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Beliefs about inevitable decline among home-living older adults at risk of malnutrition: a qualitative study

Beliefs about inevitable decline among home-living older adults at risk of malnutrition: a qualitative study
Beliefs about inevitable decline among home-living older adults at risk of malnutrition: a qualitative study
Background: about 14% of free-living adults aged 65 and over are at risk of malnutrition. Malnutrition screen and treat interventions in primary care are few, show mixed results and advice given is not always accepted and followed. We need to better understand the experiences and contexts of older adults in order to develop interventions that are engaging, optimally persuasive and relevant.

Methodology: using the Person-based Approach, we carried out 23 semi-structured interviews with purposively selected adults aged 65 and over with chronic health or social conditions associated with malnutrition risk. Thematic analysis informed the development of key principles to guide planned intervention development.

Results: we found that individuals’ beliefs about inevitable decline in appetite and eating in older age compounds the many and varied physical and physiological barriers they experience. Also, we found that expectations of decline in appetite and physical ability may encourage resignation, reduce self-efficacy to overcome barriers and reduce motivation to address weight loss and/or recognise it as an issue that needs to be addressed. Fear of loss of independence may also reduce the likelihood of asking GPs for advice.

Principal conclusions: key findings identified include a sense of resignation, multiple different barriers to eating, and a need for independence, each underpinned by expectation of decline in older adulthood. Interventions need to address misperceptions about the inevitability of decline, highlight how and why diet recommendations are somewhat different to recommendations for the general population, and suggest easy ways to increase food intake that address common barriers.
Person-based Approach, Malnutrition, Older adults, Eating patterns, Intervention 31 development, Qualitative research
0952-3871
841-851
Payne, Liz
862f8fcf-711d-4146-a723-a9109339c70a
Harris, Philine S.
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Ghio, Daniela
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Slodkowska-Barabasz, Joanna
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Sutcliffe, Michelle
223dd288-72e7-4da0-baf7-f9937260bbae
Kelly, Joanne Marie
b7094829-aeb1-4bc1-b64c-7b7c716f73b5
Stroud, Michael A.
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Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Morrison, Leanne
920a4eda-0f9d-4bd9-842d-6873b1afafef
Payne, Liz
862f8fcf-711d-4146-a723-a9109339c70a
Harris, Philine S.
f58996a4-7dfc-4960-aa27-0bc5d40674e8
Ghio, Daniela
68e87380-d790-4f20-b24d-d3ac0ca5765d
Slodkowska-Barabasz, Joanna
18182048-55ee-474c-9790-1f5b81fa585c
Sutcliffe, Michelle
223dd288-72e7-4da0-baf7-f9937260bbae
Kelly, Joanne Marie
b7094829-aeb1-4bc1-b64c-7b7c716f73b5
Stroud, Michael A.
4543ff51-a8fe-4271-b11d-636a2f30c12f
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Morrison, Leanne
920a4eda-0f9d-4bd9-842d-6873b1afafef

Payne, Liz, Harris, Philine S., Ghio, Daniela, Slodkowska-Barabasz, Joanna, Sutcliffe, Michelle, Kelly, Joanne Marie, Stroud, Michael A., Little, Paul, Yardley, Lucy and Morrison, Leanne (2020) Beliefs about inevitable decline among home-living older adults at risk of malnutrition: a qualitative study. Journal of Human Nutrition and Dietetics, 33 (6), 841-851. (doi:10.1111/jhn.12807).

Record type: Article

Abstract

Background: about 14% of free-living adults aged 65 and over are at risk of malnutrition. Malnutrition screen and treat interventions in primary care are few, show mixed results and advice given is not always accepted and followed. We need to better understand the experiences and contexts of older adults in order to develop interventions that are engaging, optimally persuasive and relevant.

Methodology: using the Person-based Approach, we carried out 23 semi-structured interviews with purposively selected adults aged 65 and over with chronic health or social conditions associated with malnutrition risk. Thematic analysis informed the development of key principles to guide planned intervention development.

Results: we found that individuals’ beliefs about inevitable decline in appetite and eating in older age compounds the many and varied physical and physiological barriers they experience. Also, we found that expectations of decline in appetite and physical ability may encourage resignation, reduce self-efficacy to overcome barriers and reduce motivation to address weight loss and/or recognise it as an issue that needs to be addressed. Fear of loss of independence may also reduce the likelihood of asking GPs for advice.

Principal conclusions: key findings identified include a sense of resignation, multiple different barriers to eating, and a need for independence, each underpinned by expectation of decline in older adulthood. Interventions need to address misperceptions about the inevitability of decline, highlight how and why diet recommendations are somewhat different to recommendations for the general population, and suggest easy ways to increase food intake that address common barriers.

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Accepted/In Press date: 23 July 2020
e-pub ahead of print date: 25 August 2020
Keywords: Person-based Approach, Malnutrition, Older adults, Eating patterns, Intervention 31 development, Qualitative research

Identifiers

Local EPrints ID: 443275
URI: http://eprints.soton.ac.uk/id/eprint/443275
ISSN: 0952-3871
PURE UUID: 2e45de6d-a6b3-4652-9e33-0f02e6819cbf
ORCID for Liz Payne: ORCID iD orcid.org/0000-0002-6594-5668
ORCID for Philine S. Harris: ORCID iD orcid.org/0000-0001-6289-129X
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X
ORCID for Leanne Morrison: ORCID iD orcid.org/0000-0002-9961-551X

Catalogue record

Date deposited: 19 Aug 2020 16:32
Last modified: 10 Jan 2022 06:08

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Contributors

Author: Liz Payne ORCID iD
Author: Philine S. Harris ORCID iD
Author: Daniela Ghio
Author: Michelle Sutcliffe
Author: Michael A. Stroud
Author: Paul Little
Author: Lucy Yardley ORCID iD
Author: Leanne Morrison ORCID iD

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