Permanent Total Parenteral Nutrition

Psychological and Social Responses of the Early Stages
  • Beth S. Price
  • Eleanor L. Levine


Permanent total parenteral nutrition (TPN) is a new form of life-sustaining therapy.1,2 This treatment is indicated in situations where the disease results in a state in which the small bowel is no longer able to perform its normal absorptive functions to support life.2,3 Initiating this type of therapy requires the operative insertion of a permanent silastic catheter into the subclavian vein through which essential nutrients are infused into the body to meet the daily requirements for growth and metabolism. TPN is an artificial and unnatural source of feeding and nurturance which demands major adjustments in life-style. Patients must learn the intricacies of the entire TPN system and become totally self-sufficient in its use. For this, patients undergo a period of training during which they learn to operate this complicated apparatus independently. This highly complex and completely sterile procedure is repeated 365 days a year!


Body Image Total Parenteral Nutrition Physical Illness Operative Insertion Toronto General Hospital 
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  1. 1.
    Dudrick, S. J., Wilmore, D. W., Vars, H. M., & Rhoads, J. e. Long-term total parenteral nutrition with growth, development, and positive nitrogen balance. Surgery, 1968, 64, 134–142.PubMedGoogle Scholar
  2. 2.
    Dudrick, S. J., &Rubert, P. L. Principles and practices of parenteral nutrition. Gastroenterology, 1971, 910–910.Google Scholar
  3. 3.
    Jeejeebhoy, K. N., & Anderson, G. H., Sanderson, I., & Bryan, M. H. Total parenteral nutrition: Nutrient needs and technical tips. Modern Medicine in Canada. 1974, 29, 832–841, 944–947.Google Scholar
  4. 4.
    Moos, R. H. The crisis of treatment: Survival by machine. In R. H. Moos (Ed.), Coping with physical illness(Vol. 1). New York: Plenum Medical, 1977.CrossRefGoogle Scholar
  5. 5.
    Moos, R. H., &Tsu, V. D. The crisis of physical illness: An overview. In R. H. Moos (Ed.),Coping with physical illness(Vol. 1). New York: Plenum Medical, 1977.CrossRefGoogle Scholar
  6. 6.
    Kübler-Ross, E. On death and dying. New York: Macmillan, 1969.Google Scholar
  7. 7.
    Adler, M. L. Kidney transplantation and coping mechanisms.Psychosomatics, 1972, IB, 337–341.Google Scholar
  8. 8.
    Andreasen, N. J. C., &Norris, A. S. Long-term adjustment and adaptation mechanisms in severely burned adults.Journal of Nervous and Mental Disease, 1972, 154, 352- 362.PubMedCrossRefGoogle Scholar
  9. 9.
    Williams, C. D. The CCU nurse has a pacemaker. American Journal of Nursing, 1972, 72, 900–902.PubMedGoogle Scholar
  10. 10.
    Abram, H. S. Survival by machine. The psychological stress of chronic hemodialysis. In R. H. Moos (Ed.), Coping with physical illness(Vol. 1). New York: Plenum Medical, 1977.Google Scholar
  11. 11.
    Jeejeebhoy, K. N., Langer, B., Tsallas, G., Chu, R. C., Kuksis, A., & Anderson, G. H. Total parenteral nutrition at home: Studies in patients surviving 4 months to 5 years. Gastroenterology, 1976, 71, 943–953.PubMedGoogle Scholar
  12. 12.
    Heitzer, W. D., &Orringer, E. P. Parenteral nutrition at home for 5 years via arteriovenous fistulae. Gastroenterology, 1977, 72, 527–532.Google Scholar
  13. 13.
    Lipowski, Z. J. Physical illness, the individual and the coping process. Psychiatry in Medicine, 1970, 1, 91–102.PubMedCrossRefGoogle Scholar
  14. 14.
    Adams, J. E., & Lindemann, E. Coping with long-term disability. In G. C. Coehlo, D. A. Hamburg, & J. E. Adams (Eds.), Coping and adaptation. New York: Basic Books, 1974.Google Scholar
  15. 15.
    Langer, B., McHattie, J. D., Zohrab, W. J., & Jeejeebhoy, K. N. Prolonged survival after complete small bowel resection using intravenous alimentation at home. Journal of Surgical Research, 1973, 15, 226–233.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1984

Authors and Affiliations

  • Beth S. Price
    • 1
  • Eleanor L. Levine
    • 1
  1. 1.Social Service DepartmentToronto General HospitalTorontoCanada

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