School of Nursing & Midwifery, Queensland University of Technology, Brisbane, Australia.
J Nutr Health Aging. 2009 Dec;13(10):913-7. doi: 10.1007/s12603-009-0251-2.
To investigate the impact of a train-the-trainer program on the nutritional status of older people in residential care.
Prospective, randomized controlled study.
Eight nursing homes in Southeast Queensland, Australia.
A total of 352 residents participated - 245 were female (69.6%). The mean age was 84.2 years and the majority (79.4%) were classified as high dependency.
Residents from four nursing homes were randomly selected for a nutrition education program coordinated by Nutrition Coordinators. Residents from the other four nursing homes (control) received usual care.
The Subjective Global Assessment was used to determine prevalence of malnutrition at baseline and six months post intervention. The Resident Classification Scale measured functional dependency. Prescribed diet, fluids, oral hygiene status and allied health referrals were obtained by chart audit.
Approximately half the residents were well nourished with 49.4% moderately or severely malnourished. Residents in the intervention group were more likely to maintain or improve their nutritional status compared with the control group who were more likely to experience a deterioration (P=0.027). The odds of the control group being malnourished post test was 1.6 times more likely compared with the intervention group but this did not reach statistical significance (P=0.1).
The results of the study encourage the implementation of a Nutrition Coordinator program to maintain nutritional status of aged care residents. Nevertheless, malnutrition rates continue to be unacceptably high. In a rapidly aging society, the aged care sector needs to confront malnutrition and provide better resources for staff to take measures against this problem.
调查培训师培训计划对养老院老年人营养状况的影响。
前瞻性、随机对照研究。
澳大利亚昆士兰州东南部的 8 家养老院。
共有 352 名居民参与，其中 245 名女性（69.6%）。平均年龄为 84.2 岁，大多数（79.4%）为高依赖性。
随机选择四家养老院的居民接受营养协调员协调的营养教育计划。其他四家养老院（对照组）的居民接受常规护理。
采用主观全面评估法在基线和干预后 6 个月时确定营养不良的患病率。居民分类量表衡量功能依赖性。通过图表审查获取规定的饮食、液体、口腔卫生状况和相关健康转介。
大约一半的居民营养状况良好，49.4%的居民中度或重度营养不良。与对照组相比，干预组的居民更有可能保持或改善营养状况，而对照组更有可能出现恶化（P=0.027）。与干预组相比，对照组在测试后营养不良的可能性增加了 1.6 倍，但这并未达到统计学意义（P=0.1）。
该研究的结果鼓励实施营养协调员计划，以维持老年护理居民的营养状况。然而，营养不良率仍然高得令人无法接受。在快速老龄化的社会中，老年护理部门需要正视营养不良问题，并为员工提供更好的资源来采取措施解决这一问题。
