clogging, displacement of tube, anxiety, depressi-
on, procurement of material etc).
Data Collection and Ethical Aspects of Re-
search
Before data collection, written permission was
obtained from the Private Home Care Agency.
The questionnaire form was filled out by the in-
vestigator using the face-to-face interview met-
hod and carried out between July and September
2009. Patients were visited in their homes by the
investigator by previous appointment. An infor-
med consent form was signed by the patient or le-
gal conservator of the patient after relevant exp-
lanations were made. In the investigation, data on
the problems experienced by the patients were
obtained primarily from the patients. However, in
cases when the patient was unable to express
him/herself in oral or written manner, data were
obtained from the people who are the primary ca-
re givers of the patient.
Data Analysis
Data were analyzed using the SPSS 15.0
(SPSS Inc. Chicago, Illinois) program. In the
analysis of data, number and percentage were
used. States of consciousness and dependence le-
vels for activities of life were determined accor-
ding to criteria stated in the literature.
Results
Demographic characteristics of patients are
summarized in Table 1.
12.0% (n=6) of the patients developed aspira-
tion pneumonia and they were hospitalized. Nasal
tubes of these patients were replaced with an en-
terostomal feeding such as percutaneous endos-
copic gastrostomy (PEG) which represents 67%
(n=4) of the patients. 18.0% (n=9) of the patients
experienced infection at the entrance of the tube
on abdomen (Table 2).
Table 3 contains the distribution of the gastro-
intestinal system and metabolic problems experi-
enced by the patients as well as the applied inter-
ventions. With a rate of 58.0% (n=29) vomiting is
the most frequent problem observed in these pati-
ents. Keeping the patient’s head at a higher posi-
tion (n=19), consulting a specialist nurse (n=17)
and stopping the nutrition (n=16) are the primary
interventions to solve the vomiting problem.
The second most frequent gastrointestinal sys-
tem problem was constipation (n=22), the third
was diarrhea (n=39). Of all the patients, only one
suffered from dehydration and abdominal disten-
sion.
The most frequent mechanical problem enco-
untered was the clogging of the tube (n=15). Irri-
gating the tube with warm water was among the
interventions applied to solve this problem
(n=14). The next mechanical problem was the
displacement of the enterostomal tube which oc-
curred in 14 patients. The interventions to solve
this problem were placing a new tube in a hospi-
tal (n=11) and pushing the tube forward (n=2)
(Table 4).
The first four psychological problems experi-
enced by the patients were anxiety, crying-wee-
ping, impairment of body perception and self-es-
teem and disruption of relations with family and
friends. In addition to those problems, 47 patients
experienced difficulty in procuring materials for
enteral feeding at home and 15 patients in provi-
sion of suitable physical conditions at home (such
as a separate room).
Discussion
This study proves that the majority of the sub-
ject patients are fed with the tube enterostomy
method. With patients in need of enteral feeding
by tube for longer than six weeks the literature