Abstract
BackgroundRecent studies indicate inadequate nutritional care practices in healthcare institutions and identify several barriers to perform individualized nutritional care to older persons. Organisation of care can become rigid and standardised, thus failing to be respectful of and responsive to each person’s needs and preferences. There is limited research exploring health professionals’ views on how structure of care allows them to individualize nutritional care to older persons. In this study we aim to explore how healthcare professionals’ experience providing individualised nutritional care within the organisational frames of acute geriatric hospital care and home care.MethodsSemi-structured interviews with 23 healthcare professionals from hospital acute geriatric care and home care. Interviews were analyzed using thematic analysis.ResultsTwo main themes and six sub-themes emerged from the material. Theme 1: ‘Meeting patients with complex nutritional problems’ with the sub-themes: ‘It is much more complex than just not eating’ and ‘seeing nutrition as a part of the whole’. Theme 2: ‘The structure of the nutritional care’, with the sub-themes: ‘Nutritional routines: Much ado, but for what?’, ‘lack of time to individualize nutritional care’, ‘lack of interdisciplinary collaboration in nutritional care’ and ‘meeting challenging situations with limited resources in home care’.ConclusionsThe healthcare professionals described having a high focus on and priority of nutritional care when caring for older persons. They did however find it challenging to practice individualized nutritional care due to the complexity of the patients’ nutritional problems and constraints in the way nutritional care was organised. By describing the challenges the healthcare professionals face when trying to individualize the nutritional care, this study may provide important knowledge to health professionals and policy makers on how to decrease the gap between older patients’ preferences for care and nutritional care practice.
Highlights
Recent studies indicate inadequate nutritional care practices in healthcare institutions and identify several barriers to perform individualized nutritional care to older persons
Over the past 10 decades, studies have reported a high prevalence of malnutrition and inadequate nutritional care practices in healthcare institutions; in spite of these findings, the problem has persisted [1]
Sampling Participation required that the healthcare professionals were involved in providing nutritional care to older patients and that they held a minimum 50% position at a geriatric hospital ward or in home care services
Summary
Recent studies indicate inadequate nutritional care practices in healthcare institutions and identify several barriers to perform individualized nutritional care to older persons. A recent study found that healthcare professionals experienced a conflict between respecting a patient’s autonomy and practicing standardised nutritional care [14]. Healthcare professionals’ personal values and beliefs about what constitutes good nutritional care may conflict with the care they are able to deliver within these institutional constraints, resulting in a sense of inadequacy about their work. They are confronted with pressure from clients/patients with infinite needs [18]
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