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The impact of trained volunteer mealtime assistants on the dietary intake of older female in-patients: the Southampton Mealtime Assistance Study

The impact of trained volunteer mealtime assistants on the dietary intake of older female in-patients: the Southampton Mealtime Assistance Study
The impact of trained volunteer mealtime assistants on the dietary intake of older female in-patients: the Southampton Mealtime Assistance Study

Objective: Malnutrition among older hospital inpatients is common and is associated with poor clinical outcomes. Time-pressured staff may struggle to provide mealtime assistance. This study aimed to evaluate the impact of trained volunteer mealtime assistants on the dietary intake of older inpatients.

Design: Quasi-experimental two year pre and post- test study of the introduction of volunteer mealtime assistants to one acute medical female ward, with contemporaneous comparison with a control ward.

Setting: Two acute medical female wards in a university hospital in England.

Participants: Female acute medical inpatients aged 70 years and over who were not tube fed, nil by mouth, terminally ill or being nursed in a side room.

Intervention: The introduction of volunteer mealtime assistants to one ward to help patients during weekday lunchtimes in the intervention year.

Measurements: Patients’ background and clinical characteristics were assessed; 24-hour records were completed for individual patients to document dietary intake in both years on the two wards.

Results: A total of 407 patients, mean (SD) age 87.5 (5.4) years, were studied over the two-year period; the majority (57%) needed mealtime assistance and up to 50% were confused. Patients’ clinical characteristics did not differ between wards in the observational or intervention years. Throughout the intervention year volunteers provided mealtime assistance on weekday lunchtimes on the intervention ward only. Daily energy (median 1039 kcal; IQR 709, 1414) and protein (median 38.9 g: IQR 26.6, 54.0) intakes were very low (n=407). No differences in dietary intake were found between the wards in the observational or intervention years, or in a pre-post-test comparison of patients on the intervention ward. Data were therefore combined for further analysis to explore influences on dietary intake. In a multivariate model, the only independent predictor of energy intake was the feeding assistance required by patients; greater need for help was associated with lower energy intake (P<0.001). Independent predictors of protein intake were the feeding assistance given (P<0.001) and use of sip feeds; sip feed users had slightly higher protein intakes (P=0.014).

Conclusions: Trained volunteers were able to deliver mealtime assistance on a large scale in an effective and sustainable manner, with the potential to release time for nursing staff to complete other clinical tasks. The study participants had a low median intake of energy and protein highlighting the importance of patient factors associated with acute illness; a stratified approach including oral and parenteral nutritional supplementation may be required for some acutely unwell patients. The level of mealtime assistance required was the factor most strongly associated with patients’ poor intake of energy and protein and may be a useful simple indicator of patients at risk of poor nutrition.

1279-7707
320-328
Roberts, Helen C.
5ea688b1-ef7a-4173-9da0-26290e18f253
Pilgrim, Anna L.
77ab2a9e-8b72-455b-99fa-0bb0a645c39f
Jameson, Karen A.
d5fb142d-06af-456e-9016-17497f94e9f2
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Aihie Sayer, Avan
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Robinson, Sian
ba591c98-4380-456a-be8a-c452f992b69b
Roberts, Helen C.
5ea688b1-ef7a-4173-9da0-26290e18f253
Pilgrim, Anna L.
77ab2a9e-8b72-455b-99fa-0bb0a645c39f
Jameson, Karen A.
d5fb142d-06af-456e-9016-17497f94e9f2
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Aihie Sayer, Avan
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Robinson, Sian
ba591c98-4380-456a-be8a-c452f992b69b

Roberts, Helen C., Pilgrim, Anna L., Jameson, Karen A., Cooper, Cyrus, Aihie Sayer, Avan and Robinson, Sian (2017) The impact of trained volunteer mealtime assistants on the dietary intake of older female in-patients: the Southampton Mealtime Assistance Study. The Journal of Nutrition, Health & Aging, 21 (3), 320-328. (doi:10.1007/s12603-016-0791-1).

Record type: Article

Abstract

Objective: Malnutrition among older hospital inpatients is common and is associated with poor clinical outcomes. Time-pressured staff may struggle to provide mealtime assistance. This study aimed to evaluate the impact of trained volunteer mealtime assistants on the dietary intake of older inpatients.

Design: Quasi-experimental two year pre and post- test study of the introduction of volunteer mealtime assistants to one acute medical female ward, with contemporaneous comparison with a control ward.

Setting: Two acute medical female wards in a university hospital in England.

Participants: Female acute medical inpatients aged 70 years and over who were not tube fed, nil by mouth, terminally ill or being nursed in a side room.

Intervention: The introduction of volunteer mealtime assistants to one ward to help patients during weekday lunchtimes in the intervention year.

Measurements: Patients’ background and clinical characteristics were assessed; 24-hour records were completed for individual patients to document dietary intake in both years on the two wards.

Results: A total of 407 patients, mean (SD) age 87.5 (5.4) years, were studied over the two-year period; the majority (57%) needed mealtime assistance and up to 50% were confused. Patients’ clinical characteristics did not differ between wards in the observational or intervention years. Throughout the intervention year volunteers provided mealtime assistance on weekday lunchtimes on the intervention ward only. Daily energy (median 1039 kcal; IQR 709, 1414) and protein (median 38.9 g: IQR 26.6, 54.0) intakes were very low (n=407). No differences in dietary intake were found between the wards in the observational or intervention years, or in a pre-post-test comparison of patients on the intervention ward. Data were therefore combined for further analysis to explore influences on dietary intake. In a multivariate model, the only independent predictor of energy intake was the feeding assistance required by patients; greater need for help was associated with lower energy intake (P<0.001). Independent predictors of protein intake were the feeding assistance given (P<0.001) and use of sip feeds; sip feed users had slightly higher protein intakes (P=0.014).

Conclusions: Trained volunteers were able to deliver mealtime assistance on a large scale in an effective and sustainable manner, with the potential to release time for nursing staff to complete other clinical tasks. The study participants had a low median intake of energy and protein highlighting the importance of patient factors associated with acute illness; a stratified approach including oral and parenteral nutritional supplementation may be required for some acutely unwell patients. The level of mealtime assistance required was the factor most strongly associated with patients’ poor intake of energy and protein and may be a useful simple indicator of patients at risk of poor nutrition.

Full text not available from this repository.

More information

Accepted/In Press date: 16 June 2016
e-pub ahead of print date: 6 September 2016
Published date: March 2017
Organisations: Faculty of Medicine, Medical Research Council, Human Development & Health

Identifiers

Local EPrints ID: 410372
URI: http://eprints.soton.ac.uk/id/eprint/410372
ISSN: 1279-7707
PURE UUID: a93f6b86-a6db-4781-af11-2d91b9e64eac
ORCID for Helen C. Roberts: ORCID iD orcid.org/0000-0002-5291-1880
ORCID for Anna L. Pilgrim: ORCID iD orcid.org/0000-0002-3645-8289
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Sian Robinson: ORCID iD orcid.org/0000-0003-1766-7269

Catalogue record

Date deposited: 07 Jun 2017 16:31
Last modified: 18 Feb 2021 17:00

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