Burger C, Kiesswetter E, Gietl A, Pfannes U, Arens-Azevedo U, Sieber C C, Volkert D
D. Volkert, Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany,
J Nutr Health Aging. 2017;21(4):464-472. doi: 10.1007/s12603-016-0767-1.
The aim of this study is to comprehensively describe nutritional care in German nursing homes (NHs) and to examine if nutritional care differs between small, medium and large NHs.
Nationwide cross-sectional postal survey.
Nursing homes.
541 NHs across Germany.
Information on structural NH characteristics and nutritional care (food provision and menu planning, nursing care, and management and quality assurance) was collected by means of a questionnaire addressed to the management of a random sample of German NHs. NHs were grouped by size as small (≤ 50 beds), medium (50 - 100 beds) or large (> 100 beds) institutions. Frequencies were used to describe nutritional care, and Chi2-test to identify differences in nutritional care by NH size.
Aspects in the domain of food provision and menu planning regarding food variety and choice were widely implemented in German NHs (77 - 100 %). Best results were achieved in the domain of nursing care, where all aspects were implemented in at least 68 % of the NHs. Aspects regarding management and quality assurance, especially those concerning staffing, i.e. the availability of an interface manager (14 %), an interdisciplinary nutrition team (12 %) and a dietician (42 %), were only rarely implemented. Differences by NH size were found between small and medium or large NHs. On the one hand, small NHs stated more often to consider individual capabilities of the residents with texture-modified food (81 % vs. 60 %, p<0.05) and produce more often hot meals at ward level on a regular base (46 % vs. 32 %, p<0.05) than large NHs. On the other hand, several aspects regarding food provision and menu planning, and management and quality assurance were significantly more often implemented in larger than smaller NHs.
Whereas kitchen and nursing-related aspects of nutritional care seem to be widely implemented in German NHs, management and quality assurance demands are often not met. The differences found by NH size support the hypothesis that the number of residents living in a NH has an impact on how nutritional care is performed.
本研究旨在全面描述德国养老院的营养护理情况，并探讨小型、中型和大型养老院的营养护理是否存在差异。
全国性横断面邮政调查。
养老院。
德国各地的541家养老院。
通过向德国随机抽取的养老院管理人员发放问卷，收集有关养老院结构特征和营养护理（食物供应和菜单规划、护理、管理和质量保证）的信息。养老院按规模分为小型（≤50张床位）、中型（50 - 100张床位）或大型（>100张床位）机构。采用频率描述营养护理情况，并使用卡方检验确定不同规模养老院营养护理的差异。
在德国养老院中，食物供应和菜单规划领域中关于食物种类和选择的方面得到了广泛实施（77 - 100%）。护理领域取得了最佳效果，所有方面在至少68%的养老院中得到了实施。管理和质量保证方面，特别是与人员配备有关的方面，即接口管理人员的可用性（14%）、跨学科营养团队（12%）和营养师（42%），实施情况很少。小型养老院与中型或大型养老院之间存在规模差异。一方面，小型养老院比大型养老院更常表示会考虑为食用质地改良食物的居民提供个性化服务（81%对60%，p<0.05），并且更常在病房层面定期提供热餐（46%对32%，p<0.05）。另一方面，在食物供应和菜单规划以及管理和质量保证方面，大型养老院比小型养老院更常实施几个方面。
尽管营养护理中与厨房和护理相关的方面似乎在德国养老院中得到了广泛实施，但管理和质量保证方面的要求往往无法满足。按养老院规模发现的差异支持了这样一种假设，即居住在养老院中的居民数量会对营养护理的实施方式产生影响。
