Pedersen Preben U, Tewes Marianne, Bjerrum Merete
Department of Nursing Science, School of Public Health, Aarhus University, Aarhus, Denmark.
Scand J Caring Sci. 2012 Mar;26(1):178-85. doi: 10.1111/j.1471-6712.2011.00912.x. Epub 2011 Sep 2.
Approximately 40% of patients admitted to hospitals are undernourished. Implementing nutritional guidelines might reduce the incidence of malnutrition, and it requires education and training for the hospital staff.
It was hypothesised that a training programme focusing on the staff behaviour would increase the identification of eating difficulties, improve patients' knowledge about appropriate food choices and increase the number of snacks eaten between meals and thereby to reduce the risk of undernutrition.
A pre- and post-test design was used to evaluate the effect of the training programme for nurses. The training was conducted in five modules over 1 year and combined nutritional issues with issues on implementation and theories of planned change. The programme was based on experimental learning theories and the steps of look, think and act. The effect on the patients was measured by a patient questionnaire.
After implementing the guidelines, more patients discussed their eating difficulties with the staff, received relevant assistance during the meal and were served the type of food they had ordered and could chew. The patients' knowledge of appropriate food choices from the menu increased, suggesting that the nutritional intake of the patients had improved.
Our findings suggest that a strategy based on the principles of experimental learning theory and the phases in the look, think and act model facilitated the implementation of nutritional guidelines in a hospital setting.
入院患者中约40%存在营养不良问题。实施营养指南可能会降低营养不良的发生率,而这需要对医院工作人员进行教育和培训。
据推测,一个侧重于工作人员行为的培训项目将提高对饮食困难的识别能力,增进患者对合理食物选择的了解,增加餐间零食的摄入量,从而降低营养不良的风险。
采用前后测试设计来评估针对护士的培训项目的效果。培训在1年内分五个模块进行,将营养问题与实施问题以及计划变革理论相结合。该项目基于体验式学习理论以及观察、思考和行动的步骤。通过患者问卷来衡量对患者的影响。
实施指南后,更多患者与工作人员讨论了他们的饮食困难,在用餐期间得到了相关帮助,并得到了他们所点且能咀嚼的食物。患者从菜单中选择合适食物的知识有所增加,这表明患者的营养摄入有所改善。
我们的研究结果表明,基于体验式学习理论原则以及观察、思考和行动模型各阶段的策略有助于在医院环境中实施营养指南。