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Kevdzija M, Laviano A, Worf I, Schuh C, Tarantino S, Hiesmayr M. Indirect Nutrition and Mobility Risks during Hospitalization: An Architectural Perspective on the nutritionDay Study Findings. Nutrients 2023; 15:nu15061527. [PMID: 36986257 PMCID: PMC10059895 DOI: 10.3390/nu15061527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Nutrition and mobility risks include complex and interrelated physiological, medical, and social factors. A growing body of evidence demonstrates that the built environment can affect patients' well-being and recovery. Nevertheless, the relationship between the built environment, nutrition, and mobility in general hospitals is largely unexplored. This study examines the implications of the nutritionDay study's results for the architectural design of hospital wards and nutrition environments. This one-day annual cross-sectional study uses online questionnaires in 31 different languages to collect ward-specific and patient-specific variables. The main findings relevant to the design of hospital wards were: (1) 61.5% of patients (n = 48,700) could walk before hospitalization and (2) this number dropped to 56.8% on nutritionDay (p < 0.0001), while the number of bedridden patients increased from 6.5% to 11.5% (p < 0.0001), (3) patients who needed more assistance had a much longer mean LOS than mobile patients, (4) mobility was associated with changes in eating, and (5) 72% of units (n = 2793) offered additional meals or snacks, but only 30% promoted a positive eating environment. The built environment may indirectly affect hospitalized patients' mobility, independence, and nutritional intake. Possible future study directions are suggested to further investigate this relationship.
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Affiliation(s)
- Maja Kevdzija
- TU Wien, Faculty of Architecture and Planning, Institute of Architecture and Design, 1040 Vienna, Austria
| | - Alessandro Laviano
- Department of Translational and Precision Medicine, University of Rome La Sapienza, 00185 Roma, Italy
| | - Isabella Worf
- Center for Medical Data Science (CeDAS), Medical University of Vienna, 1090 Vienna, Austria
| | - Christian Schuh
- IT-Systems & Communications (ITSC), Medical University of Vienna, 1090 Vienna, Austria
| | - Silvia Tarantino
- Center for Medical Data Science (CeDAS), Medical University of Vienna, 1090 Vienna, Austria
| | - Michael Hiesmayr
- Center for Medical Data Science (CeDAS), Medical University of Vienna, 1090 Vienna, Austria
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Pashley A, Young A, Wright O. Foodservice systems and mealtime models in rehabilitation: Scoping review. J Adv Nurs 2022; 78:3559-3586. [PMID: 35880760 PMCID: PMC9796490 DOI: 10.1111/jan.15379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/31/2022] [Accepted: 07/05/2022] [Indexed: 01/01/2023]
Abstract
AIMS To describe current foodservice systems and mealtime care utilized in the rehabilitation setting. A secondary aim was to identify commonly used outcome measures in foodservice research in the rehabilitation setting. DESIGN A scoping review. DATA SOURCES PubMed, CINAHL, Scopus, Embase, PsycINFO and Cochrane were searched until January 2022. REVIEW METHODS The review was conducted according to Joanna Briggs Institute's methodology for scoping reviews. Included studies were conducted in the inpatient rehabilitation setting, adult population ≥18 years old and provided a description of at least one element of the foodservice system, food and menu, waste and/or eating environment. RESULTS Of 5882 articles screened, 37 articles were included, reporting 31 unique studies. Most rehabilitation units had cook-fresh production methods (50%), used decentralized bulk delivery methods (67%) had a communal dining room (67%) and had a 3-week menu cycle (71%). Mealtime care was predominantly provided by nursing staff, however few studies reported on specific activities. Nutritional intake was a key outcome measure across included studies (43%), with only six papers reporting on rehabilitation outcomes. Of the intervention studies (n = 9), all were aimed at improving nutritional intake through menu or mealtime care modifications; few (n = 3) studied changes in rehabilitation outcomes. CONCLUSION This scoping review identified a considerable lack of reporting of foodservice and mealtime care systems used in rehabilitation settings in the available literature. Further investigation is required to understand what models of mealtime care are provided to patients and to understand the impact of changes to foodservice and mealtime systems on patient outcomes. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was necessary for this review.
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Affiliation(s)
- Alice Pashley
- School of Human Movement and Nutrition SciencesThe University of QueenslandBrisbaneAustralia
| | - Adrienne Young
- Department of Nutrition and DieteticsRoyal Brisbane and Women's HospitalHerstonAustralia,Centre for Health Services ResearchThe University of QueenslandBrisbaneAustralia
| | - Olivia Wright
- School of Human Movement and Nutrition SciencesThe University of QueenslandBrisbaneAustralia,Centre for Nutrition and Food SciencesQueensland Alliance for Agriculture and Food InnovationSt LuciaAustralia
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Mathiesen SL, Aadal L, Uldbæk ML, Astrup P, Byrne DV, Wang QJ. Music Is Served: How Acoustic Interventions in Hospital Dining Environments Can Improve Patient Mealtime Wellbeing. Foods 2021; 10:foods10112590. [PMID: 34828871 PMCID: PMC8622365 DOI: 10.3390/foods10112590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/19/2021] [Accepted: 10/23/2021] [Indexed: 11/18/2022] Open
Abstract
Eating-related challenges and discomforts arising from moderately acquired brain injuries (ABI)—including physiological and cognitive difficulties—can interfere with patients’ eating experience and impede the recovery process. At the same time, external environmental factors have been proven to be influential in our mealtime experience. This experimental pilot study investigates whether redesigning the sonic environment in hospital dining areas can positively influence ABI patients’ (n = 17) nutritional state and mealtime experience. Using a three-phase between-subjects interventional design, we investigate the effects of installing sound proofing materials and playing music during the lunch meals at a specialised ABI hospital unit. Comprising both quantitative and qualitative research approaches and data acquisition methods, this project provides multidisciplinary and holistic insights into the importance of attending to sound in hospital surroundings. Our results demonstrate that improved acoustics and music playback during lunch meals might improve the mealtime atmosphere, the patient well-being, and social interaction, which potentially supports patient food intake and nutritional state. The results are discussed in terms of potential future implications for the healthcare sector.
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Affiliation(s)
- Signe Lund Mathiesen
- Department of Food Science, Faculty of Technical Sciences, Aarhus University, 8200 Aarhus N, Denmark; (D.V.B.); (Q.J.W.)
- Correspondence: ; Tel.: +45-2577-2779
| | - Lena Aadal
- Hammel Neurorehabilitation and Research Center, 8450 Hammel, Denmark;
- Department of Clinical Medicine, Faculty of Health, Aarhus University, 8000 Aarhus C, Denmark
| | | | - Peter Astrup
- Test and Development Center for Welfaretech, 8800 Viborg, Denmark;
| | - Derek Victor Byrne
- Department of Food Science, Faculty of Technical Sciences, Aarhus University, 8200 Aarhus N, Denmark; (D.V.B.); (Q.J.W.)
| | - Qian Janice Wang
- Department of Food Science, Faculty of Technical Sciences, Aarhus University, 8200 Aarhus N, Denmark; (D.V.B.); (Q.J.W.)
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Jong J, Porter J, Palermo C, Ottrey E. Meals beyond the bedside: An ethnographic exploration of staffs' perspectives and experiences of communal dining in subacute care. Nurs Health Sci 2021; 23:372-380. [PMID: 33438822 DOI: 10.1111/nhs.12812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/14/2020] [Accepted: 01/05/2021] [Indexed: 12/25/2022]
Abstract
Communal dining offers multiple benefits for hospital patients, yet dining rooms may be underutilized in practice. This study aimed to understand and explore staffs' perspectives and experiences of communal dining in subacute care, and the impacts on staff mealtime practice. Using qualitative, ethnographic methodology, 94 hours of fieldwork were conducted across two subacute care wards. Participants were staff involved in nutrition care or present on the ward at mealtimes. Ninety-one semistructured and ethnographic interviews were conducted with 59 staff, and 54 episodes of observation captured more than 190 staff. Interviews and field notes were thematically analyzed using an inductive approach. Three themes were identified: (i) benefits to patients; (ii) logistical and practical challenges; and (iii) supportive cultural factors. While staff recognized how communal dining benefited patients, logistical and practical challenges impacted their ability to facilitate it in practice. Healthcare organizations seeking to embed communal dining into the mealtime routine should recognize that clear delineation of staff roles and responsibilities, and cultural change involving normalization, setting expectations, and collective advocacy may be needed to optimize benefits for patients.
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Affiliation(s)
- Jessica Jong
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Judi Porter
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia.,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Ella Ottrey
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia.,Monash Centre for Scholarship in Health Education (MCSHE), Monash University, Clayton, Victoria, Australia
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McLaren-Hedwards T, D'cunha K, Elder-Robinson E, Smith C, Jennings C, Marsh A, Young A. Effect of communal dining and dining room enhancement interventions on nutritional, clinical and functional outcomes of patients in acute and sub-acute hospital, rehabilitation and aged-care settings: A systematic review. Nutr Diet 2021; 79:140-168. [PMID: 33416215 DOI: 10.1111/1747-0080.12650] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/21/2020] [Accepted: 11/04/2020] [Indexed: 11/30/2022]
Abstract
AIMS This review aimed to synthesise evidence on the impact of communal dining and/or dining room enhancement interventions on nutritional, clinical and functional outcomes of patients in hospital (acute or subacute), rehabilitation and residential aged-care facility settings. METHODS Five electronic databases were searched in March 2020. Included studies considered the impact of communal dining and/or dining room enhancements on outcomes related to malnutrition in hospital (acute or subacute), rehabilitation and residential aged care facility settings. Risk of bias was assessed using the Academy of Nutrition and Dietetics quality checklist. Overall quality was assessed using GRADEpro software. Outcome data were combined narratively for communal dining and dining room enhancements respectively. RESULTS Eighteen articles from 17 unique studies were identified. Of these studies, one was a randomised control trial (moderate quality) and 16 were observational studies (all low quality). Communal dining interventions (four studies, n = 490) were associated with greater energy and protein intake and higher measures of quality of life than non-communal mealtime settings. Dining room enhancement interventions (14 studies, n = 912), overall, contributed to increased intake of food, energy, protein and fluid. CONCLUSIONS Results indicate that communal dining and/or dining room enhancement has a positive impact on several outcomes of interest, however, most available evidence is of low quality. Therefore, there is a need for further large-scale, well-designed experimental studies to assess the potential impacts of these interventions.
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Affiliation(s)
- Taya McLaren-Hedwards
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Kelly D'cunha
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Elaina Elder-Robinson
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Claire Smith
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Cindy Jennings
- Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Abigail Marsh
- Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Adrienne Young
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia.,Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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Jonsson AS, Nyberg M, Jonsson IM, Öström Å. Older patients' perspectives on mealtimes in hospitals: a scoping review of qualitative studies. Scand J Caring Sci 2020; 35:390-404. [PMID: 32372410 DOI: 10.1111/scs.12866] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 04/13/2020] [Indexed: 01/12/2023]
Abstract
The increasing age of populations throughout the world means that healthcare services are faced with new challenges, not least regarding the provision of food during hospital stay. There is a lack of knowledge of how hospital mealtimes are experienced by older patients, and so the aim of this article was to review current knowledge regarding mealtimes in hospitals from the perspectives of older patients. A literature search was performed using seven databases: PubMed, Web of Science, Scopus, Sociological Abstracts, SweMed+, ASSIA and CINAHL with no limits regarding publication date. The inclusion criteria were peer-reviewed articles in English or Swedish that used qualitative methods to examine older patients' (>65 years) mealtime experiences. The Five Aspect Meal Model (FAMM) served as a framework for understanding the complexity behind a mealtime experience. Qualitative content analysis was used as a guide when analysing the material. The search produced 415 studies, 14 of which were included in the review. The findings generated three main themes for understanding how older patients experience mealtimes while in hospital: (1) the food and the food service, (2) mealtime assistance and commensality during mealtimes and (3) the importance of retaining one's independence. The review also clearly indicated a shortage of studies that solely focus on older patients' experiences of their mealtime. More research is therefore needed to be fully able to understand the complex task of providing meals in hospitals.
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Affiliation(s)
- Ann-Sofie Jonsson
- School of Hospitality, Culinary Arts and Meal Science, Örebro University, Grythyttan, Sweden
| | - Maria Nyberg
- Department of Food and Meal Science, Kristianstad University, Kristianstad, Sweden
| | - Inger M Jonsson
- School of Hospitality, Culinary Arts and Meal Science, Örebro University, Grythyttan, Sweden
| | - Åsa Öström
- School of Hospitality, Culinary Arts and Meal Science, Örebro University, Grythyttan, Sweden
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Ottrey E, Palermo C, Huggins CE, Porter J. Exploring staff perceptions and experiences of volunteers and visitors on the hospital ward at mealtimes using an ethnographic approach. J Clin Nurs 2018; 27:e1571-e1579. [PMID: 29493833 DOI: 10.1111/jocn.14318] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2018] [Indexed: 12/12/2022]
Abstract
AIMS AND OBJECTIVES To explore multiple perspectives and experiences of volunteer and visitor involvement and interactions at hospital mealtimes. In addition, to understand how the volunteer and visitor role at mealtimes is perceived within the hospital system. BACKGROUND Mealtime assistance can improve patients' food intake and mealtime experience. Barriers to providing mealtime assistance include time pressures, staff availability and inadequate communication. Volunteers and visitors can encourage and assist patients at mealtimes. There is a lack of evidence on the relationship between hospital staff, volunteers and visitors. DESIGN A qualitative, ethnographic approach. METHODS Sixty-seven hours of fieldwork were conducted on two subacute wards within an Australian healthcare network in 2015. Mealtime practices and interactions of hospital staff, volunteers and visitors were observed. Sixty-one staff, volunteers and visitors were interviewed in 75 ethnographic and semi-structured interviews. Data were inductively and thematically analysed. RESULTS Three key themes emerged as follows: "help"-volunteers and visitors were considered helpful when they assisted patients at mealtimes, supported well-being and aided staff-patient communication; "hindrance"-staff perceived visitors as negative presences when they inhibited patient progress and impacted staff work practices; and "reality of practice"-visiting hours, visitor engagement in patient therapy and communication between staff, volunteers and visitors were important practical considerations of mealtime involvement. CONCLUSIONS The findings show how and why volunteers and visitors can be helpful and unhelpful at hospital mealtimes on subacute wards. More research on the role and contribution of volunteers and visitors on hospital wards will inform future practice in healthcare settings. RELEVANCE TO CLINICAL PRACTICE This healthcare organisation should continue to encourage volunteer and visitor involvement at hospital mealtimes. More effort is needed to educate visitors about patients' therapeutic goals and the importance of nutrition. The working relationship between hospital staff, volunteers and visitors should be strengthened to improve nutritional care.
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Affiliation(s)
- Ella Ottrey
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia.,Dietetics Department, Eastern Health, Box Hill, VIC, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Catherine E Huggins
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Judi Porter
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia.,Allied Health Clinical Research Office, Eastern Health, Box Hill, VIC, Australia
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Markovski K, Nenov A, Ottaway A, Skinner E. Does eating environment have an impact on the protein and energy intake in the hospitalised elderly? Nutr Diet 2016; 74:224-228. [DOI: 10.1111/1747-0080.12314] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 07/05/2016] [Accepted: 07/15/2016] [Indexed: 12/01/2022]
Affiliation(s)
| | - Aranka Nenov
- Western Health Hospital; Melbourne Victoria Australia
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Abd-El-Gawad WM, Rasheedy D. Nutrition in the Hospitalized Elderly. MOLECULAR BASIS OF NUTRITION AND AGING 2016:57-72. [DOI: 10.1016/b978-0-12-801816-3.00006-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Abstract
BackgroundIn Canada, the rise of private-pay assisted living facilities is changing the long-term care landscape. Even so, few clinical implications of having these facilities in the spectrum of care have been studied. Our objective was to compare events and symptoms that might predispose and precipitate a move of older adults to assisted living or to a nursing home.MethodsCross-sectional, descriptive Nova Scotia survey of residents and family members on admission. Health-care use and dementia diagnosis were recorded from the admission record. Dementia was staged using the Global Deterioration Scale and the Dependence Scale. The SymptomGuide, a standardized dementia symptom inventory, was used to assay which symptoms were most influential in the decision to seek long term care. Caregiver stress was elicited by a self-report questionnaire.ResultsOf 353 people admitted during the enrolment period, 174 (49%) took part in the survey. Most (97; 55.7%) were involved in a move from the community to a nursing home, 54 (31.0%) from the community to assisted living, and 23 (13.2%) from assisted living to a nursing home. In each setting, dementia was the commonest predisposing factor (seen in >90%) with a precipitating event seen in 120 (69%) people. The precipitating events included a medical illness (n = 97; 55%) or caregiver illness, death or move (33; 19%). Dependence was associated with place of care, with more severely impaired people more commonly represented in people who moved to nursing homes.ConclusionsPeople move from the community chiefly due to dementia, and often with a precipitant. Compared with a move to assisted living, moving to nursing homes generally indicates greater dependence, and typically worse dementia severity. Even so, assisted-living facilities are not just for the “worried well”, but are used by people with dementia, caregiver stress, and recent hospitalization.
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