Abstract
BackgroundThe evaluation and treatment of older people’s nutritional care is generally viewed as a low priority by nurses. However, given that eating and drinking are fundamental human activities, the support and enhancement of an optimal nutritional status should be regarded as a vital part of nursing. Registered nurses must therefore be viewed as having an important role in assessing and evaluating the nutritional needs of older people as well as the ability to intervene in cases of malnutrition. This study aimed to illuminate the experience of participating in nutritional care from the perspectives of older people and registered nurses. A further aim is to illuminate the latter’s experience of nutritional care per se.MethodsA qualitative, descriptive design was adopted. Data were collected through semi-structured interviews (n = 12) with eight registered nurses and four older persons (mean age 85.7 years) in a city in the southern part of Sweden. The subsequent analysis was conducted by content analysis.ResultThe analysis reflected three themes: ‘participation in nutritional care equals information’, ‘nutritional care out of remit and competence’ and ‘nutritional care more than just choosing a flavour’. They were interpreted to illuminate the experience of participation in nutritional care from the perspective of older people and RNs, and the latter’s experience of nutritional care in particular per se.ConclusionsOur findings indicate that a paternalistic attitude in care as well as asymmetry in the nurse-patient relationship are still common characteristics of modern clinical nursing practice for older people. Considering that participation should be central to nursing care, and despite the RN’s awareness of the importance of involving the older persons in their nutritional care this was not reflected in reality. Strategies to involve older persons in their nutritional care in a nursing home context need to take into account that for this population participation might not always be experienced as an important part of nursing care.
Highlights
The evaluation and treatment of older people’s nutritional care is generally viewed as a low priority by nurses
Our findings indicate that a paternalistic attitude in care as well as asymmetry in the nurse-patient relationship are still common characteristics of modern clinical nursing practice for older people
Considering that participation should be central to nursing care, and despite the Registered nurses (RN)’s awareness of the importance of involving the older persons in their nutritional care this was not reflected in reality
Summary
The evaluation and treatment of older people’s nutritional care is generally viewed as a low priority by nurses. The prevalence of malnutrition is known to range from 15 to 40% in nursing homes [3,4,5,6], in terms of evaluation and treatment [7, 8], nutritional care in general is not a highly prioritised issue. This is noteworthy, as food and drink are essential human needs a vital part of the fundamentals of care [9] and a mandatory competency practice skill within the remit of the RNs role in care. Another explanation may be that RNs need further in-depth knowledge about nutritional nursing care issues [1], as this has been shown to increase their awareness of nutritional nursing care [12], and the nutritional status of older people living in nursing homes [13, 14]
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