Abstract
Eating difficulties and nutritional deficits are common among persons with acute stroke and during rehabilitation. Little is known about such problems after discharge from hospital. In addition the relationship between fatigue and nutritional status among stroke survivors living in the community remains to be explored. The aim of this pilot study was to describe mealtime preparation, eating, fatigue, mood and nutritional status among persons with stroke six months after discharge from hospital and to explore associations between these factors. Patients were interviewed six months poststroke. Standardised questions and methods were used. The mean age of the 89 respondents was 77.2 (SD 6.6) years, 44 were women and 45 men. Difficulties with swallowing, ingestion and energy to eat occurred among 27%, 20% and 7% respectively. Difficulties with cooking and buying food occurred among 57% and 56% respectively and 41% were at nutritional risk. Feeling full of energy less than some of the time was experienced by 61% while 15% had felt gloomy and sad at least some of the time during the previous four weeks. Considering activities of daily living (ADL), having a less favourable nutritional status was significantly predicted by difficulties with buying food, difficulties with ingestion and being a woman. Considering psychological state (mood and energy), having a less favourable nutritional status was significantly predicted by a lack of energy and high age. This study supports the occurrence of a nutritionally related fatigue by means of “lack of energy”. The associations between poor nutritional status and fatigue can work in both directions. Thus persons with fatigue are more prone to have poor nutritional status and those with poor nutritional status are at greater risk of fatigue. Besides fatigue also difficulties with buying food and ingestion are associated with nutritional risk. As nutritional deficits occur a long time after stroke onset it is important to assess aspects of mealtime preparation and the eating process and when necessary provide food delivery service and eating assistance in order to prevent a vicious circle of undernourishment and fatigue to develop.
Highlights
Eating difficulties and nutritional deficits are common among persons with acute stroke and during rehabilitation [1, 2]
The results indicate that most of the patients were in need of help with home-care activities while most only had a moderate dependency in personal activities of daily living
As nutritional deficits occur a long time after stroke onset it is important to assess aspects of mealtime preparation as well as the eating process and when necessary provide food delivery service and eating assistance in order to prevent a vicious circle of undernourishment and fatigue to develop
Summary
Eating difficulties and nutritional deficits are common among persons with acute stroke and during rehabilitation [1, 2]. Little is known about such problems after discharge from hospital. In addition there is a lack of knowledge about the associations between fatigue and nutritional status in this group. Stroke has a significant impact on health due to its high incidence, prevalence and subsequent disability rate [3]. Stroke patients can experience disabilities that influence eating habits and dietary intake. Stroke can cause problems with mealtime-related activities such as buying and cooking food, and it can affect the mealtime situation by causing eating difficulties. Various functional impairments relating to arm movement, posture, lip closure, chewing and swallowing abilities, perception, attention and sensation contribute to eating difficulties among stroke survivors [4]
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