Department of Pediatrics, Section of Pediatric Hospital Medicine, Baylor College of Medicine, Texas Children's Hospital (AM Lee, MA Lopez, H Haq, and R Quiñonez), Houston, Tex.
Department of Pediatrics, Section of Pediatric Hospital Medicine, Baylor College of Medicine, Texas Children's Hospital (AM Lee, MA Lopez, H Haq, and R Quiñonez), Houston, Tex.
Acad Pediatr. 2021 Nov-Dec;21(8):1404-1413. doi: 10.1016/j.acap.2021.04.018. Epub 2021 Apr 24.
Among US households with children, 14% are food insecure. Household food insecurity (FI) is associated with poorer health outcomes and increased hospital admissions. There is less known about caregivers' ability to obtain adequate food during hospitalization (inpatient FI).
We conducted a mixed methods study of primary caregivers of hospitalized children 0 to 18 years. A modified US Household Food Security Survey was used to identify inpatient FI. Associated factors were identified using logistic regression adjusted for covariables. Caregiver semistructured interviews were conducted to elicit perceptions on food accessibility and effects of and solutions for inpatient FI.
The prevalence of inpatient FI was 43%. Household FI was present in 38% of families. Inpatient FI was associated with household FI (P < .01). In multivariable analysis, odds of inpatient FI were increased among caregivers with annual household income <$30,000 (adjusted odds ratio [aOR] 2.14), public transportation use (aOR 6.33), living >30 miles from the hospital (aOR 2.80), self-rated fair/poor health (aOR 3.31), maternity leave (aOR 4.75), and past/current Supplemental Nutrition Assistance Program benefit utilization (aOR 2.52). Qualitative analysis identified barriers to food access, such as lack of affordable options, and found that caregivers made sacrifices for their hospitalized child, including skipping meals. Caregivers viewed their presence at their child's bedside and personal nourishment as important factors affecting their child's care.
Inpatient FI may affect a significant proportion of hospitalized children's caregivers. Pediatric hospitals should ensure that caregivers have access to food in order to fully engage in their child's care.
在美国有孩子的家庭中，有 14%存在食物不安全问题。家庭食物不安全与较差的健康结果和增加的住院有关。对于照顾者在住院期间（住院食物不安全）获得足够食物的能力，了解较少。
我们对 0 至 18 岁住院儿童的主要照顾者进行了一项混合方法研究。使用经过修改的美国家庭食物安全调查来识别住院食物不安全。使用调整了协变量的逻辑回归来确定相关因素。进行了照顾者半结构化访谈，以了解对食物可及性的看法以及住院食物不安全的影响和解决方案。
住院食物不安全的患病率为 43%。有 38%的家庭存在家庭食物不安全。住院食物不安全与家庭食物不安全有关（P<.01）。在多变量分析中，年收入<$30000 的照顾者、使用公共交通工具、居住地距离医院>30 英里、自我评估健康状况为一般/较差、休陪产假、过去/现在享受补充营养援助计划福利的照顾者，其住院食物不安全的可能性增加（调整后的优势比分别为 2.14、6.33、2.80、3.31、4.75 和 2.52）。定性分析确定了获取食物的障碍，例如缺乏负担得起的选择，并发现照顾者为住院的孩子做出了牺牲，包括不吃饭。照顾者认为自己在孩子床边的存在和个人营养是影响他们孩子护理的重要因素。
住院食物不安全可能会影响很大比例的住院儿童照顾者。儿科医院应确保照顾者能够获得食物，以便他们能够充分参与其孩子的护理。
