School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland.
UCD Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland.
Eur J Public Health. 2021 Dec 1;31(6):1284-1290. doi: 10.1093/eurpub/ckab099.
Malnutrition affects approximately 20% of older adult populations in Europe, yet their views on the condition are rarely explored. This qualitative study aimed to explore the experiences of older adults living with malnutrition and prescribed oral nutritional supplements in the community setting.
Semi-structured individual interviews were used to collect data from 13 community-dwelling individuals aged ≥60 years with a current or previous prescription for oral nutritional supplements. Self-perceived health status was measured using the EuroQol EQ-5D-5L, a short questionnaire and visual analogue scale. Interviews were audio-recorded and transcribed verbatim. Interview data were organized using NVivo 12 and analyzed using inductive thematic analysis.
Median age was 80.0 (interquartile range 19.5) years, seven were male and six were female. Median health score was 60.0 (interquartile range 35.0) out of 100. Almost one-third reported severe or extreme problems with usual activities, and pain or discomfort. One main theme was identified from the interviews: 'It takes a village', with four subthemes (i) 'I get by with a little help from my friends', (ii) 'The obvious diagnosis', (iii) 'The missing T in MDT' and (iv) 'Confusion'. Participants with malnutrition reported relying on friends, family and carers with poor multidisciplinary team communication and lack of dietetic support.
Participants in this study experienced poor management of malnutrition with missing links between the hospital and community healthcare settings, and lack of dietetic services. Patient views should be used to inform public health guidelines and guide future interventions in the community to improve the health status of older adults with malnutrition.
在欧洲，大约有 20%的老年人群体存在营养不良的问题，但他们对这种情况的看法很少被探讨。本定性研究旨在探讨在社区环境中患有营养不良和开具口服营养补充剂的老年患者的经历。
采用半结构化个体访谈的方法，从 13 名年龄≥60 岁且目前或之前开具过口服营养补充剂处方的社区居住者中收集数据。使用欧洲五维健康量表（EQ-5D-5L）来衡量自我感知的健康状况，该量表是一个简短的问卷和视觉模拟量表。对访谈进行录音并逐字转录。使用 NVivo 12 对访谈数据进行组织，并采用归纳主题分析方法进行分析。
中位年龄为 80.0（四分位距 19.5）岁，7 名男性，6 名女性。健康评分的中位数为 100 分中的 60.0（四分位距 35.0）。近三分之一的人报告在日常活动方面存在严重或极度问题，以及疼痛或不适。从访谈中确定了一个主要主题：“它需要一个村庄”，包括四个子主题：（i）“我在朋友的一点帮助下度过难关”，（ii）“明显的诊断”，（iii）“MDT 中缺失的 T”和（iv）“困惑”。患有营养不良的参与者报告依赖朋友、家人和照顾者，多学科团队沟通不畅，缺乏饮食支持。
本研究中的参与者经历了营养不良管理不善的情况，医院和社区医疗保健环境之间存在缺失环节，缺乏饮食服务。应该利用患者的意见来为公共卫生指南提供信息，并指导未来在社区中进行干预，以改善患有营养不良的老年患者的健康状况。
