Hope Kelti, Ferguson Maree, Reidlinger Dianne P, Agarwal Ekta
School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia.
Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia; School of Human Movement Studies, The University of Queensland, Brisbane, Australia.
Maturitas. 2017 Mar;97:6-13. doi: 10.1016/j.maturitas.2016.12.001. Epub 2016 Dec 12.
Inadequate dietary intake is a common problem amongst older acute-care patients and has been identified as an independent risk factor for in-hospital mortality. This study aimed to explore whether food and mealtime experiences contribute to inadequate dietary intake in older people during hospitalisation.
This was a qualitative phenomenological study, data for which were collected using semi-structured interviews over a three-week period. During this time, 26 patients aged 65 years or more, admitted to medical and surgical wards in a tertiary acute-care hospital, were asked to participate if they were observed to eat less than half of the meal offered at lunch. Participants provided their perspectives on food and mealtimes in hospital. Responses were recorded as hand-written notes, which were agreed with the interviewee, and analysed thematically using the framework method.
Twenty-five older people were interviewed across six wards. Two main themes, 'validating circumstances' and 'hospital systems', were identified. Each theme had several sub-themes. The sub-themes within validating circumstances included 'expectations in hospital', 'prioritising medical treatment', 'being inactive', and 'feeling down'. Those within 'hospital systems' were 'accommodating inconvenience', 'inflexible systems', and 'motivating encouragement'.
Inadequate dietary intake by older hospital patients is complex and influenced by a range of barriers. Multilevel and multidisciplinary interventions based on a shared understanding of food and nutrition as an important component of hospital care are essential to improve dietary intake and reduce the risk of adverse clinical outcomes. Improving awareness of the importance of food for recovery amongst hospitalised older people and healthcare staff is a priority.
饮食摄入不足是老年急性护理患者中常见的问题，并且已被确定为院内死亡的独立危险因素。本研究旨在探讨食物和用餐体验是否会导致老年人住院期间饮食摄入不足。
这是一项质性现象学研究，数据通过为期三周的半结构式访谈收集。在此期间，一家三级急性护理医院内科和外科病房收治的26名65岁及以上患者，若观察到他们午餐摄入量不足所提供食物的一半，则被邀请参与研究。参与者分享了他们对医院食物和用餐时间的看法。回答以手写笔记形式记录，并与受访者核对，然后使用框架法进行主题分析。
在六个病房对25名老年人进行了访谈。确定了两个主要主题，即“验证情况”和“医院系统”。每个主题都有几个子主题。“验证情况”中的子主题包括“住院期望”“优先进行医疗治疗”“不活动”和“情绪低落”。“医院系统”中的子主题是“适应不便”“系统缺乏灵活性”和“激励鼓励”。
老年住院患者饮食摄入不足情况复杂，受到一系列障碍的影响。基于将食物和营养作为医院护理重要组成部分的共同理解而开展的多层次、多学科干预对于改善饮食摄入和降低不良临床结局风险至关重要。提高住院老年人和医护人员对食物对康复重要性的认识是当务之急。
