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评估一项关于营养护理的更新教育干预措施,以预防初级卫生保健中老年人的营养不良。

Evaluation of an updated educational intervention on nutritional care to prevent undernutrition among older adults in primary health care.

作者信息

Berggren Erika, Sandlund Christina, Samuelsson Liisa, Lundh Lena

机构信息

Academic Primary Health Care Centre, Stockholm County Council, Sweden.

Department of Neurobiology, Care Sciences and Society; Karolinska Institutet, Huddinge, Sweden.

出版信息

Prim Health Care Res Dev. 2025 Jan 24;26:e6. doi: 10.1017/S1463423624000690.

Abstract

AIM

The aim of this study was to evaluate district nurses' perceived and factual knowledge about nutritional care after an updated and expanded educational intervention. Furthermore, we aimed to compare the outcomes of the revised and the original educational intervention.

BACKGROUND

In-depth knowledge of nutritional care is a prerequisite to supporting older adults' well-being and health. District nurses' actual knowledge of the nutrition care process, older adults' need for food, and palliative care in diverse phases of disease is therefore of utmost importance. An updated and expanded educational intervention meeting these needs was evaluated.

METHODS

A study-specific questionnaire about nutritional care was used before and after the educational intervention. Participants ( = 118) were district nurses working in primary health care in Region Stockholm. Additionally, a pre- and post-test quasi-experimental design was used to assess differences in learning outcomes of the revised intervention compared with the original intervention.

FINDINGS

District nurses who completed the questionnaire had worked in health care for about 18 years and as district nurses for 5 years after their specialist examination. After the revised educational intervention, significant improvements were found in all statements concerning perceived challenges and actions related to nutritional care, while questions about factual knowledge showed significant improvements in three of the four questions.Comparison between the revised and the original intervention revealed no differences in most areas of perceived challenges and actions related to nutritional care. Additionally, in half of the areas assessed, factual knowledge improved more after the revision than after the original educational intervention, including the maximum length of overnight fast and the type of oral nutritional supplements (ONS) that should be prescribed.

CONCLUSION

The intervention was successful in increasing knowledge about nutritional care, nutritional counselling, food adaptation, and prescribing ONS in an individually tailored way. In-depth knowledge supports usability in clinical practice. Nevertheless, we need to follow-up and understand how increased knowledge about undernutrition and ONS prescription are implemented in primary health care when caring for older adults' desires and needs.

摘要

目的

本研究旨在评估经过更新和扩展的教育干预后,社区护士对营养护理的认知及实际知识。此外,我们旨在比较修订后的教育干预与原始教育干预的效果。

背景

深入了解营养护理是支持老年人福祉和健康的先决条件。因此,社区护士对营养护理过程、老年人的食物需求以及疾病不同阶段的姑息治疗的实际知识至关重要。对一项满足这些需求的更新和扩展的教育干预进行了评估。

方法

在教育干预前后使用一份关于营养护理的特定研究问卷。参与者(n = 118)是在斯德哥尔摩地区初级卫生保健机构工作的社区护士。此外,采用前后测准实验设计来评估修订后的干预与原始干预在学习成果上的差异。

结果

完成问卷的社区护士在医疗保健领域工作了约18年,在专科考试后担任社区护士5年。经过修订后的教育干预,在所有关于营养护理相关的感知挑战和行动的陈述方面都有显著改善,而关于实际知识的问题在四个问题中有三个显示出显著改善。修订后的干预与原始干预之间的比较显示,在与营养护理相关的感知挑战和行动的大多数领域没有差异。此外,在评估的一半领域中,修订后的实际知识改善比原始教育干预后更多,包括禁食的最长时长以及应开具的口服营养补充剂(ONS)的类型。

结论

该干预成功地增加了关于营养护理、营养咨询、食物调整以及以个性化方式开具ONS的知识。深入的知识支持在临床实践中的实用性。然而,我们需要跟进并了解在初级卫生保健中照顾老年人的愿望和需求时,如何将关于营养不良和ONS处方的增加的知识付诸实践。

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