Department of Public Health Sciences, King's College London, London, UK.
J Hum Nutr Diet. 2010 Dec;23(6):575-82. doi: 10.1111/j.1365-277X.2010.01119.x. Epub 2010 Aug 27.
Problems of undernutrition are common in hospital in-patients. Multiple morbidity increases with age and may contribute to nutritional risks. This research aimed to determine whether increased burden of long-term conditions is associated with patients' difficulties gaining access to food in hospital.
A survey was implemented in 29 wards at four hospitals using a questionnaire measure of patients' experiences of food access and the Cumulative Illness Rating Scale (CIRS) to evaluate the burden of long-term illness in each patient. Experiences of food access were evaluated in relation to CIRS score category using random effects logistic regression to adjust for age group, sex and clustering by ward.
Data were analysed for 764/1154 (66%) eligible participants, including 384 women. The median age was 60 years (range 18-96 years). CIRS scores were analysed using the categories 0 (104 patients), 1-3 (197), 4-6 (285), 7-9 (144) and ≥10 (34). When the CIRS was zero, 10% of patients experienced physical problems with food access, whereas, when the CIRS was ≥10, 41% experienced physical barriers to food access, adjusted odds ratio 3.65 (1.14-11.7, P = 0.029). Problems with food quality were experienced by 13% with CIRS = 0 and 32% with CIRS ≥ 10 (adjusted odds ratio 3.97, 1.35-11.6, P = 0.012). Participants with greater morbidity were more likely to report that depression, breathing difficulties or chewing and swallowing difficulties affected the amount of food that they ate at mealtimes.
Patients with multiple morbidities are more vulnerable to experiencing physical barriers to accessing food and increased concerns with food quality. Assessing barriers to food access is particularly important in multiple morbidity.
营养不良问题在住院患者中很常见。多种疾病随着年龄的增长而增加，并且可能导致营养风险。本研究旨在确定长期疾病负担的增加是否与患者在医院获得食物的困难有关。
在四家医院的 29 个病房中使用问卷调查了患者获得食物的经验和累积疾病评分量表（CIRS），以评估每个患者的长期疾病负担。使用随机效应逻辑回归，根据 CIRS 评分类别评估获得食物的经验，以调整年龄组、性别和病房聚类。
对 764/1154 名（66%）符合条件的参与者的数据进行了分析，包括 384 名女性。中位年龄为 60 岁（范围 18-96 岁）。CIRS 评分分析使用以下类别：0（104 名患者）、1-3（197 名）、4-6（285 名）、7-9（144 名）和≥10（34 名）。当 CIRS 为零时，10%的患者在获得食物方面存在身体问题，而当 CIRS 为≥10 时，41%的患者在获得食物方面存在身体障碍，调整后的优势比为 3.65（1.14-11.7，P=0.029）。CIRS=0 时有 13%的患者经历食物质量问题，而 CIRS≥10 时有 32%的患者经历食物质量问题（调整后的优势比为 3.97，1.35-11.6，P=0.012）。患有更多疾病的患者更有可能报告抑郁、呼吸困难或咀嚼和吞咽困难会影响他们在进餐时吃的食物量。
患有多种疾病的患者更容易出现获取食物的身体障碍和对食物质量的更多担忧。评估获取食物的障碍在多种疾病中尤为重要。
