老年患者及其家庭护理人员对医院与家庭护理过渡阶段中食物、膳食及营养护理的看法：一项定性研究。
Older patients' and their family caregivers' perceptions of food, meals and nutritional care in the transition between hospital and home care: a qualitative study.
作者信息
Hestevik Christine Hillestad, Molin Marianne, Debesay Jonas, Bergland Astrid, Bye Asta
机构信息
1Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.
2Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.
出版信息
BMC Nutr. 2020 Mar 18;6:11. doi: 10.1186/s40795-020-00335-w. eCollection 2020.
BACKGROUND
Older people have varying degrees of unmet nutritional needs following discharge from hospital. Inadequate involvement of the older person and his or her family caregivers in care and care planning, and inadequate support of self-management in the discharge process and follow-up care at home, negatively affects the quality of care. Research on older patients' and their family caregivers' experiences with nutritional care in hospital and home care and in the transition between these settings is limited. Thus, the aim of this study was to explore older patients' and their family caregivers' perceptions regarding the food, meals and nutritional care provided in the transition between hospital and home care services, focusing on the first 30 days at home. The overall aim of this study is to produce knowledge that can inform policy and clinical practice about how to optimise the care provided to older persons that are malnourished or at risk of malnutrition.
METHODS
Using a qualitative interpretive descriptive design, we carried out face-to-face semi-structured interviews with 15 older patients, with documented risk of malnutrition or malnourishment (Mini Nutritional Assessment [MNA]), two and five weeks after hospital discharge. In addition, we interviewed nine family caregivers once during this five week period. The questions focused on perceptions of food, meals and nutritional care in hospital and home care and in the transition between these settings. We analysed the data thematically.
RESULTS
Four overarching themes emerged from the material: 1) the need for a comprehensive approach to nutritional care, 2) non-individualised nutritional care at home, 3) lack of mutual comprehension and shared decision making and 4) the role of family caregivers.
CONCLUSION
The organisation of nutritional care and food provision to older people, depending on care, lack consideration for the individual's values, needs and preferences. Older patients' and their family caregivers' needs and preferences should guide how nutritional care is provided.
背景
老年人出院后存在不同程度未满足的营养需求。老年人及其家庭照顾者在护理及护理计划中参与不足，以及在出院过程和居家后续护理中自我管理支持不足，会对护理质量产生负面影响。关于老年患者及其家庭照顾者在医院护理、居家护理以及这两种护理环境转换过程中营养护理体验的研究有限。因此，本研究的目的是探讨老年患者及其家庭照顾者对医院护理与居家护理转换过程中提供的食物、膳食和营养护理的看法，重点关注居家的前30天。本研究的总体目标是生成知识，为如何优化对营养不良或有营养不良风险的老年人的护理的政策和临床实践提供参考。
方法
采用定性解释性描述设计，在15名有营养不良或营养不足记录风险（微型营养评定法[MNA]）的老年患者出院后两周和五周进行面对面半结构式访谈。此外，在这五周期间，我们对九名家庭照顾者进行了一次访谈。问题集中在对医院护理、居家护理以及这两种护理环境转换过程中的食物、膳食和营养护理的看法。我们对数据进行了主题分析。
结果
材料中出现了四个总体主题：1）营养护理需要综合方法；2）居家营养护理缺乏个性化；3）缺乏相互理解和共同决策；4）家庭照顾者的作用。
结论
为老年人提供营养护理和食物的组织方式，取决于护理情况，缺乏对个人价值观、需求和偏好的考虑。老年患者及其家庭照顾者的需求和偏好应指导营养护理的提供方式。
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