Marshall S, Reidlinger D P, Young A, Isenring E
Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Robina, Qld, Australia.
Royal Brisbane and Women's Hospital, Herston, Qld, Australia.
J Hum Nutr Diet. 2017 Feb;30(1):16-26. doi: 10.1111/jhn.12397. Epub 2016 Jul 14.
To improve perceived value of nutrition support and patient outcomes, the present study aimed to determine the nutrition and food-related roles, experiences and support needs of female family carers of community-dwelling malnourished older adults admitted to rehabilitation units in rural New South Wales, Australia, both during admission and following discharge.
Four female family carers of malnourished rehabilitation patients aged ≥65 years were interviewed during their care-recipients' rehabilitation admission and again at 2 weeks post-discharge. The semi-structured interviews were audiotaped, transcribed and analysed reflecting an interpretative phenomenological approach by three researchers. A series of 'drivers' relevant to the research question were agreed upon and discussed.
Three drivers were identified. 'Responsibility' was related to the agency who assumed responsibility for providing nutrition support and understanding family carer obligation to provide nutrition support. 'Family carer nutrition ethos' was related to how carer nutrition beliefs, knowledge and values impacted the nutrition support they provided, the high self-efficacy of family carers and an incongruence with an evidence-based approach for treating malnutrition. 'Quality of life' was related to the carers' focus upon quality of life as a nutrition strategy and outcome for their care-recipients, as well as how nutrition support impacted upon carer burden.
Rehabilitation units and rehabilitation dietitians should recognise and support family carers of malnourished patients, which may ultimately lead to an improved perceived benefit of care and patient outcomes. Intervention research is required to make strong recommendations for practice.
为提高营养支持的感知价值及患者治疗效果,本研究旨在确定澳大利亚新南威尔士州农村地区康复机构收治的社区营养不良老年人的女性家庭照顾者在入院期间及出院后与营养和食物相关的角色、经历及支持需求。
对4名年龄≥65岁的营养不良康复患者的女性家庭照顾者在其照顾对象康复入院期间及出院后2周进行了访谈。半结构化访谈进行了录音、转录,并由3名研究人员采用解释现象学方法进行分析。商定并讨论了一系列与研究问题相关的“驱动因素”。
确定了三个驱动因素。“责任”与承担提供营养支持责任的机构以及理解家庭照顾者提供营养支持的义务有关。“家庭照顾者营养理念”与照顾者的营养信念、知识和价值观如何影响他们提供的营养支持、家庭照顾者的高自我效能感以及与治疗营养不良的循证方法不一致有关。“生活质量”与照顾者将生活质量作为其照顾对象的营养策略和结果的关注点,以及营养支持如何影响照顾者负担有关。
康复机构和康复营养师应认识并支持营养不良患者的家庭照顾者,这可能最终提高护理的感知效益和患者治疗效果。需要进行干预研究以提出有力的实践建议。