Contenuto dell'articolo principale

Abstract

Scopo: valutare le attitudini degli infermieri nei confronti dell'assistenza nutrizionale nell'anziano ospedalizzato, utilizzando la scala "The Staff Attitudes To Nutritional Nursing Care Geriatric Scale (SANN-G Scale)", recentemente validata in lingua italiana. Metodo: è stata condotta un'indagine descrittiva, coinvolgendo tutti i coordinatori e gli infermieri delle unití  operative di tipo medico presso le aziende ospedaliere Clinica Universitaria San Martino di Genova e Asl3 Genovese di Villa Scassi. È stato eseguito un confronto utilizzando il test di Kruscall-Wallis tra le unití  operative, al fine di capire se vi erano differenze significative nelle attitudini rispetto all'assistenza nutrizionale. Si sono confrontati i risultati di coloro che avevano seguito un corso sull'assistenza nutrizionale e coloro che non lo avevano fatto, utilizzando il test MannWhitney. Risultati: su 110 questionari somministrati ne sono stati riconsegnati 103 (94%). Solo il 26% dei partecipanti hanno dimostrato un'attitudine nettamente positiva rispetto all'assistenza nutrizionale nell'anziano. Non sono state trovate differenze significative né tra una Unití  Operativa e l'altra né tra chi ha seguito corsi e chi no. Conclusioni: Lo studio ha evidenziato una sostanziale attitudine negativa dei partecipanti nei confronti dell'assistenza nutrizionale nell'anziano e della malnutrizione, confermando che gli aspetti legati all'alimentazione della persona anziana spesso passano in secondo piano, rispetto ad altre attivití  assistenziali. I nostri risultati sono sovrapponibili a quanto avviene a livello internazionale. È perciò necessario anche in Italia aumentare la consapevolezza degli operatori sanitari su queste problematiche.

Parole chiave: attitudine personale sanitario, stato nutrizionale, geriatria, malnutrizione, staff infermieristico, dietista.

 

Nurses' attitudes towards nutritional care and malnutrition in hospitalised older people: A Survey in the Liguria Region

Aim: Evaluate nurses' attitudes towards nutritional assistance in elderly hospitalized individuals, using the scale "The Staff Attitudes To Nutritional Geriatric Nursing Care Scale (SANN-G Scale)", recently validated in Italian. Methods: A descriptive survey was carried out, involving all head nurses and nurses of wards within University Hospital San Martino Hospital in Genoa and ASL3 Genovese Villa Scassi. A comparison was carried out using the Kruscall-Wallis test between wards, in order to determine whether there were significant differences in attitudes with respect to nutritional assistance. Results were compared between individuals who had follow a lecture on nutritional assistance and those who had not, using the test Mann Whitney. Results: 110 questionnaires were delivered of these 103 were filled in (94%). Only 26% of the sample shows to have a strong positive attitude with respect nutritional assistance in elderly people. No significant differences were found either between wards and the other or between those who nurse had lecturer and those who have not. Conclusions: The study revealed a substantial negative attitude with respect to nutritional assitance and malnutrition in the elderly, confirming that aspects related to nutrition of the elderly are not properly taken into account in comparison to other nursing care activities. Our results are similar to those of the internationl literature. There is therefore a need also in Italy to increase awareness of professionals on these issues.

Key words: Attitude of Health Personnel, nutritional status, geriatrics, malnutrition, nursing staff, dietetics

Dettagli dell'articolo

Come citare
Casanova, N., Bagnasco, A., Bonetti, L., & Sasso, L. (2016). Attitudini degli infermieri nei confronti dell’assistenza nutrizionale e della malnutrizione nell’anziano in ospedale: un’indagine nella Regione Liguria. PROFESSIONI INFERMIERISTICHE, 68(4). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/151

Riferimenti

  • Adams, N.E., Bowie, A.J., Simmance, N., Murray, M., & Crowe, T.C. (2008) Recognition by medical and nursing professionals of malnutrition and risk of malnutrition in elderly hospitalised patients. Nutrition & Dietetics, 65, 144150. doi:10.1111/j.17470080.2008.00226.x
  • Bachrach- Lindstrí¶m, M., Jensen, S., Lundin, R., & Christensson, L. (2007) Attitudes of nursing staff working with older people towards nutritional nursing care. Journal of Clinical Nursing, 16, 2007-2014
  • Bavelaar, J.W., Otter, C.D., van Bodegraven, A.A., Thijs, A., & van Bokhorst-de van der Schueren, M.A. (2008) Diagnosis and treatment of (disease-related) in hospital malnutrition: the performance of medical and nursing staff. Clinical Nutrition, 27, 431-438. doi: 10.1016/j.clnu.2008.01.016.
  • Bauer, S., Halfens, R.J., & Lohrmann, C. (2015) Knowledge and Attitudes of Nursing Staff Towards Malnutrition Care in Nursing Homes: A Multicentre Cross-Sectional Study. Journal of Nutrition Health & Aging, 19(7):734-740. doi: 10.1007/s12603-015-0535-7.
  • Beck, A.M., Balknäs, U.N., Camilo, M.E., Fí¼rst, P., Gentile, M.G., Hasunen, K., Jones, L., Jonkers-Schuitema, C., Keller, U., Melchior, J.C., Mikkelsen, B.E., Pavcic, M., Schauder, P., Sivonen, L., Zinck, O., í˜ien, H., & Ovesen, L. (2002) Practices in relation to nutritional care and support"”report from the Council of Europe. Clinical Nutrition, 21, 351-354.
  • Bonetti, L., Bagnasco A., Aleo, G., & Sasso, L. (2013) "˜The transit of the food trolley' – malnutrition in older people and nurses' perception of the problem. Scandinavian Journal of Caring Sciences, 27(2), 440-444. doi: 10.1111/j.1471-6712.2012.01043.x
  • Bonetti, L., Bagnasco A., Aleo, G., & Sasso, L. (2013) Validation of the Staff Attitudes to Nutritional Nursing Care Geriatric scale in Italian. International Nursing Review, 60(3), 389-396, doi: 10.1111/inr.12033.
  • Bjerrum, M., Tewes, M., & Pedersen, P. (2012) Nurses' self-reported knowledge about and attitude to nutrition- before and after a training programme. Scandinavian Journal of Caring Sciences, 26, 81-89. doi: 10.1111/j.1471-6712.2011.00906.x.
  • Cairella, G. & Berni Canani, R. (2007) La malnutrizione. in Fatati, G. Dietetica e nutrizione. Clinica, terapia e organizzazione. Roma: Il pensiero Scientifico editore.
  • Chapman, I.M. (2006) Nutritional Disorders in the Elderly. The Medical Clinics of North America, 90, 887-907.
  • Christensson, L., & Bachrach- Lindstrí¶m, M. (2009) Adapting "the staff attitudes to nutritional nursing care scale" to geriatric nursing care. Journal of Nutrition Health & Aging, 13(2), 102-107.
  • Christensson, L., Ek, A.C., & Unosson, M. (2001) Individually adjusted meals for older people with protein- energy malnutrition: a single-case study. Journal of Clinical Nursing, 10, 491-502.
  • Christensson, L., Unosson, M., Bachrach- Lindstrí¶m, M., & Ek, A.C. (2003) Attitudes of nursing staff towards nutritional nursing care. Scandinavian Journal of Caring Sciences, 17, 223-231.
  • Correira, M.I., & Waitzberg, D.L. (2003) The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clinical Nutrition, 22, 235-239.
  • Destrebecq, A.L., & Lodini, R. (2008) La malnutrizione energetico-proteica nel paziente anziano ricoverato in unití operativa di medicina: il contributo infermieristico nella valutazione nutrizionale e nella gestione del pasto ospedaliero. International nursing perspectives, 8(2), 65–71.
  • Determina del Commissario Straordinario ARS Liguria n.58 del 30/07/2012 "Indirizzi regionali ai sensi dell'art.62, comma 2 bis, della L.R. n. 41/2006 e ss.mm. E ii. per la "Gestione della malnutrizione ospedaliera".
  • Eberhardie, C. (2002) Nutrition and the older adult. Nursing Older People, 4(2), 22-27.
  • Green, S.M., & Watson, R. (2006) Nutritional screening and assessment tools for older adults: literature review. Journal of Advanced Nursing, 54(4), 477-490.
  • Grol, R., & Grimshaw, J. (2003) From best evidence to best practice: effective implementation of change in patients' care. The lancet, 362(9391):1225-30.
  • ISTAT (2007). Previsioni demografiche 1° Gennaio 2007- 1° Gennaio 2051. [Online]. 2007 (Consultato il 21.01.10; disponibile all'indirizzo:http://www.istat.it/salastampa/comunicati/non_calendario/20080619_00/testointegrale20080619.pdf )
  • ISTAT (2012) Noi Italia, 100 statistiche per capire il paese in cui viviamo. (Consultato il 14 febbraio 2013; disponibile all'indirizzo: http://noi63 italia.istat.it/index.php?id=6&user_100ind_pi1[uid_categoria]=3&cHash=96f288d6c52c849a2a9b820b69b01e87).
  • Johnstone, C., Farley, A., & Hendry, C. (2006a) Nurses' role in nutritional assessment and screening. Part 1. Nursing Times, 102(49), 28-29.
  • Johnstone, C., Farley, A., & Hendry, C. (2006b) Nurses' role in nutritional assessment and screening. Part 2. Nursing Times, 102(50), 28-29.
  • Kondrup, J., Allison, S.P., Elia, M., Vellas, B., & Plauth, M. (2003) ESPEN Guidelines for Nutritional Screening 2002. Clinical Nutrition, 22(4), 415-21.
  • Kondrup, J., Johansen, N., Plum, L.M., Bak, L, Larsen IH, Martinsen A...Lauesen, N. (2002) Incidence of nutritional risk and causes of inadequate nutritional care in hospitals. Clinical Nutrition, 21(6), 461-468.
  • Lazarus C., & Hamlyn, J. (2005) Prevalence and documentation of malnutrition in hospital: a case study in a large private hospital setting. Nutrition & Dietetics 62, 41-47. doi: 10.1111/j.1747-0080.2005.tb00008.x
  • Lucchin, L, D'Amicis, A, Gentile, M.G., Battistini N.C, Fusco, MA., Palmo, A., Muscaritoli, M., Contaldo, F., & Cereda, E. (2009) An italian investigation on nutritional risk at hospital admission: the PIMAI: (Project: Iatrogenic MAlnutrition in Italy) study. The European e-Journal of Clinical Nutrition and Metabolis ;4:e199-e202.
  • Milne, A.C., Potter, J., Vivanti, A., & Avenell A. (2009) Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane database of systematic review, 15(2), doi: 10.1002/14651858.CD003288.pub3.
  • Mowe, M., Bosaeus, I., Rasmussen, H.H., Kondrup, J., Unosson, M., Rothenberg, E. & Irtun í˜ (2008) Insufficient nutritional knowledge among health care workers? Clinical Nutrition, 27, 196-202. doi: 10.1016/j.clnu.2007.10.014.
  • Mowe, M., Bosaeus, I., Rasmussenc, H.H., Kondrup, J., Unosson, M., & Irtun í˜. (2006) Nutritional routines and attitudes among doctors and nurses in Scandinavia: A questionnaire based survey. Clinical Nutrition, 25, 524–532.
  • Nijs, K.A., de Graaf, C., Siebelink, E., Blauw, Y.H., Vanneste, V., Kok, F.J., & van Staveren, W.A. (2006) Effect of Family-Style Meals on Energy Intake and Risk of Malnutrition in Dutch Nursing Home Residents: A randomized Controlled Trial. The Journals of gerontology. Series A, Biological sciences and medical sciences, 61A(9), 935-942.
  • Paquet, C., St-Arnaud-McKenzie, D., Kergoat, M.J., Ferland, G., & Dubé, L. (2003) Direct and Indirect Effects of Everyday Emotion on Food Intake of Elderly Patients in Istitutions. The Journals of gerontology. Series A, Biological sciences and medical sciences, 58(2): 153-158.
  • Paquet, C., St-Arnaud-McKenzie, D., Ma, Z., Kergoat, M.J., Ferland, G., & Dubé, L.(2008) More than just not being alone: the number, nature, and complementarity of meal-time social interactions influence food intake in hospitalized elderly patients. The Gerontologist, 48(5), 603-611.
  • Persenius, M.W., Hall-Lord, M.L., Bí¥í¥th, C., & Larsson, B.W. (2008) Assessment and documentation of patients' nutritional status: perceptions of registered nurses and their chief nurses. Journal of Clinical Nursing, 17, 2125- 2136. doi: 10.1111/j.1365-2702.2007.02202.x.
  • Polit, D.F. & Tatano Beck, C. (2004) Nursing research. Principles and Methods. VII ed., Lippicott Williams & Wilkins, Philadelphia PA, US.
  • Price, D.M. (2008) Protein-energy malnutrition among the elderly: implications for nursing care. Holistic Nursing Practice, 22(6), 355-360. doi: 10.1097/01.HNP.0000339347.03629.41.
  • Simmons, S.F., Keeler, E., Zhuo, X., Hickey, K.A., Sato, H.W., & Schnelle, J.F. (2008) Prevention of unintentional weight loss in nursing home residents: a controlled trial of feeding assistance. Journal of the American Geriatrics Society, 56, 1466-1473. doi: 10.1111/j.1532-5415.2008 .01801.x.
  • Suominen, M.H., Sandelin, E., Soini, H., & Pitkala, K.H. (2009) How well do nurses recognize malnutrition in elderly patients? European Journal of Clinical Nutrition, 63, 292-296.
  • Teo, Y.K., & Wynne, H.A. (2001) Malnutrition of the elderly patient in hospital: risk factors, detection and management. Reviews in Clinical Gerontology, 11, 229-236.
  • Vanderwee, K., Clays, E., Bocquaert, I., Verhaeghe, S., Lardennois, M., Gobert, M., & Defloor, T. (2011) Malnutrition and nutritional care practices in hospital wards for older people. Journal of Advanced Nursing, 67, 736–746. doi: 10.1111/j.1365-2648.2010.05531.x.