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Bolanos G, Hentschel C, Jahan M, Gupta S, Akhiary M, Wisdom-Goulbourne T, Reyes-Farias D, Resnick B, Brown RT. "I'll fill in the gaps": perspectives of HHAs on promoting aging in place for older adults with low incomes. Home Health Care Serv Q 2024; 43:114-132. [PMID: 38116781 PMCID: PMC10978290 DOI: 10.1080/01621424.2023.2296061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Older adults with low incomes experience disproportionate rates of cognitive and functional impairment and an elevated risk of nursing home admission. Home health aides (HHAs) may have insight into how to optimize aging in place for this population, yet little is known about HHAs' perspectives on this topic. We conducted 6 focus groups with 21 English-speaking and 10 Spanish-speaking HHAs in Pennsylvania and New Jersey. Transcripts were analyzed using qualitative thematic analysis, and three themes emerged. First, HHAs described the uniqueness of their role within multidisciplinary care teams. Second, HHAs shared concrete interventions they employ to help their clients improve their function at home. Third, HHAs discussed barriers they face when helping clients age in place. Our findings suggest that HHAs have important insights into improving aging in place for older adults with low incomes and that their perspectives should be incorporated into care planning and intervention delivery.
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Affiliation(s)
- Graciela Bolanos
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Claudia Hentschel
- Division of Geriatric Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Momana Jahan
- Division of Geriatric Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sonia Gupta
- Division of Geriatric Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mona Akhiary
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - David Reyes-Farias
- Division of Geriatric Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Barbara Resnick
- School of Nursing, University of Maryland, Baltimore, Maryland
| | - Rebecca T. Brown
- Division of Geriatric Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Geriatrics and Extended Care Program, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
- Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
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Ibrahim Puri J. Disease-specific nutrition for the elderly and their Caretakers- What was and what could be. J Prev Interv Community 2021; 50:51-71. [PMID: 34569445 DOI: 10.1080/10852352.2021.1915732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Older adults who suffer from chronic illnesses often employ the help of Home Care Aides (HCAs). These HCAs assist their client's nutrition and other activities of daily living. However, many HCAs who care for the elderly are themselves unaware of proper nutrition habits that can improve health outcomes. This project proposal centers on a nutrition-training program that focuses on HCAs and their knowledge of proper nutrition. It will challenge participants to eat better using foods are best suited to the chronic illness that their client suffers from. APPROACH The Nutrition Training Package contains materials that can be used in training sessions conducted over two days. Each day consists of interactive activities, discussions and presentations. These materials were adapted from interventions used by the Healthy Aging Program- an intervention previously hosted by EverThrive IL. OUTCOMES Although pilot testing is yet to be conducted, the training package is complete and ready for implementation. CONCLUSION Based on literature review, the contents of the Nutrition Training Package for Home Care Aides will guide participants through stages of the Model of Change, simultaneously creating the self-efficacy to contribute to elongated, healthier living for the elderly.
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Zanini M, Catania G, Ripamonti S, Watson R, Romano A, Aleo G, Timmins F, Sasso L, Bagnasco A. The WeanCare nutritional intervention in institutionalized dysphagic older people and its impact on nursing workload and costs: A quasi-experimental study. J Nurs Manag 2021; 29:2620-2629. [PMID: 34342076 PMCID: PMC9292428 DOI: 10.1111/jonm.13435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/21/2021] [Accepted: 07/30/2021] [Indexed: 12/29/2022]
Abstract
AIM The aim of this study is to explore how a nutritional intervention that improves the biochemical and functional profile of dysphagic older people impacts on nursing workload and costs for nursing homes. BACKGROUND Dysphagic institutionalized older people particularly at risk of malnutrition require more intensive support from nursing staff and higher costs for nursing homes. METHOD This is an open pre-post longitudinal multicentre quasi-experimental study without a control group. RESULTS There is a significant reduction in the number of enemas (from 3.51 to 1.11 enemas), with an average nursing workload reduction from 52 to 16 min per patient every month. Each nurse also spent 20 h less per patient every month spoon-feeding. This resulted in nursing staff cost savings. CONCLUSIONS The nutritional intervention led to a significantly better quality of life for the patients manifested through increased independence and social engagement. This reduced workload for nursing staff and costs for nursing home administrators. IMPLICATIONS FOR NURSING MANAGEMENT Sensitive, targeted nutritional interventions have the potential to improve nursing home residents' quality of life and enable a more efficient use of resources. This study revealed reduced workload and cost savings due to less time spent administering enemas and spoon-feeding, in addition to reduced malnutritional consequences.
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Affiliation(s)
- Milko Zanini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Gianluca Catania
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | | | - Roger Watson
- Faculty of Health and Social Care, University of Hull, Hull, UK
| | - Antonio Romano
- Pharmaceutical and Technical Chemistry, Head R&D Healthy Ageing Research Group, Cremona, Italy
| | - Giuseppe Aleo
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Fiona Timmins
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin, Ireland
| | - Loredana Sasso
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Annamaria Bagnasco
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
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Brglez M, Plazar N, Poklar Vatovec T, Meulenberg CJW. Health concerns regarding malnutrition among the older populations: considerations from a Slovenian perspective. Health Promot Int 2021; 37:6310297. [PMID: 34179974 DOI: 10.1093/heapro/daab097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Diet is an important factor in a healthy lifestyle for all age groups. However, with aging it is important to be aware that the diet, due to changed physiology, needs an accordingly adjusted and balanced daily regime. This article reviews the field of older population's nutrition and presents: the most common nutritional disorders, causes, demographics and malnutrition measurement tools. Relevant scientific literature as well as professional Slovenian papers were identified through specific searches with topic-related keywords in EBSCO, PubMed, Web of Science and COBISS databases. The results of the identified papers are subsequently discussed in a descriptive narrative. The reviewed literature shows noticeable trends of high proportions of malnutrition among older persons, both globally and in Slovenia: predominantly observed are overnutrition like overweight and obese, but as well, and often unnoticed, undernutrition. The latter is more worrying, as inadequate knowledge in health care institutions regarding nutritional screening tools and measures to prevent drastic forms of undernutrition, seem to facilitate these trends. Though there are many reasons for insufficient food intake in older people, the article formulates considerations that can feed appropriate education and awareness programs, and through correct screening point to timely identification of malnourished individuals and those with risk of malnutrition. The promotion and implementation of such considerations could prevent malnutrition among the older population, reduce the frequency of nutritional disorders and co-morbidities, and generally improve the nutritional status of the older population, thus, provide better quality of health later in life.
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Affiliation(s)
- Monika Brglez
- Alma Mater Europaea, European Centre, Maribor, Slovenia
| | - Nadja Plazar
- Alma Mater Europaea, European Centre, Maribor, Slovenia
| | | | - Cécil J W Meulenberg
- Institute for Kinesiology Research, Science and Research Centre, Koper, Slovenia
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Rasmussen RL, Holst M, Nielsen L, Villumsen M, Andreasen J. The perspectives of health professionals in Denmark on physical exercise and nutritional interventions for acutely admitted frail older people during and after hospitalisation. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:2140-2149. [PMID: 32483900 DOI: 10.1111/hsc.13025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/03/2020] [Accepted: 04/21/2020] [Indexed: 06/11/2023]
Abstract
Frailty is associated with several negative health outcomes, such as readmissions to hospital. Physical exercise, including strength training and nutritional optimisation are essential parts of documented interventions for frail older people in preventing or minimising frailty. Further knowledge is necessary to ensure feasible and successful interventions encompassing both physical exercise and nutritional optimisation. The aim of this qualitative study was to investigate the perspectives of health professionals on which factors may affect interventions, including physical exercise and nutrition, for frail older people in relation to discharge after acute admission to hospital. Data were gathered in two semi-structured focus groups, totalling 11 health professionals working with frail older people in a Danish university hospital and a municipality. The sampling of participants was purposive and the interviews were facilitated by a semi-structured interview guide. Data were analysed applying a six-step data-driven thematic analysis. Findings showed that health professionals experienced working with nutritional optimisation and physical exercise within a frail older population as challenging, and they mostly used extrinsic motivation, such as incentives, deals or intensified messages, as external factors in their approaches as to affect specific behaviours. A discourse on the importance of activity- and functional training was prevalent, while diverging perspectives were present in relation to strength training, which was considered less feasible or meaningful in a community-dwelling setting. Organisational barriers such as communication between sectors and time limitations affected negatively the work of health professionals, as they hindered co-ordinated and adequate interventions from the health professionals. Findings and theory-based knowledge indicate that health professionals should work towards a person-centred approach, which includes goal-setting, to improve physical training and nutritional interventions for frail older people. Furthermore, health professionals may need more support in order to incorporate strength training in interventions. In addition to this, improved co-ordination between sectors is warranted.
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Affiliation(s)
- Rikke L Rasmussen
- Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Holst
- Center for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurine Nielsen
- Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark
| | - Morten Villumsen
- Department of Elderly and Health, Section of Training and Activity, Aalborg Municipality, Aalborg, Denmark
- SMI®, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Jane Andreasen
- Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark
- Public Health and Epidemiology Group, Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark
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Type of Care and Living Situation Are Associated with Nutritional Care but Not Nutritional Status of Older Persons Receiving Home Care. Healthcare (Basel) 2020; 8:healthcare8030296. [PMID: 32854303 PMCID: PMC7551165 DOI: 10.3390/healthcare8030296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/17/2020] [Accepted: 08/21/2020] [Indexed: 12/03/2022] Open
Abstract
Nutritional care and nutritional status may differ in older persons receiving informal (IC) or professional (PC) home care and further depend on the living situation, but little is known in this regard. In this analysis of a cross-sectional multicenter study, type of care, living situation, and nutritional care were enquired in 353 older adults (≥65) receiving IC or PC, living either with partner (LP), with others (LO) or alone (LA), and the nutritional status was determined by BMI and MNA®. For IC receivers, food shopping (IC-LP 94%, IC-LO 96%, IC-LA 92%) and warm meals (IC-LP 89%, IC-LO 90%, IC-LA 71%) were mainly provided by relatives, whereas 47% of PC-LA prepared warm meals by themselves and 22% received meals on wheels. Thirteen percent were underweight, 13% malnourished, and 57% at risk of malnutrition without differences between the groups. Adjusted odds ratios (OR) of being malnourished were also not different (IC-LP 2.2 [95% CI 0.5–9.7], IC-LO 1.4 [0.3–6.6], IC-LA 1.4 [0.3–6.6]) compared to PC-LA. In conclusion, provision of nutritional care obviously differed according to the type of care and living situation, whereas nutritional status does not seem to be affected by these aspects. More research is clearly needed in this field.
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Hestevik CH, Molin M, Debesay J, Bergland A, Bye A. Hospital nurses and home care providers’ experiences of participation in nutritional care among older persons and their family caregivers: a qualitative study. J Hum Nutr Diet 2019; 33:198-206. [DOI: 10.1111/jhn.12729] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- C. H. Hestevik
- Department of Physiotherapy Faculty of Health Sciences OsloMet–Oslo Metropolitan University Oslo Norway
| | - M. Molin
- Department of Nursing and Health Promotion Faculty of Health Sciences OsloMet – Oslo Metropolitan University Oslo Norway
- Bjorknes University College Oslo Norway
| | - J. Debesay
- Department of Nursing and Health Promotion Faculty of Health Sciences OsloMet – Oslo Metropolitan University Oslo Norway
| | - A. Bergland
- Department of Physiotherapy Faculty of Health Sciences OsloMet–Oslo Metropolitan University Oslo Norway
| | - A. Bye
- Department of Nursing and Health Promotion Faculty of Health Sciences OsloMet – Oslo Metropolitan University Oslo Norway
- Regional Advisory Unit in Palliative Care Department of Oncology Oslo University Hospital Oslo Norway
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Hestevik CH, Molin M, Debesay J, Bergland A, Bye A. Healthcare professionals' experiences of providing individualized nutritional care for Older People in hospital and home care: a qualitative study. BMC Geriatr 2019; 19:317. [PMID: 31747884 PMCID: PMC6865038 DOI: 10.1186/s12877-019-1339-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/31/2019] [Indexed: 01/04/2023] Open
Abstract
Background Recent studies indicate inadequate nutritional care practices in healthcare institutions and identify several barriers to perform individualized nutritional care to older persons. Organisation of care can become rigid and standardised, thus failing to be respectful of and responsive to each person’s needs and preferences. There is limited research exploring health professionals’ views on how structure of care allows them to individualize nutritional care to older persons. In this study we aim to explore how healthcare professionals’ experience providing individualised nutritional care within the organisational frames of acute geriatric hospital care and home care. Methods Semi-structured interviews with 23 healthcare professionals from hospital acute geriatric care and home care. Interviews were analyzed using thematic analysis. Results Two main themes and six sub-themes emerged from the material. Theme 1: ‘Meeting patients with complex nutritional problems’ with the sub-themes: ‘It is much more complex than just not eating’ and ‘seeing nutrition as a part of the whole’. Theme 2: ‘The structure of the nutritional care’, with the sub-themes: ‘Nutritional routines: Much ado, but for what?’, ‘lack of time to individualize nutritional care’, ‘lack of interdisciplinary collaboration in nutritional care’ and ‘meeting challenging situations with limited resources in home care’. Conclusions The healthcare professionals described having a high focus on and priority of nutritional care when caring for older persons. They did however find it challenging to practice individualized nutritional care due to the complexity of the patients’ nutritional problems and constraints in the way nutritional care was organised. By describing the challenges the healthcare professionals face when trying to individualize the nutritional care, this study may provide important knowledge to health professionals and policy makers on how to decrease the gap between older patients’ preferences for care and nutritional care practice.
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Affiliation(s)
| | - Marianne Molin
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Bjorknes University College, Lovisenberggata 13, 0456, Oslo, Norway
| | - Jonas Debesay
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Astrid Bergland
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Asta Bye
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Regional Advisory Unit in Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway
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Tsuji T, Yamamoto K, Yamasaki K, Hayashi F, Momoki C, Yasui Y, Ohfuji S, Fukushima W, Habu D. Lower dietary variety is a relevant factor for malnutrition in older Japanese home-care recipients: a cross-sectional study. BMC Geriatr 2019; 19:197. [PMID: 31349800 PMCID: PMC6659217 DOI: 10.1186/s12877-019-1206-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 07/09/2019] [Indexed: 01/10/2023] Open
Abstract
Background Nutritional status of the older people is affected by various life-style factors. Although dietary habit is one of the life-style factors, it is unknown which of older home-care recipients’ dietary habits are associated with malnutrition. The purpose of this study was to examine the association of dietary variety, as an evaluation index for dietary habits, with malnutrition in Japanese older home-care recipients. Methods This cross-sectional study was conducted in a single city, Hyogo Prefecture, Japan between July and October 2016. Three hundred thirty-three community-dwelling older care recipients (aged 65 years or older who were receiving home-visit nursing care services) were enrolled. Their nutritional status (Mini Nutritional Assessment®-short form: MNA®-SF), dietary variety (Food frequency score [FFS]), socio-demographic characteristics (age, sex, marital status, etc.), health indicators (comorbidity [Charlson Comorbidity Index] and dysphagia status [Dysphagia Severity Scale]) were assessed. The participants were classified into two groups: malnourished (0–7 points) and non-malnourished (8–14 points), according to their MNA®-SF scores. Multivariate logistic regression analysis was used to examine the factors associated with malnutrition. Results A total of 317 participants were analyzed (118 men, 199 women, median age: 84 years). Compared to the fourth (highest) quartile of FFS, odds ratios (OR) (95% confidence intervals [CI]) of the third, second, and first (lowest) quartiles of FFS were 1.08 (0.42–2.80), 1.29 (0.56–2.98), and 2.30 (1.02–5.19), respectively (p for trend = 0.049). Higher Charlson Comorbidity Index score and the presence of dysphagia were also significantly associated with malnutrition (OR: 2.08, 95% CI: 1.08–4.00 and OR: 3.86, 95% CI: 2.08–7.17, respectively). Conclusion Lower dietary variety was significantly associated with malnutrition in Japanese older home-care recipients.
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Affiliation(s)
- Taeko Tsuji
- Department of Medical Nutrition, Graduate School of Human Life Science, Osaka City University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka, 558-8585, Japan
| | - Kaoru Yamamoto
- Department of Medical Nutrition, Graduate School of Human Life Science, Osaka City University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka, 558-8585, Japan
| | - Kazuyo Yamasaki
- Division of Visiting Nursing, Nishinomiya Social Welfare Corporation, Hyogo, Japan
| | - Fumikazu Hayashi
- Office of Epidemiology, Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Chika Momoki
- Department of Food and Nutrition, Faculty of Contemporary Human Life Science, Tezukayama University, Nara, Japan
| | - Yoko Yasui
- Department of Clinical Nutrition, Graduate School of Human Life Science, Osaka City University, Osaka, Japan
| | - Satoko Ohfuji
- Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Wakaba Fukushima
- Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Daiki Habu
- Department of Medical Nutrition, Graduate School of Human Life Science, Osaka City University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka, 558-8585, Japan.
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Farsjø C, Kluge A, Moen A. Using a tablet application about nutrition in home care-Experiences and perspectives of healthcare professionals. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:683-692. [PMID: 30456774 DOI: 10.1111/hsc.12685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 10/12/2018] [Accepted: 10/19/2018] [Indexed: 06/09/2023]
Abstract
Undernutrition is an extensive problem among patients in community care services. The literature identifies several barriers that hinder health professionals in identifying nutritional problems and providing nutrition interventions. We developed Appetitus, a tablet application (app) focused on nutrition for older adults. Patients used the app, advised by healthcare professionals. In this study with qualitative design, we explored experiences and perspectives of healthcare professionals who used Appetitus when providing home care. We interviewed 24 healthcare professionals individually and in focus groups. We subjected the data to qualitative content analysis. Healthcare professionals used Appetitus as a mediator in dialogues with patients about nutrition. Giving the older adults an active role in nutrition assessment afforded opportunities to strengthen their involvement in care. Registrations of food and drink consumption gave the healthcare professionals insight into patients' situations and revealed problems of which the healthcare professionals had not been aware. Based on their experience with Appetitus, healthcare professionals suggested using electronic tools to assess and document the nutritional situation of a larger patient group in home care. In future use of Appetitus, healthcare professionals' levels of knowledge and confidence when advising patients about nutrition must be emphasised and addressed. Barriers such as time constraints and limited continuity of care are also areas that require attention when new nutrition practices are implemented.
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Affiliation(s)
- Caroline Farsjø
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Anders Kluge
- Department of Education, Faculty of Educational Sciences, University of Oslo, Oslo, Norway
| | - Anne Moen
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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Fuel for Life: A Literature Review of Nutrition Education and Assessment Among Older Adults Living at Home. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2018. [DOI: 10.1177/1084822318754843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Living alone but eating together: Exploring lunch clubs as a dining out experience. Appetite 2017; 119:34-40. [DOI: 10.1016/j.appet.2017.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 02/28/2017] [Accepted: 03/03/2017] [Indexed: 11/17/2022]
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Acne, sedentary behaviour, malnutrition, and COPD. Br J Gen Pract 2014; 64:523. [DOI: 10.3399/bjgp14x681889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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