Skye Marshall, School of Human Movement Studies, Room 407B, Building 26, the University of Queensland, Brisbane, Queensland, 4072, Australia. Phone: 61+ 07336 56982, Fax: 61+ 07 3365 6877,
J Nutr Health Aging. 2013;17(8):645-51. doi: 10.1007/s12603-013-0341-z.
Enhancing the effectiveness of the community and aged care workforce to prevent malnutrition and functional decline is important in reducing hospital and aged care facility demand.
To investigate the impact of nutrition-related interventions delivered to or by informal carers and non-clinical community care workers on malnutrition-related health outcomes of community-dwelling older adults (≥65 years).
Intervention studies were searched for using six electronic databases for English-language publications from January 1980 to 30 May 2012.
Nine studies were eligible for inclusion. The strength and quality of the evidence was moderate (six studies with level II intervention evidence, five with positive quality). Types of interventions used were highly varied. The majority of interventions were delivered to informal carers (6 studies), with three of these studies also involving older adult care recipients. Five interventions were targeted at identifying, preventing and/or treating malnutrition specifically (two positive quality, three neutral quality, n=2368). As a result of these interventions, nutritional status improved or stabilized (two positive quality, two neutral quality, n=2333). No study reported an improvement in functional status but two successfully prevented further decline in their participants (two neutral quality, n=1097).
Interventions targeted at identifying, preventing and/or treating malnutrition were able to improve or prevent decline in nutritional and functional status, without increasing informal carer burden. The findings of this review support the involvement of non-clinical community care workers and informal carers as part of the nutritional care team for community-dwelling older adults.
提高社区和老年护理人员的工作效率，以预防营养不良和功能下降，对于减少医院和老年护理机构的需求非常重要。
调查针对非专业照护者和非临床社区护理人员开展的营养相关干预措施对社区居住的老年人（≥65 岁）营养不良相关健康结局的影响。
使用六个电子数据库，对 1980 年 1 月至 2012 年 5 月 30 日期间发表的英文文献进行了营养相关干预措施的研究检索。
有 9 项研究符合纳入标准。证据的强度和质量为中等（6 项具有 II 级干预证据的研究，5 项具有阳性质量的研究）。所使用的干预措施类型多种多样。大多数干预措施是针对非专业照护者（6 项研究），其中 3 项研究还涉及老年护理接受者。有 5 项干预措施旨在专门识别、预防和/或治疗营养不良（2 项具有阳性质量，3 项具有中性质量，n=2368）。这些干预措施使营养状况得到改善或稳定（2 项具有阳性质量，2 项具有中性质量，n=2333）。没有研究报告功能状态得到改善，但有 2 项研究成功地阻止了参与者的功能进一步下降（2 项具有中性质量，n=1097）。
针对识别、预防和/或治疗营养不良的干预措施能够改善或预防营养和功能状态的下降，同时不会增加非专业照护者的负担。本综述的研究结果支持将非临床社区护理人员和非专业照护者纳入社区居住的老年人的营养护理团队。
