Mackay Sarah, Rushton Alita, Bell Jack, Young Adrienne
Centre for Health Services Research, The University of Queensland, Queensland, Australia; Nutrition and Dietetics, The Prince Charles Hospital, Queensland, Australia.
Centre for Health Services Research, The University of Queensland, Queensland, Australia; School of Health Sciences and Social Work, Griffith University, Queensland, Australia.
J Acad Nutr Diet. 2025 Jul;125(7):984-1008.e8. doi: 10.1016/j.jand.2024.10.024. Epub 2024 Nov 7.
Malnutrition is prevalent across health care settings and has adverse outcomes for patients and the health system. However, some patients do not recall being informed about their malnutrition risk/diagnosis.
This meta-synthesis of qualitative studies aimed to identify and synthesize patient, carer, and health worker perceptions and understanding of the terminology used by health workers for malnutrition risk/malnutrition.
Four databases were searched (Medline, Cumulated Index in Nursing and Allied Health Literature, PsycINFO, and Embase) up until August 2023. Title, abstract, and full text screening were independently completed by 2 reviewers. The quality of the included studies was assessed using the Critical Appraisal Skills Programme Qualitative Studies Checklist. Data were analyzed by the review team using thematic synthesis. The resulting themes informed review findings. The confidence in each finding was assessed using GRADE-Confidence in the Evidence from Reviews of Qualitative Research.
Seventeen studies were included, contributing perspectives from patients (n = 7 studies), health workers (n = 5 studies), or both patients and health workers (n = 5 studies); no studies included carer perspectives. There were 5 themes: patients have differing understanding, interpretation of, and identification with, malnutrition risk and malnutrition terminology (very low confidence); health workers perceive that patients do not identify with or understand malnutrition risk and malnutrition terminology (low confidence); Patients do not routinely perceive their malnutrition risk or malnutrition diagnosis as problematic (low confidence); health workers use varied terminology for malnutrition risk and malnutrition (low confidence); and action is required to improve malnutrition diagnostic communication (low confidence).
Findings highlighted disparity in patients' perspectives regarding the terms used for malnutrition risk and malnutrition. Varied terms were used by health workers, and patients did not often associate these terms with a health condition that required treatment. Health workers and patients called for action to improve the communication of malnutrition. To do this, further research exploring malnutrition terminology and the broader concept of malnutrition communication is required with patients, carers and health workers.
营养不良在各类医疗环境中普遍存在,对患者及卫生系统都会产生不良后果。然而,一些患者并不记得曾被告知其营养不良风险/诊断情况。
这项定性研究的元综合分析旨在识别并综合患者、护理人员及卫生工作者对卫生工作者用于描述营养不良风险/营养不良的术语的看法和理解。
检索了四个数据库(Medline、护理及相关健康文献累积索引、PsycINFO和Embase),检索截至2023年8月。两名评审员独立完成标题、摘要及全文筛选。使用批判性评估技能计划定性研究清单评估纳入研究的质量。评审团队采用主题综合分析法对数据进行分析。得出的主题为评审结果提供依据。使用定性研究综述证据的GRADE信心评估法评估每项结果的可信度。
纳入了17项研究,提供了来自患者(7项研究)、卫生工作者(5项研究)或患者与卫生工作者双方(5项研究)的观点;没有研究纳入护理人员的观点。有5个主题:患者对营养不良风险和营养不良术语有不同的理解、解读及认同(可信度极低);卫生工作者认为患者不认同或不理解营养不良风险和营养不良术语(可信度低);患者通常不认为其营养不良风险或营养不良诊断存在问题(可信度低);卫生工作者对营养不良风险和营养不良使用多种不同术语(可信度低);需要采取行动改善营养不良诊断方面的沟通(可信度低)。
研究结果凸显了患者在营养不良风险和营养不良所用术语方面观点的差异。卫生工作者使用了多种不同术语,而患者通常不会将这些术语与需要治疗的健康状况联系起来。卫生工作者和患者呼吁采取行动改善营养不良方面的沟通。为此,需要与患者、护理人员和卫生工作者开展进一步研究,探索营养不良术语及更广泛的营养不良沟通概念。