Do study circles and a nutritional care policy improve nutritional care in a short- and long-term perspective in special accommodations?

Abstract

BackgroundDisease-related malnutrition is a major health problem in the elderly population and management issues are under-explored.ObjectivesWhat is the prevalence of undernutrition-risk (UN-risk), underweight, and overweight in special accommodations (SAs)? Do study circles and a nutritional care policy (NCP) improve the precision in nutritional care (NC) and decrease the prevalence of under- and overweight in a short- and/or long-term perspective?DesignQuasi-experimental pre- and post-intervention design with three experimental groups and one control group (CG).SettingSAs.ParticipantsIn 2005 (Time 1 – T1), 1726 (90.4%) residents agreed to participate; in 2007 (Time 2 – T2), 1,526 (81.8%); and in 2009 (Time 3 – T3), 1,459 (81.3%) residents participated.InterventionsExperimental groups: between T1 and T2 the first period of study circles was conducted in one municipality; between T2 and T3 a second period of study circles in another municipality was conducted; after T1 a NCP was implemented in one municipality. CG: residents in three municipalities.MeasurementsUnder- and overweight were defined based on BMI. Risk of undernutrition was defined as involving any of: involuntary weight loss, low BMI, and/or eating difficulties. The ‘precision in NC’ describes the relationship between nutritional treatment (protein- and energy-enriched food (PE-food) and/or oral supplements) and UN-risk.ResultsThe prevalence of UN-risk varied between 64 and 66%, underweight between 25 and 30%, and overweight between 30 and 33% in T1–T3. At T2 the prevalence of underweight was significantly lower in the first period study circle municipality, and at T3 in the second period study circle municipality compared to in the CG. The precision in NC was higher in a short-term perspective in the study circle municipalities and both in a short- and long-term perspective in the NCP municipality. At T3 between 54 and 70% of residents at UN-risk did not receive PE-food or oral supplements.ConclusionsStudy circles give positive short-term effects and a NCP gives positive short- and long-term effects on NC. Whether a combination of study circles and the implementation of a NCP can give even better results is an area for future studies.

Food Preparation at Home an Example of New Practical Strategies in the Swedish Municipal Food Service - A Qualitative Study

“…The positive evaluation of the personnel was shown in another study that the attitudes of professionals in relation to the introduction of something new in their daily routines is related to their professional background (Christensson et al, 2010;Landstrom, Sidenvall, Koivisto Hursti, & Magnusson, 2007;Scott-Samuel & Springett, 2007;Westergren & Hedin, 2010). Those professionals who have a higher educational and professional background and level of possibility to see the big picture and the possible benefits of a new service are more optimistic (Landstrom, et al, 2007).…”

“…Another study showed that nutrition study circles and a nutritional care policy improve nutritional care in both the short-and long-term perspective (Westergren & Hedin, 2010). The present study shows that there is still a need to work on routines and ways of changing any negative attitudes among the personnel related to food preparation as a work task.…”

A Network for Eating and Nutrition as a platform for cooperation over the organisational borders between healthcare sectors in Sweden

“…In 2004, joint guidelines were drawn up and developed regarding how to detect those at risk for malnutrition, which in 2005, contributed as input to the fi rst large scale point prevalence study in Sweden on eating and nutrition (13). Th is study was followed up by two further studies in 2007 and 2009 that showed some improvement in nutritional care following an educational intervention (14)(15)(16). One indicator of success appeared to be due to the relatively fast feedback to each unit that had the ability to compare its performance with their own community or hospital (14).…”

The effect of nutrition training for health care staff on learner and patient outcomes in adults: a systematic review and meta-analysis

“…Nine studies (28-30, 38, 40, 41, 44, 46, 47) took place in the acute setting, 8 (26,33,37,39,42,43,45,48) in nursing homes, 5 (25,31,32,34,36) in the community, and 2 (27,35) in sheltered accommodation. Sample sizes ranged from 21 to 5571 patients or residents, and from 11 to 592 health care staff.…”

“…Sample sizes ranged from 21 to 5571 patients or residents, and from 11 to 592 health care staff. Nine studies included older people (.64 y old) (25,27,29,35,37,39,43,45,48), and nurses or nursing assistants were the most commonly targeted staff group for nutrition training (n = 14 studies) (26,29,33,34,(38)(39)(40)(41)(42)(43)(44)(45)(46)(47).…”