Merriweather J L, Salisbury L G, Walsh T S, Smith P
Royal Infirmary of Edinburgh, Edinburgh, UK.
The University of Edinburgh, Edinburgh, UK.
J Hum Nutr Diet. 2016 Apr;29(2):127-36. doi: 10.1111/jhn.12287. Epub 2014 Dec 18.
The present qualitative study aimed to explore the factors influencing nutritional recovery in patients after critical illness and to develop a model of care to improve current management of nutrition for this patient group.
Patients were recruited into the study on discharge from a general intensive care unit (ICU) of a large teaching hospital in central Scotland. Semi-structured interviews were carried out after discharge from the ICU, weekly for the duration of their ward stay, and at 3 months post ICU discharge. Observations of ward practice were undertaken thrice weekly for the duration of the ward stay.
Seventeen patients were recruited into the study and, using a grounded theory approach, 'inter-related system breakdowns during the nutritional recovery process' emerged as the overarching core category that influenced patients' experiences of eating after critical illness. This encompassed the categories, 'experiencing a dysfunctional body', 'experiencing socio-cultural changes in relation to eating' and 'encountering nutritional care delivery failures'.
The findings from the present study provide a unique contribution to knowledge by offering important insights into patients' experiences of eating after critical illness. The study has identified numerous nutritional problems and raises questions about the efficacy of current nutritional management in this patient group. Adopting a more individualised approach to nutritional care could ameliorate the nutritional issues experienced by post ICU patients. This will be evaluated in future work.
本定性研究旨在探讨影响危重症患者营养恢复的因素，并建立一种护理模式，以改善该患者群体目前的营养管理。
从苏格兰中部一家大型教学医院的综合重症监护病房（ICU）出院的患者被纳入本研究。在患者从ICU出院后、住院期间每周、ICU出院后3个月进行半结构化访谈。在患者住院期间，每周三次对病房实践进行观察。
17名患者被纳入本研究，采用扎根理论方法，“营养恢复过程中的相互关联系统故障”成为影响危重症患者进食体验的总体核心类别。这包括“身体功能失调”、“饮食方面经历社会文化变化”和“营养护理提供失败”等类别。
本研究结果通过对危重症患者进食体验提供重要见解，为知识做出了独特贡献。该研究发现了许多营养问题，并对该患者群体目前营养管理的有效性提出了疑问。采用更个性化的营养护理方法可能会改善ICU后患者经历的营养问题。这将在未来的工作中进行评估。
