Rodríguez-Sánchez Beatriz, Aranda-Reneo Isaac, Mora Toni
Department of Applied Economics, Public Economics and Political Economy, Faculty of Law, University Complutense of Madrid, Madrid, Spain.
CIBERFES, ISCIII, Spain.
PLoS One. 2024 Dec 16;19(12):e0310856. doi: 10.1371/journal.pone.0310856. eCollection 2024.
Existing research does not provide definitive conclusions on the most effective initiatives for preventing malnutrition among older adult residents in nursing homes.
We aimed to assess whether a nutrition education intervention provided to nursing home managers can improve dietary managerial decisions within nursing homes.
We performed a multicenter study, where each center was randomized to an intervention or a control group. To ensure homogeneous group representation, we stratified the sample based on the facility size and the availability of kitchen equipment. The baseline survey contained questions related to center characteristics, kitchen size and availability of cooking tools, availability of different daily menu options and the staff working in the kitchen. The follow-up survey included questions about the staff responsible for making nutritional decisions, the degree of food handling, the availability of texture-modification tools, and the residents' satisfaction. We use ordered probit regression models to estimate the effect of the educational intervention on decisions around food management.
From the 238 nursing homes that responded to the initial survey, 176 were followed-up; 56 were allocated to the intervention group and 120 to the control group. There were 53.32 residents per center among the treated group and 40.82 residents in the non-treated institutions. The intervention increased by 24% the nursing homes' probability of increasing their stock of texture-modification tools, which rose to 26% after controlling for the effect of receiving specific training on textures or presentation, compared to the control group.
The intervention improved managerial decisions in nursing homes concerning meal presentation through an increase in the number of cooking tools. Incorporating structured and comprehensive sessions to improve food texture and presentation could help fight the risk of residents' malnutrition.
现有研究并未就预防养老院老年居民营养不良的最有效举措给出明确结论。
我们旨在评估向养老院管理人员提供营养教育干预措施是否能改善养老院的饮食管理决策。
我们开展了一项多中心研究，每个中心被随机分配到干预组或对照组。为确保组内成员具有同质性，我们根据机构规模和厨房设备的可用性对样本进行了分层。基线调查包含与中心特征、厨房面积、烹饪工具的可用性、不同日常菜单选项的可用性以及厨房工作人员相关的问题。随访调查包括有关负责做出营养决策的人员、食物处理程度、质地改良工具的可用性以及居民满意度的问题。我们使用有序概率回归模型来估计教育干预对食品管理决策的影响。
在对初始调查做出回应的238家养老院中，176家接受了随访；56家被分配到干预组，120家被分配到对照组。治疗组每个中心有53.32名居民，未治疗机构中有40.82名居民。与对照组相比，干预使养老院增加质地改良工具储备的概率提高了24%，在控制了接受质地或呈现方式特定培训的影响后，这一概率升至26%。
该干预通过增加烹饪工具数量改善了养老院在餐食呈现方面的管理决策。纳入结构化和全面的课程以改善食物质地和呈现方式有助于对抗居民营养不良的风险。
