Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia.
Clin Nutr. 2013 Aug;32(4):543-9. doi: 10.1016/j.clnu.2012.11.009. Epub 2012 Nov 17.
BACKGROUND & AIMS: Inadequate feeding assistance and mealtime interruptions during hospitalisation may contribute to malnutrition and poor nutritional intake in older people. This study aimed to implement and compare three interventions designed to specifically address mealtime barriers and improve energy intakes of medical inpatients aged ≥ 65 years.
Pre-post study compared three mealtime assistance interventions: PM: Protected Mealtimes with multidisciplinary education; AIN: additional assistant-in-nursing (AIN) with dedicated meal role; PM + AIN: combined intervention. Dietary intake of 254 patients (pre: n = 115, post: n = 141; mean age 80 ± 8) was visually estimated on a single day in the first week of hospitalisation and compared with estimated energy requirements. Assistance activities were observed and recorded.
Mealtime assistance levels significantly increased in all interventions (p < 0.01). Post-intervention participants were more likely to achieve adequate energy intake (OR = 3.4, p = 0.01), with no difference noted between interventions (p = 0.29). Patients with cognitive impairment or feeding dependency appeared to gain substantial benefit from mealtime assistance interventions.
Protected Mealtimes and additional AIN assistance (implemented alone or in combination) may produce modest improvements in nutritional intake. Targeted feeding assistance for certain patient groups holds promise; however, alternative strategies are required to address the complex problem of malnutrition in this population. AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY NUMBER: ACTRN12609000525280.
住院期间喂养辅助不足和用餐中断可能导致老年人营养不良和营养摄入不良。本研究旨在实施并比较三种干预措施，以专门解决用餐障碍并提高≥65 岁住院患者的能量摄入。
前后研究比较了三种用餐辅助干预措施：PM：多学科教育的保护性用餐时间；AIN：助理护士（AIN）的额外辅助-护理（AIN）；PM + AIN：联合干预。对 254 名患者（入院前：n = 115，入院后：n = 141；平均年龄 80 ± 8）的饮食摄入情况进行了为期一周内的单一住院日视觉估计，并与估计的能量需求进行了比较。观察并记录了辅助活动。
所有干预措施的用餐辅助水平均显著增加（p < 0.01）。干预后参与者更有可能获得足够的能量摄入（OR = 3.4，p = 0.01），但干预之间无差异（p = 0.29）。认知障碍或进食依赖的患者似乎从用餐辅助干预中获得了实质性的益处。
保护性用餐时间和额外的 AIN 辅助（单独或联合实施）可能会适度改善营养摄入。针对某些患者群体的有针对性的喂养辅助措施有希望，但需要替代策略来解决该人群营养不良的复杂问题。澳大利亚新西兰临床试验注册编号：ACTRN12609000525280。
