Staged Care Needs of Home Enteral Nutrition Patients: A Longitudinal Qualitative Study Based on Maslow’s Hierarchy

Ru-Ting Shen,* Ye-Hua Xie,* Yang Yang, Li-Fang Xie, Li-Li Gu, Wei Yan Research Institute of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wei Yan, Research Institute of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Zhongshan East Road, Number 305, Nanjing, 210002, People’s Republic of China, Tel +86 13815433358, Email [email protected] Li-Li Gu, Research Institute of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Zhongshan East Road, Number 305, Nanjing, 210002, People’s Republic of China, Tel +86 13770688551, Email [email protected]: This study aimed to examine the staged characteristics and variations in care needs among patients receiving home enteral nutrition (HEN) during the transition from healthcare institutions to home settings, using Maslow’s hierarchy of needs as a theoretical framework. The study aimed to inform the development of a needs-based nursing system specific to HEN.Methods: For purposive sampling, 15 patients meeting clinical indications for HEN were recruited. Following timing theory, each patient participated in three semi-structured interviews: 1– 3 days prior to discharge, 7– 14 days following discharge, and approximately 90 days post-discharge (± 3 days). Data were analyzed using Colaizzi’s seven-step phenomenological method to synthesize findings, interpret experiences, and identify key themes.Results: Three primary themes, seven secondary themes, and thirteen tertiary themes were identified. During the discharge preparation phase, care needs were primarily focused on physiological stability and safety. In the home-transition phase, continued attention to these needs was observed. In the home-adaptation phase, care needs evolved toward psychological well-being and self-actualization.Conclusion: Care needs among patients receiving HEN demonstrated distinct stage-specific and multidimensional changes during the transition from institutional to home care. This progression followed a trajectory from physical survival to emotional support to the reconstruction of personal value. These findings emphasize the importance of holistic nursing approaches and support the development of a structured, needs-based HEN care model.Keywords: home enteral nutrition, Maslow’s theory, needs, nursing, qualitative study