{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:59:52Z","timestamp":1792425592995,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Home parenteral nutrition is a life-sustaining therapy for patients with chronic intestinal failure, increasingly delivered in the home setting worldwide. While home parenteral nutrition supports nutritional status, survival, and functional independence, it also transfers complex clinical responsibilities to patients and family caregivers, raising concerns about care quality and safety. This study aimed to explore patients\u2019 and primary caregivers\u2019 experiences of home parenteral nutrition and to identify structural, process-related, and outcome-related factors influencing care quality and safety, guided by the Donabedian model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An interpretive descriptive qualitative design was used. Semi-structured interviews and structured home-based observational assessments were conducted with 22 participants (11 adult patients and 11 primary caregivers) recruited from a tertiary university hospital in Turkiye. Interviews explored lived experiences of home parenteral nutrition, while observations focused on caregivers\u2019 adherence to aseptic technique during parenteral nutrition preparation, catheter care, and infusion procedures. Data were analysed using directed content analysis guided by Donabedian\u2019s structure\u2013process\u2013outcome framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine themes were identified across the three domains of the Donabedian model. Structural factors included the critical role of comprehensive discharge education, challenges in establishing safe home environments, and the absence of professional home care services. Process-related findings revealed frequent deviations from standard protocols, influenced by procedural complexity, emotional distress, and limited access to reimbursed supplies. Outcome-related experiences encompassed catheter-related complications, reduced quality of life, substantial caregiver burden, and mixed satisfaction with care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates that safe and high-quality home parenteral nutrition depends on more than technical training alone. Integrated post-discharge support, continuous caregiver education, and accessible home care services are essential to reduce complications and caregiver burden. Strengthening health system structures is crucial to ensure quality and safety in home parenteral nutrition care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/intqhc\/mzag027","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T12:44:04Z","timestamp":1771937044000},"source":"Crossref","is-referenced-by-count":1,"title":["Patients\u2019 and their caregivers\u2019 experiences with home parenteral nutrition: a qualitative study using the Donabedian model"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1449-2881","authenticated-orcid":false,"given":"Fatma","family":"Tamer","sequence":"first","affiliation":[{"name":"Clinical Nutrition Unit, Hacettepe University Hospitals , Ankara,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevgisun","family":"Kapucu","sequence":"additional","affiliation":[{"name":"Department of Medical Nursing, Hacettepe University Nursing Faculty , Ankara,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meltem G\u00fclhan","family":"Halil","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine , Ankara,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"2026031715153478700_mzag027-B1","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1097\/NAN.0000000000000068","article-title":"Long-term home parenteral nutrition: it takes an interdisciplinary approach","volume":"37","author":"Winkler","year":"2014","journal-title":"J Infus Nurs"},{"key":"2026031715153478700_mzag027-B2","author":"Shatnawei","year":"2015"},{"key":"2026031715153478700_mzag027-B3","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1093\/ajhp\/zxae081","article-title":"Parenteral nutrition at home\/long-term parenteral nutrition","volume":"81","author":"Kumpf","year":"2024","journal-title":"Am J Health Syst Pharm"},{"key":"2026031715153478700_mzag027-B4","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1016\/j.clnu.2020.03.005","article-title":"ESPEN guideline on home parenteral nutrition","volume":"39","author":"Pironi","year":"2020","journal-title":"Clin Nutr"},{"key":"2026031715153478700_mzag027-B5","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1016\/j.clnu.2005.06.008","article-title":"Home parenteral nutrition: a qualitative interview study of the experiences of advanced cancer patients and their families","volume":"24","author":"Orrevall","year":"2005","journal-title":"Clin Nutr"},{"key":"2026031715153478700_mzag027-B6","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.clnesp.2018.07.006","article-title":"The impact of home parenteral nutrition on the burden of disease including morbidity, mortality and rate of hospitalisations","volume":"28","author":"Burden","year":"2018","journal-title":"Clin Nutr ESPEN"},{"key":"2026031715153478700_mzag027-B7","first-page":"e13003","article-title":"Is home parenteral nutrition safe for cancer patients? 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