Nutritional care of older people: investigating nurses’ attitudes in medical and surgical units.

Abstract

Background Malnutrition in older people in hospitals leads to negative outcomes for patients and to increased costs for the hospital. Nurses often underestimate the problem, showing negative attitudes. Aims: To compare the attitudes of surgical and medical nurses towards nutritional care of the elderly in hospital, in order to identify differences and nutritional care improvement strategies. Design: A multicentre cross-sectional survey was conducted in January 2015. Methods: All the nurses in the surgical and medical wards in 10 hospitals in northern Italy were surveyed using the Staff Attitudes to Nutritional Nursing Care Geriatric Scale (SANN-G scales). The chi squared test was used for comparing nominal variables and the t-test or Mann–Whitney test for was used for non-matched means depending on variable distribution. Results: 799 out of 1,293 questionnaires were returned(61.8%). 23.2%(185) of nurses had a negative attitude, 56.6%(452) had a neutral attitude, and 20.2%(162), positive. The ratio of attitudes was similar in both types of wards(surgical wards: negative 23.2%, neutral 56.6%, positive 20.2%, Median[IQR]=63[55;70], medical units: negative 23.3%, neutral 56.7%, positive 21%, Median[IQR]=63[55;70]). In both surgical and medical wards, the domains with median attitude scores below the cut-off were “interventions and individualisation”, without significant differences between them. No differences were found between nurses who had attended courses on nutritional care and those who had not, or between nurses working in teaching and non-teaching hospitals. Multivariate analysis did not show significant differences between the ratios of attitudes in medical and surgical wards (OR=1.298;CI95%=.883-1.886,p=.18). Conclusions: We found no differences in attitude between nurses who work in surgical and medical units. It is necessary to raise nurses’ awareness of poor nutritional care in both settings. More research is needed on barriers to nutritional care. Impact statement: Strategies such as education and more clearly defined nutritional responsibilities are needed to improve nurses’ attitudes.