Fernández-Barrés Sílvia, García-Barco Montse, Basora Josep, Martínez Teresa, Pedret Roser, Arija Victoria
Departament de Ciències Mèdiques Bàsiques, Nutrition and Mental Health Research Group (NUTRISAM), Facultat de Medicina i Ciències de la Salut (FMCS), Universitat Rovira i Virgili (URV), c/Sant Llorenç, 21, 43201 Reus, Tarragona, Spain.
Primary Care Department, Camp de Tarragona, Catalan Health Institute, Recinte Joan XXIII, 43001 Tarragona, Spain.
Int J Nurs Stud. 2017 May;70:131-141. doi: 10.1016/j.ijnurstu.2017.02.020. Epub 2017 Feb 23.
To assess the effect of a nutrition education intervention included in the Home Care Program for caregivers to prevent the increasing risk of malnutrition of dependent patients at risk of malnutrition.
Randomized controlled multicenter trial of 6 months of duration and 12 months follow-up.
10 Primary Care Centers, Spain.
Patients enrolled in the Home Care Program between January 2010 and March 2012, who were dependent and at risk of malnutrition, older than 65, and had caregivers (n=190).
The nurses conducted initial educational intervention sessions for caregivers and then monitored at home every month for 6 months.
The nutritional status was assessed using the Mini Nutritional Assessment test (primary outcome), diet, anthropometry, and biochemical parameters (albumin, prealbumin, hemoglobin and cholesterol). Other descriptive and outcome measures were recorded: current medical history, Activities of daily living (Barthel test), cognitive state (Pfeiffer test), and mood status (Yesavage test). All the measures were recorded in a schedule of 0-6-12 months.
173 individuals participated after exclusions (intervention n=101; control n=72). Mean age was 87.8±8.9years, 68.2% were women. Difference were found between the groups for Mini Nutritional Assessment test score change (repeated measures ANOVA, F=10.1; P<0.001), the intervention improved the Mini Nutritional Assessment test score of the participants in the intervention group. The egg consumption (F=4.1; P=0.018), protein intake (F=3.0; P=0.050), polyunsaturated fatty acid intake (F=5.3; P=0.006), folate (F=3.3; P=0.041) and vitamin E (F=6.4; P=0.002) showed significant group×time interactions.
A nutrition education intervention for caregivers halted the tendency of nutritional decline, and reduced the risk of malnutrition of older dependent patients.
Clinical Trial Registration-URL: www.clinicaltrials.gov. Identifier: NCT01360775.
评估家庭护理计划中包含的营养教育干预措施对照顾者的效果，以预防存在营养不良风险的依赖型患者营养不良风险的增加。
为期6个月、随访12个月的随机对照多中心试验。
西班牙10个初级保健中心。
2010年1月至2012年3月期间参加家庭护理计划的患者，这些患者为依赖型且有营养不良风险，年龄超过65岁，并有照顾者（n = 190）。
护士为照顾者开展初始教育干预课程，然后每月进行6个月的家庭监测。
使用小型营养评估测试评估营养状况（主要结局）、饮食、人体测量学和生化参数（白蛋白、前白蛋白、血红蛋白和胆固醇）。记录其他描述性和结局指标：当前病史、日常生活活动能力（巴氏试验）、认知状态（ Pfeiffer试验）和情绪状态（Yesavage试验）。所有指标均在0 - 6 - 12个月的时间表中记录。
排除后173人参与（干预组n = 101；对照组n = 72）。平均年龄为87.8±8.9岁，68.2%为女性。在小型营养评估测试得分变化方面发现组间差异（重复测量方差分析，F = 10.1；P < 0.001），干预改善了干预组参与者的小型营养评估测试得分。鸡蛋摄入量（F = 4.1；P = 0.018）、蛋白质摄入量（F = 3.0；P = 0.050）、多不饱和脂肪酸摄入量（F = 5.3；P = 0.006）、叶酸（F = 3.3；P = 0.041）和维生素E（F = 6.4；P = 0.002）显示出显著的组×时间交互作用。
对照顾者的营养教育干预措施遏制了营养下降趋势，并降低了老年依赖型患者营养不良的风险。
临床试验注册 - URL：www.clinicaltrials.gov。标识符：NCT01360775。
