Holst Mette, Beermann Tina, Mortensen Marie Nerup, Skadhauge Lotte Boa, Køhler Marianne, Lindorff-Larsen Karen, Rasmussen Henrik Højgaard
Centre for Nutrition and Bowel Disease, Aalborg University Hospital and Aalborg University, School of Medicine and Health, Aalborg, Denmark.
Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark.
Nutrition. 2017 Feb;34:14-20. doi: 10.1016/j.nut.2016.05.011. Epub 2016 Jun 8.
Optimizing protein and energy intake by food in nutritional risk patients is difficult. The aim of this study was to improve the ≥75% of energy and protein requirements. We would like to see nurses take on the role of hosting the nutritional-risk patients, including focusing on bringing nutrition to the forefront in the collaboration between nurses and patients.
This was an interventional study that included patients admitted to the Departments of Infectious Diseases, Hematology, and Heart-Lung Surgery in a baseline and follow-up investigation. It included 24-h food intake registrations (FRs) for 3 d consecutively, a questionnaire, and a semistructured patient interview. The interventions included in this study helped to improve the eating environment and serving, integrated nutrition into the nurse-patient welcome interview, and targeted individual preferences and challenges for eating.
The study comprised 76 24-h FRs at baseline and 108 FRs at follow-up. The total group had improved food intake; 75% of individual energy requirements were met by (67.6% vs. 40%; P = 0.036) and the Heart-Lung Surgery group (85.7 vs. 38.5; P = 0.036). This was not reflected for protein (NS). Energy intake improved for the entire group, albeit not significantly (P = 0.862). Patients reported being happy with the interventions regarding individualized food serving, nurse communication, and improved meal environments.
Only insignificant improvements to overall energy intake were seen in two of the three departments and in the overall group, and no statistical or clinically significant improvements to protein intake were observed. The relative risk of meeting 75% of energy requirements was improved in the overall group and in patients in the Department of Heart-Lung Surgery. This did not include the meeting of protein requirements. Improvements were welcomed by patients and staff. Focus on individualized nutrition from the nursing staff also improved.
通过食物优化营养风险患者的蛋白质和能量摄入具有挑战性。本研究的目的是满足≥75%的能量和蛋白质需求。我们希望看到护士承担起照顾营养风险患者的角色，包括在护士与患者的合作中把营养放在首位。
这是一项干预性研究，在基线和随访调查中纳入了感染科、血液科和心肺外科收治的患者。研究包括连续3天的24小时食物摄入量记录（FRs）、一份问卷以及一次半结构化的患者访谈。本研究中的干预措施有助于改善饮食环境和服务，将营养融入医患初次见面的访谈中，并针对个体饮食偏好和挑战提供个性化服务。
研究在基线时收集了76份24小时食物摄入量记录，随访时收集了108份。总体而言，患者的食物摄入量有所改善；整个组中75%的个体能量需求得到满足（67.6%对40%；P = 0.036），心肺外科组（85.7对38.5；P = 0.036）。蛋白质方面未体现出这种改善（无统计学差异）。整个组的能量摄入量有所提高，尽管不显著（P = 0.862）。患者报告对个性化食物供应、护士沟通以及改善后的用餐环境方面的干预措施感到满意。
三个科室中的两个科室以及总体组在总体能量摄入方面仅有不显著的改善，蛋白质摄入量未观察到统计学或临床显著改善。总体组和心肺外科患者满足75%能量需求的相对风险有所提高。这并不包括蛋白质需求的满足情况。患者和工作人员对这些改善表示欢迎。护理人员对个性化营养的关注也有所提高。
