title: Caregiver and health care provider preferences of nutritional support in a hematopoietic stem cell transplant unit.
abstract: BACKGROUND
  Many pediatric oncology patients undergoing hematopoietic stem cell transplantation (HSCT) require nutritional support (NS) because of their inability to consume adequate caloric intake enough calories orally. Although NS can be provided either enteraly (EN) or parenteraly (PN), EN is the preferred method of NS as long as if the gastrointestinal tract is functioning. In this qualitative study, we determined the type of NS preferences and the reservations of caregivers of pediatric HSCT patients undergoing hematopoietic stem cell transplantation (HSCT) as well as those of health care (HC) providers working on the HSCT unit.
  
  
  METHODS
  A survey was developed and completed anonymously by HC providers and caregivers. The hypothesis was that HC providers and caregivers would prefer PN because it is convenient to use in patients who already have a central line in place.
  
  
  RESULTS
  Most caregivers preferred PN to EN, while most HC providers preferred EN to PN. The barrier between EN initiation and caregivers' approval was the caregivers' perception that EN was invasive and painful, most common obstacle for initiation of EN among caregivers was that it hurts/is invasive, while the barrier with HC providers was vomiting and/abdominal pain associated with EN.
  
  
  CONCLUSIONS
  If caregivers were better educated about NS and the advantages/disadvantages of the different forms of NS, their preferences may change. There have been policy changes at St. Jude have been implemented since this study, and an outpatient dietitian now provides education to caregivers about NS during the pre-evaluation for HSCT.
authors: Clinical Nutrition Masters/Dietetic Internship Program, The University of Memphis, Memphis, Tennessee.
authors: Ruth
authors: R
authors: Williams-Hooker
authors: Methodist North Hospital, Memphis, Tennessee.
authors: Marissa
authors: M
authors: Adams
authors: Department of Food and Nutrition, Region One Medical Center, Memphis, Tennessee.
authors: David A
authors: DA
authors: Havrilla
authors: Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors: Wing
authors: W
authors: Leung
authors: Master's Program in Environmental Nutrition, The University of Memphis, Memphis, Tennessee.
authors: Robin R
authors: RR
authors: Roach
authors: Tennessee Technological University, Cookeville, Tennessee.
authors: Terezie T
authors: TT
authors: Mosby
mesh_terms: D000328:Adult; D017028:Caregivers / Q000193:education / Q000523:psychology*; D002648:Child; D003625:Data Collection; D004032:Diet; D002149:Energy Intake; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000379:methods*; D055815:Young Adult
keywords: bone marrow transplant; caregiver preferences; healthcare providers preferences; nutrition support