Role of Psychological Flexibility and Self-compassion in People on Home Parenteral Nutrition: Psychological, Line Care Adherence and Infection Outcomes

Sara Anne Rea, Victoria Marianne Samuel, Nuno Ferreira, Marc Owen Williams

Abstract


Background: Home parenteral nutrition (HPN) is an often life-saving nutritional treatment. However, it requires meticulous adherence to line care procedures and poses challenges to daily activities which can impact a person’s quality of life (QOL) and psychological wellbeing. Less is understood about psychological processes that affect outcomes in HPN. Psychological flexibility (PF) and self-compassion (SC) have been identified as important processes in other chronic illness populations. This study aimed to examine the unique role of PF and SC in predicting psychological distress, wellbeing, QOL, line care adherence and line infections in adults on HPN.


Methods: The study was a cross-sectional, observational questionnaire design with data collected online through convenience sampling. Data collection was completed between May 2021 and February 2022; the study was advertised on online platforms and shared by relevant third sector organisations. Participants were adults currently on HPN. A measure of line care adherence was developed for the current study and the results of a principal components analysis indicated a final 9-item line care routine questionnaire.


Results: The sixty-six participants were primarily from the United Kingdom. Higher PF and SC were significantly correlated with the following outcomes in the predicted directions: lower psychological distress, higher wellbeing, higher QOL and increased line care adherence. Multiple linear regression models explained a significant proportion of the variance in all outcomes, except for line infections. PF was uniquely associated with lower total distress, lower anxiety, better wellbeing and higher QOL after controlling for SC, gender and age. Whereas SC was uniquely associated with lower total distress, depression and stress when controlling for PF, gender and age.


Conclusions: Interventions aimed at improving PF and SC may be beneficial to support the emotional wellbeing and QOL in individuals on HPN. Further research would benefit from prospective designs and consideration of objective measures of infection.

Keywords


Home parenteral nutrition (HPN); Psychological flexibility (PF); Self-compassion (SC); Quality of life (QOL); Adherence.

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References


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DOI: https://doi.org/10.13129/2282-1619/mjcp-3696

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