition supplementation required when the oral or enteral route for nutrition support is unavailable or impossible. In this article, a clinical case scenario for a 34-year-old man with a history of cancer and an extensive bowel resection will be presented to better explore the decision-making process for determining appropriate nutrition support. In addition, various issues the health practitioner needs to consider when managing the nutritional health of the complex gastrointestinal patient will be explored, relative to Jean Watson's Theory of Caring.
authors.affiliation: Home Parenteral Nutrition Program Coordinator, Hamilton Health Sciences, Hamilton, Ontario, Canada. anne.childs@sympatico.ca
authors.forename: Anne
authors.initials: A
authors.lastname: Childs
mesh_terms: D000328:Adult; D003110:Colonic Neoplasms / Q000150:complications* / Q000628:therapy; D004645:Empathy; D017809:Fatal Outcome; D005247:Feeding Behavior; D005518:Food Preferences; D006379:Helping Behavior; D006694:Holistic Health; D006801:Humans; D008297:Male; D008487:Medical History Taking; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009730:Nursing Assessment; D009742:Nursing Theory; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000209:etiology / Q000517:prevention & control*; D009752:Nutritional Status; D018529:Nutritional Support / Q000379:methods / Q000451:nursing* / Q000523:psychology; D010347:Patient Care Planning; D035502:Trust