A Cross Sectional Survey-Based Study to Investigate the Availability and Utilisation of Home Nutrition Support in Saudi Arabia

Figures & data

Table 1 General Characteristics of the Study Participants

		Total Participants (n=114)	Participants Indicated They Have HNS in Their Work Facilities (n=55)
Region	Western region	82 (71.9%)	46 (83.6%)
	Eastern region	10 (8.8%)	2 (3.6%)
	Central region	19 (16.6%)	7 (12.7%)
	Southern region	3 (2.6%)	0 (0.0%)
	Northern region	0 (0.0%)	0 (0.0%)
Years of experience	Newly graduated	11 (9.6%)	2 (3.6%)
	2 to 5 years	43 (37.7%)	24 (43.6%)
	6 to 10 years	29 (25.4%)	19 (34.5%)
	More than 10 years	38 (33.3%)	10 (18.2%)
Type of health care facility	Medical cities (eg Prince Sultan Medical City)	6 (5.3%)	5 (9.1%)
	Military hospitals	12 (10.5%)	10 (18.2%)
	Ministry of Health (MOH) hospitals	31 (27.2%)	21 (38.2%)
	National guard hospitals	7 (6.1%)	3 (5.5%)
	Private hospitals	18 (15.8%)	10 (18.2%)
	Security Forces Hospital	2 (1.8%)	0 (0.0%)
	Specialized hospitals (King Faisal Specialist Hospital and Research Centre)	15 (13.2%)	4 (7.3%)
	University teaching hospitals	23 (20.2%)	2 (3.6%)
Capacity of health care facility	<100 beds	11 (9.6%)	2 (3.6%)
	100–250 beds	17 (14.9%)	11 (20.0%)
	251–500 beds	41 (36.0%)	28 (50.9%)
	>500 bed	36 (31.6%)	12 (21.8%)
	Do not know	9 (7.9%)	2 (3.6%)
Nutritional Qualification	ASPEN nutrition support certification	5 (4.4%)	2 (3.6%)
	ESPEN diploma in clinical nutrition and metabolism	3 (2.6%)	2 (3.6%)
	Fellowship in clinical nutrition	9 (7.9%)	3 (5.5%)
	Master of clinical nutrition with focus on nutrition support	10 (8.8%)	8 (14.5%)
	More than one certificate	1 (0.9%)	1 (1.8%)
	Nutrition support training in their local hospital	4 (3.5%)	35 (63.6%)
	Others	4 (3.5%)	1 (1.8%)
	None	78 (68.4%)	3 (5.5%)

Note: Data are presented as frequencies and percentages.

Table 2 Home Nutrition Support (HNS) Services in Saudi Arabia

Questions	Answers	Total (n=55)
1 What type of home nutrition support does your facility provide	Home EN	44 (80.0%)
	Home PN	1 (1.8%)
	Both	10 (18.2%)
2 Who provides training for patients, family members, caregivers for patients who needs to be discharged from the hospital with home nutrition support (HEN or HPN)?*	Physician	33 (60.0%)
	Dietitian	49 (89.1%)
	Pharmacist	6 (10.9%)
	Nurse	30 (54.5%)
	Whole nutrition support team	10 (18.2%)
	No training is provided for the patient or his family members	1 (1.8%)
	Other	0 (0.0%)
3 Who provides monitoring for patients on home nutrition support in your hospital?*	Physician	30 (54.5%)
	Dietitian	37 (67.3%)
	Pharmacist	0 (0.0%)
	Nurse	24 (43.6%)
	Whole nutrition support team	5 (9.1%)
	I do not Know	10 (18.2%)
	Other	0 (0.0%)
4 How does monitoring patient on home nutrition support is being conducted in your hospital?*	By phone call	24 (43.6%)
	By clinic visit	34 (61.8%)
	By home visit	35 (63.6%)
	Other	1 (1.8%)
5 Based on your current practice, what is/are the most commonly encountered complication/s of home nutrition support?*	Metabolic complication (hyperglycaemia, hypertriglyceridemia)	25 (45.5%)
	Infection complication (local infection of the insertion site, sepsis)	33 (60.0%)
	Mechanical complications (tube displacement/blockage or leakage)	32 (58.2%)
	I did not come across any complications	5 (9.1%)
	I Do not know	11 (20.0%)
	Other	1 (1.8%)

Notes: Data are presented as frequencies and percentages. *Participants were allowed to choose more than one option.

Table 3 Assessing the Association Between the Geographical Distribution of the Participants, the Type and Capacity of the Healthcare Facility in Which They Worked, and the Availability of HNS Services

Region	Western (n=82)	Eastern (n=10)		Central (n=19)		Southern (n=3)	Northern (n=0)		P-value
1. Participants who indicated that they have HNS services in their facilities	46 (56.1%)	2 (20.0%)		7 (38.8%)		0 (0.0%)	0 (0.0%)		0.015*
2. Participants who indicated they do not have HN Services in their facilities OR not aware of such service	36 (43.9%)	8 (80.0%)		12 (63.1%)		3 (100.0%)	0 (0.0%)
Type of health care facility	MOH (n=31)	Military hospitals (n=12)	University teaching hospitals (n=23)	Specialized hospitals (n=15)	National guard hospitals (n=7)	Medical cities (n=6)	Security Forces Hospital (n=2)	Private hospitals (n=18)	P-value
1. Participants who indicated that they have HNS services in their facilities	21 (67.7%)	10 (83.3%)	5 (21.7%)	2 (13.3%)	3 (42.8%)	5 (83.3%)	0 (0.0%)	10 (55.5%)	0.001*
2. Participants who indicated they do not have HN Services in their facilities OR not aware of such service	10 (32.2%)	2 (16.6%)	18 (78.2%)	13 (68.6%)	4 (57.2%)	1 (16.6%)	2 (100%)	8 (44.4%)
Capacity of health care facility	<100 beds (n=11)	100–250 beds (n=17)		251–500 beds (n=41)		>500 bed (n=36)	Do not know (n= 9)		P-value
1. Participants who indicated that they have HNS services in their facilities	2 (18.1%)	11 (64.7%)		28 (68.2%)		12 (33.3%)	2 (22.2%)		0.001*
2. Participants who indicated they do not have HN Services in their facilities OR not aware of such service	9 (81.8%)	6 (35.2%)		13 (31.7%)		24 (66.6%)	7 (77.7%)

Notes: Data are presented as frequencies and percentages. Fisher’s exact test was used to determine the association between the categorial variables. *P <0.05 is statistically significant.

Table 4 Logistic Regression Analysis of HNS Services, the Geographical Distribution of the Participants, and the Type and Capacity of Healthcare Facility in Which They Worked

Model 1	n	Beta	OR	95% CI	P-value
Total n= 114
Outcome Variable: Availability of HNS (Yes/No
Independent variables:
Region
Western	82	Reference category
Central	19	−0.34	0.72	0.18–2.93	0.642
Other regions**	13	−2.32	0.10	0.01–0.69	0.02*
Type of Health Care Facility***
Ministry of Health (MOH) hospitals	31	Reference category
Military hospitals	12	2.03	7.65	1.04–56.50	0.046
University teaching hospitals	23	−2.19	0.11	0.02–0.71	0.02*
Specialized hospitals (King Faisal Specialist Hospital and Research Centre)	15	−2.17	0.11	0.02–0.56	0.007*
National guard hospitals	7	−0.99	0.37	0.05–2.59	0.317
Medical cities (eg Prince Sultan Medical City)	6	0.72	2.05	0.16 −26.22	0.582
Private hospitals	18	−0.29	0.75	0.15–3.69	0.721
Capacity of health care facility
<100 beds	11	Reference category
100–250 beds	17	2.58	13.17	1.09–159.49	0.043*
251–500 beds	41	3.11	22.52	2.04–248.77	0.011*
>500 bed	36	1.26	3.51	0.34–36.89	0.295
On’t know	9	0.08	1.08	0.06–19.83	0.958

Notes: *P <0.05 is statistically significant. The model was adjusted for regional distribution. **Eastern and Southern regions were combined in one variable. ***Security Forces Hospitals were excluded from this analysis because the n=2.