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: Approximately 14% of free-living adults aged ≥65 years are at risk of malnutrition. Malnutrition screen and treat interventions in primary care are few, show mixed results, and the advice given is not always accepted and followed. We need to better understand the experiences and contexts of older adults when aiming to develop interventions that are engaging, optimally persuasive and relevant. Methods: Using the Person-based Approach, we carried out 23 semi-structured interviews with purposively selected adults ≥65 years 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 an inevitable decline in appetite and eating in older age compound the many and varied physical and physiological barriers that 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 general practitioners for advice. Conclusions: The key findings identified include a sense of resignation, multiple different barriers to eating and a need for independence, each underpinned by the expectation of a decline in older adulthood. Interventions need to address misperceptions about the inevitability of decline, highlight how and why diet recommendations are somewhat different from 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
841-851
Payne, Liz
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Harris, Philine S.
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Ghio, Daniela
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Slodkowska-Barabasz, Joanna
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Sutcliffe, Michelle
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Kelly, Joanne Marie
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Stroud, Michael A.
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Little, Paul
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Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Morrison, Leanne
920a4eda-0f9d-4bd9-842d-6873b1afafef
1 December 2020
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), .
(doi:10.1111/jhn.12807).
Abstract
Background: Approximately 14% of free-living adults aged ≥65 years are at risk of malnutrition. Malnutrition screen and treat interventions in primary care are few, show mixed results, and the advice given is not always accepted and followed. We need to better understand the experiences and contexts of older adults when aiming to develop interventions that are engaging, optimally persuasive and relevant. Methods: Using the Person-based Approach, we carried out 23 semi-structured interviews with purposively selected adults ≥65 years 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 an inevitable decline in appetite and eating in older age compound the many and varied physical and physiological barriers that 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 general practitioners for advice. Conclusions: The key findings identified include a sense of resignation, multiple different barriers to eating and a need for independence, each underpinned by the expectation of a decline in older adulthood. Interventions need to address misperceptions about the inevitability of decline, highlight how and why diet recommendations are somewhat different from recommendations for the general population, and suggest easy ways to increase food intake that address common barriers.
Text
Payne et al 2020 Accepted manuscript
- Accepted Manuscript
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jhn.12807
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More information
Accepted/In Press date: 23 July 2020
e-pub ahead of print date: 25 August 2020
Published date: 1 December 2020
Additional Information:
Funding Information:
This paper is from the STREAM project, which aims to develop and test an intervention targeting healthcare professionals and older adults in primary care, funded from an NIHR Programme Grant for Applied Research, Reference RP‐PG‐0614‐20004. The research programme of LY and LM is partly supported by the NIHR Southampton Biomedical Research Centre. The funding body approved the project team’s study design, although it was not involved in the data collection, analysis or write‐up.
Publisher Copyright:
© 2020 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association
Keywords:
Person-based Approach, Malnutrition, Older adults, Eating patterns, Intervention 31 development, Qualitative research
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Local EPrints ID: 443275
URI: http://eprints.soton.ac.uk/id/eprint/443275
ISSN: 0952-3871
PURE UUID: 2e45de6d-a6b3-4652-9e33-0f02e6819cbf
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Date deposited: 19 Aug 2020 16:32
Last modified: 17 Mar 2024 05:49
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Contributors
Author:
Philine S. Harris
Author:
Daniela Ghio
Author:
Michelle Sutcliffe
Author:
Michael A. Stroud
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