Psychological impact of vascular access devices in young patients receiving parenteral nutrition: A meta-analysis

Abstract

Background: Vascular access devices (VADs) are crucial for administering parenteral nutrition to young patients with various medical conditions. However, the psychological impact of these devices on this vulnerable population is not well understood.

Objective: To synthesize and quantify the existing literature on the psychological effects of VADs in young patients (0-25 years) receiving parenteral nutrition.

Methods: A systematic review and meta-analysis were conducted using PubMed, EMBASE, PsycINFO, and CINAHL databases. Studies published between January 2000 and December 2023 were included if they reported quantitative psychological outcomes in young patients with VADs for parenteral nutrition. Random-effects models were used to pool effect sizes for anxiety, depression, body image, and quality of life outcomes.

Results: Twenty-eight studies met the inclusion criteria, encompassing 2437 patients. The pooled prevalence of clinically significant anxiety was 31.7 % (95 % CI: 26.4-37.5 %), and depression was 23.9 % (95 % CI: 19.2-29.3 %). VADs were associated with moderate negative effects on body image (Hedges' g = -0.62, 95 % CI: -0.78 to -0.46) and small but significant reductions in overall quality of life (Hedges' g = -0.34, 95 % CI: -0.47 to -0.21). Subgroup analyses revealed that centrally inserted catheters had a greater psychological impact compared to peripherally inserted devices.

Conclusion: VADs for parenteral nutrition are associated with significant psychological burden in young patients. These findings highlight the need for routine psychological screening and targeted interventions to support this population.

Keywords: Adolescents; Meta-analysis; Parenteral nutrition; Pediatric patients; Psychological impact; Vascular access devices; Young adults.