Edwards Deborah, Carrier Judith, Hopkinson Jane
1The Wales Centre for Evidence-based Care, a Joanna Briggs Institute Centre of Excellence 2School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
JBI Database System Rev Implement Rep. 2016 Sep;14(9):261-357. doi: 10.11124/JBISRIR-2016-003100.
The prevalence of malnutrition for older adults (>65 years) in hospital and rehabilitation units has been reported as being as high as 60%; some older patients with good appetites do not receive sufficient nourishment because of inadequate feeding assistance. Mealtime assistance can therefore enhance nutritional intake, clinical outcomes and patient experience.
This mixed methods review sought to develop an aggregated synthesis of quantitative and qualitative data on assistance at mealtimes for older adults in hospital settings and rehabilitation units to determine current practices, what practices work, and the perceptions of patients, families, and healthcare professionals of mealtime assistance.
TYPES OF PARTICIPANTS: Participants included older adults (65 years and over) in hospital settings, including rehabilitation units.
TYPES OF INTERVENTION(S)/PHENOMENA OF INTEREST: The review focused on interventions for mealtime assistance, observed mealtime assistance, or discussed experiences of mealtime assistance with patients, families and healthcare professionals.
The review included qualitative, quantitative and mixed methods studies.
The outcomes of interest were the effectiveness of mealtime assistance initiatives and experiences of assistance at mealtimes.
The search strategy identified studies from seven databases published between 1998 and 2015.
Methodological quality of studies was independently assessed by two reviewers using standardized Joanna Briggs Institute critical appraisal instruments.
Standardized Joanna Briggs Institute data extraction tools were used.
Synthesis of the findings was reached through discussion. The results of quantitative studies could not be statistically pooled because of heterogeneity and are presented in narrative form. The results are presented as three aggregated mixed methods syntheses.
A total of 21 publications (19 studies) were included: 11 quantitative, five qualitative and three mixed method studies. Two studies were conducted in rehabilitation units, and 17 in hospital wards. Eight qualitative studies (nine papers) considered extrinsic and intrinsic factors that influence mealtime support. Evidence for the effectiveness of interventions was limited to eight studies (nine papers); the remaining quantitative studies included two cross-sectional studies, three descriptive evaluations (four papers) and one observational/case study. The following are the aggregated mixed methods syntheses: CONCLUSION: No firm conclusions can be drawn with respect to the most effective initiatives. Initiatives with merit include those that encourage social interaction, either through the use of a dining room, or employed staff or volunteers, relatives or visitors supporting the older patient during mealtimes. Volunteers value training and support and clarification of their roles and responsibilities.
据报道，医院和康复机构中65岁及以上老年人的营养不良患病率高达60%；一些食欲良好的老年患者由于喂养协助不足而未获得足够的营养。因此，进餐协助可以提高营养摄入量、改善临床结局并提升患者体验。
本混合方法综述旨在对医院环境和康复机构中老年人进餐协助的定量和定性数据进行综合分析，以确定当前的做法、有效的做法以及患者、家属和医护人员对进餐协助的看法。
参与者类型：参与者包括医院环境（包括康复机构）中的老年人（65岁及以上）。
干预类型/感兴趣的现象：综述重点关注进餐协助干预措施、观察到的进餐协助情况，或与患者、家属和医护人员讨论的进餐协助经历。
综述包括定性、定量和混合方法研究。
感兴趣的结局是进餐协助举措的有效性和进餐时的协助体验。
检索策略确定了1998年至2015年间发表的来自七个数据库的研究。
研究的方法学质量由两名评审员使用标准化的乔安娜·布里格斯研究所批判性评价工具独立评估。
使用标准化的乔安娜·布里格斯研究所数据提取工具。
通过讨论得出研究结果的综合结论。由于异质性，定量研究的结果无法进行统计合并，以叙述形式呈现。结果呈现为三个综合的混合方法综合结论。
共纳入21篇出版物（19项研究）：11项定量研究、5项定性研究和3项混合方法研究。2项研究在康复机构进行，17项在医院病房进行。8项定性研究（9篇论文）考虑了影响进餐支持的外在和内在因素。干预措施有效性的证据仅限于8项研究（9篇论文）；其余定量研究包括2项横断面研究、3项描述性评价（4篇论文）和1项观察性/案例研究。以下是综合的混合方法综合结论：结论：关于最有效的举措无法得出确凿结论。有价值的举措包括那些通过使用餐厅、雇佣员工或志愿者、亲属或访客在进餐时支持老年患者来鼓励社交互动的举措。志愿者重视培训、支持以及对其角色和职责的明确。
