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Individually adjusted meals for older people with protein-energy malnutrition: a single-case study
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
2001 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 10, no 4, 491-502 p.Article in journal (Refereed) Published
Abstract [en]

• The objective of this study was to investigate the effect of a 3-month intervention programme consisting of meals based on individual nutritional requirements in residents assessed as protein-energy malnourished on admission to a municipal care Institution.

• Using a single-case design, 11 malnourished residents were given individual care aimed at fulfilling their personal requirements for energy intake during a period of 12 weeks. The residents were selected from a sample of 261 newly admitted older adults of whom 87 were assessed to be malnourished on admission. Nutritional status, including anthropometric and biochemical variables and functional capacities were assessed before, during, and after the intervention. Energy intake was recorded every day. Body weight, and serum concentration of albumin and transthyretin were measured every other week.

•  During a 3-month period, the mean value of energy intake reached the calculated energy requirement in 10 residents. Eight residents increased in weight, triceps skin-fold thickness, and transthyretin concentration. Nine residents increased in arm muscle circumference, and 10 showed increased serum albumin concentration and functional capacity.

• We conclude that nursing care based on individual nutritional requirements, resources, and desires improves nutritional status and functional capacity in a group of malnourished residents.

Place, publisher, year, edition, pages
2001. Vol. 10, no 4, 491-502 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-26838DOI: 10.1046/j.1365-2702.2001.00508.xLocal ID: 11456OAI: oai:DiVA.org:liu-26838DiVA: diva2:247388
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Malnutrition in elderly people in need of municipal care
Open this publication in new window or tab >>Malnutrition in elderly people in need of municipal care
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to describe nutritional status in elderly people at the time of entering municipal care, to evaluate nutritional assessment techniques and to investigate the effect of a nutritional care plan. Furthermore the aim was to investigate the staffs' attitudes towards nutritional nursing care. A total of 261 residents, mean age 84 years (range 65-103 years), admitted to a community resident home in a municipality in the south of Sweden were included. At the same municipalities, 151 nursing staff responded to an attitude scale on two occasions with one year between.

During the first or second week after admission nutritional status was assessed using a combination of anthropometry and serum protein measurements as the criterion to define protein- energy malnutrition (PEM). This combination constituted the standard criterion when validity of the Subjective Global Assessment (SGA) and the Mini Nutritional Assessment (MNA) were evaluated. In 40 residents assessed as non-PEM on admission health problems were measured by the Nottingham Health Profile (NHP). To investigate the effect of a nutritional programme energy intake, anthropometry, serum protein measurements and functional capacity were assessed continuously during a five months period in 11 residents assessed as being PEM on admission. The nutritional programme consisted of meals based on individual energy requirements. An attitude scale was developed and used in order to measure whether the attitudes of nursing staff towards important issues within eating and nutrition changed after implementation of an educational programme.

On admission, 33% of 261 elderly people were assessed as being PEM. The frequency of pressure sores or leg ulcers, psychological stress or acute disease in the previous 3 months, reduced fluid intake, deteriorated appetite, reduced mobility, need of help during meals and gastrointestinal symptoms were significant higher in residents assessed as PEM compared with residents assessed as non-PEM. Both SGA and MNA proved to be useful in detecting residents objectively assessed as PEM. NHP, measuring health problems, showed power to predict residents at risk of malnutrition. Anthropometric measurements, serum protein concentration and functional capacity increased significantly in 11 residents assessed as PEM after 3 months on the individualised care programme. Nutritional education and implementation of a nutritional programme did not change the attitudes of nursing staff towards important nutritional issues.

In conclusion, at the time of entering municipal care a high frequency of residents assessed as PEM or at risk of PEM was found. The SGA and MNA were shown to be useful tools in detecting resident in need of nutritional attention. For early detection of residents at risk of malnutrition, measurement of health problems added important information. An individualised nutritional care programme was one useful approach to the improvement of nutritional status and functional capacity in residents assessed as PEM on admission. On the whole, nursing staff responded with positive attitudes towards nutritional nursing care. Nutritional education and implementation of a nutritional programme did not significantly change their attitudes.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2002. 63 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 755
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27471 (URN)12124 (Local ID)91-7373-197-8 (ISBN)12124 (Archive number)12124 (OAI)
Public defence
2002-11-22, Berzeliussalen, Hälsouniversitetet, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-09-18Bibliographically approved

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Christensson, LennartEk, Anna-ChristinaUnosson, Mitra

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