Indagine in merito alla gestione alimentare del paziente pediatrico (Survey on the food management of pediatric patients)

Abstract

Background: The purpose of this pilot study was to evaluate pediatric hospital meals in terms of servings, taste and daily schedule, trying to assess a possible related risk of malnutrition, within the pediatric ward of Pisa university hospital (AOUP).Methods: This research involved 42 patients of the pediatric ward of Pisa university hospital (AOUP).For each patient we considered the following parameters: weight, height, Body Mass Index (BMI), age and type of disease.Survey: This survey used two assessment questionnaires: the Pediatric Yorkhill Malnutrition Score (PYMS) and a questionnaire that refers to Customer Satisfaction.It can be divided in five parts: evaluation of nutritional support; qualitative evaluation of meals; study on Snacks; particular eating habits and special requests; meal ordering mode.Results: PYMS results show a considerable hospital undernourishment in the 55% of our patients; this is a well know problem, already pointed out by Italian ISTAT (Italian National Statistics Institute) data.Crosschecking our data, we observed that a substantial risk of malnutrition is related to gastrointestinal pathologies and it increases along with the duration of the hospitalization period.A qualitative analysis of meals provided good results.However, the 83% of patients declared that they could not finish their meals, mostly due to their disease and to the portion size. It appeared that the average served amount of food is too abundant for children under the age of six, according to LARN standards of food quantities for that age range.The 79% of patients said that it would be useful that the hospital provided at least one healthy snacks during the day, according to the National guidelines for Pediatric Hospital Catering; unfortunately no snacks were served all day long in pediatric wards. So the 69% of patients ate snacks brought from outside the hospital, mostly prepackaged high-calorie snacks or fast food.Special requests from patients, mostly related to intolerances or allergies, were all satisfied, but there appeared to be some problems to satisfy the requests of foreign patients.Conclusions: A lack of meals adaptation to pediatric needs causes a larger rate of waste and higher expenses, along with a decreased Customer Satisfaction. A possible solution could be represented by the reduction of the amount of food servings for children under the age of 6, together with the introduction of at least one snack in their daily meal routine.Providing foreign patients with a translated menu would improve their food choices awareness.All these new ideas should be able to reduce the nutrition risk in pediatric wards.