title: Identifying patient-centered quality indicators for the care of adult home parenteral nutrition (HPN) patients.
abstract: BACKGROUND
  Previous qualitative research, aimed at eliciting the experiences and views of home parenteral nutrition (HPN) patients in daily life, revealed little information on HPN care. However, to perform patient-centered care, it is important to understand what "quality of care" means for adult HPN patients. Therefore, the aim of this study was to identify quality indicators through patients' perspectives.
  
  
  METHODS
  In-depth, face-to-face, semistructured interviews were conducted between June and November 2011 with adult patients who recently started HPN. Patients were selected by purposive sampling. Interviews were audio recorded, transcribed verbatim, and analyzed using a framework approach. Nvivo 9.0 software was used for managing transcripts.
  
  
  RESULTS
  Twelve adult patients (7F/5M) were interviewed. At the time of the interview, median HPN experience was 59 days. Two structure, 31 process, and 9 outcome indicators were identified. The majority of process indicators are related to the home nurse, indicating the important role of these healthcare professionals in HPN care. In addition, all interviewees reported communication as an essential aspect of the complex care pathway. The identified outcome indicators are comparable with the indicators that were previously developed by an expert panel. For example, improvement in quality of life during HPN treatment and incidence of catheter-related infections were identified by both groups.
  
  
  CONCLUSIONS
  Interviews with HPN patients revealed an interesting set of indicators that can be used to perform, evaluate, or improve current HPN care and are a starting point for a more patient-centered approach.
authors.affiliation: Pharmacy Department, University Hospitals Leuven and Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium mira.dreesen@uzleuven.be.
authors.forename: Mira
authors.initials: M
authors.lastname: Dreesen
authors.affiliation: Department of Pharmaceutical and Pharmacological Sciences, Research Centre for Pharmaceutical Care and Pharmaco-economics, KU Leuven, Leuven, Belgium.
authors.forename: Veerle
authors.initials: V
authors.lastname: Foulon
authors.affiliation: Center for Health Services and Nursing Research, School of Public Health, Leuven, Belgium and Western Norway Research Network on Integrated Care, Helse Fonna, Haugesund, Norway.
authors.forename: Kris
authors.initials: K
authors.lastname: Vanhaecht
authors.affiliation: Pharmacy Department, University Hospitals Leuven and Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
authors.forename: Lutgart
authors.initials: L
authors.lastname: De Pourcq
authors.affiliation: Department of Gastroenterology, University Hospitals, Leuven, Belgium.
authors.forename: Martin
authors.initials: M
authors.lastname: Hiele
authors.affiliation: Pharmacy Department, University Hospitals Leuven and Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
authors.forename: Ludo
authors.initials: L
authors.lastname: Willems
mesh_terms: D000328:Adult; D001294:Attitude to Health; D055499:Catheter-Related Infections / Q000453:epidemiology; D003142:Communication; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D009723:Nurse-Patient Relations; D009726:Nurses / Q000592:standards; D016331:Parenteral Nutrition, Home / Q000451:nursing / Q000592:standards*; D018802:Patient-Centered Care; D019984:Quality Indicators, Health Care; D011788:Quality of Life
keywords: long-term care; nutrition; nutrition support practice; outcomes research; parenteral nutrition; quality