Download PDF
Aktuelle Ernährungsmedizin 2014; 39(02): 110-116
DOI: 10.1055/s-0034-1369924
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Mangelernährung in österreichischen Krankenhäusern und Pflegeheimen – Ergebnisse von wiederholten Querschnittstudien

Malnutrition in Austrian Hospitals and Nursing Homes – Results from Repeated Cross-Sectional Studies
S. Schönherr
1   Institut für Pflegewissenschaft, Medizinische Universität Graz, Austria
,
R. J. G. Halfens
2   Department of Health Service Research – Focusing on Chronic Care, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, die Niederlande
,
C. Lohrmann
1   Institut für Pflegewissenschaft, Medizinische Universität Graz, Austria
› Author Affiliations
Further Information

Publication History

Publication Date:
11 April 2014 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Fragestellung: Das Ziel dieser Studie ist der Vergleich der Prävalenz von Mangelernährung sowie der durchgeführten Prävention und Behandlung in Krankenhäusern und Pflegeheimen, die 3- bzw. 4-mal an wiederholten Querschnittstudien teilgenommen haben.

Material und Methode: Diese Studie nutzt Daten von 9 Krankenhäusern und 5 Pflegeheimen, die von 2009 – 2012 3- bzw. 4-mal an der Europäischen Pflegequalitätserhebung teilgenommen haben. An allen Datenerhebungszeitpunkten wurde ein überprüfter und standardisierter Fragebogen verwendet.

Ergebnisse: Die Prävalenz von Mangelernährung sank in 4-mal teilnehmenden Krankenhäusern signifikant von 29,1 auf 21,6 %. In 3-mal teilnehmenden Krankenhäusern und Pflegeheimen sanken die Prävalenz von Mangelernährung und das Risiko für Mangelernährung ebenfalls signifikant. Die Nutzung von Screeninginstrumenten zur Erfassung von Mangelernährung stieg in 4-mal teilnehmenden Krankenhäusern von 21,7 auf 41 % und im Pflegeheim von 2,4 auf 97,9 % signifikant an. In allen teilnehmenden Pflegeheimen stieg die Nutzung von energie- und proteinangereicherter Kost signifikant an. In den teilnehmenden Krankenhäusern konnten keine signifikanten Verbesserungen in den durchgeführten Interventionen beobachtet werden.

Schlussfolgerung: Die Ergebnisse zeigen einen signifikanten Rückgang in der Prävalenz bzw. des Risikos für Mangelernährung, wobei Verbesserungen in Prävention und Behandlung beobachtet wurden. Somit liefert diese Studie Hinweise dafür, dass die Teilnahme an wiederholten Querschnittstudien das Bewusstsein für Mangelernährung erhöhen kann. Es wird empfohlen, diese Ergebnisse in weiteren wiederholten multizentrischen Querschnittstudien mit größeren Stichproben und umfassenderen Analysen zu bekräftigen.

Abstract

Purpose: The aim of this study is to compare the prevalence, prevention and treatment of malnutrition in hospitals and nursing homes which participated three or four times, respectively, in repeated cross-sectional studies.

Material and Methods: This study uses data from nine hospitals and five nursing homes which participated in the European Care Quality Measurement three or four times from 2009 to 2012. For data collection purposes, a tested and standardized questionnaire was used at each data collection point.

Results: In hospitals which participated four times, the prevalence of malnutrition dropped significantly from 29.1 to 21.6 %. In hospitals and nursing homes which participated three times, the prevalence of malnutrition and malnutrition risk also decreased significantly. The use of validated screening tools increased significantly from 21.7 to 41 % in hospitals which participated four times, and from 2.4 to 97.9 % in nursing home which participated four times. The use of energy and protein-enriched diets increased significantly in all nursing homes of the study sample. No significant improvements regarding nutritional interventions could be observed in hospitals.

Conclusion: The results show a significant decrease with regard to the prevalence of malnutrition and malnutrition risk, while improvements in prevention and treatment could be observed. Participation in repeated cross-sectional studies may have played a critical role in increasing malnutrition awareness. It is recommended to verify the obtained results in further repeated multicentre cross-sectional studies, with larger sample sizes and more comprehensive analyses.

Schlüsselwörter

Mangelernährung - Krankenhäuser - Pflegeheime - Querschnittstudie

Keywords

malnutrition - hospitals - nursing homes - cross-sectional study
 

  • Literatur

  • 1 Elia M. Principles of Clinical Nutrition: Contrasting the practice of nutrition in health and disease. In: Gibney MJ, Nutrition Society Elia M. et al. Clinical nutrition. Oxford: Wiley-Blackwell; 2005
    Search in Google Scholar
  • 2 Arvanitakis M, Beck A, Coppens P et al. Nutrition in care homes and home care: How to implement adequate strategies (report of the Brussels Forum (22-23 November 2007)). Clin Nutr 2008; 27: 481-488
    CrossrefPubMedSearch in Google Scholar
  • 3 Norman K, Pichard C, Lochs H et al. Prognostic impact of disease-related malnutrition. Clin Nutr 2008; 27: 5-15
    CrossrefPubMedSearch in Google Scholar
  • 4 Banks M, Bauer J, Graves N et al. Malnutrition and pressure ulcer risk in adults in Australian health care facilities. Nutrition 2010; 26: 896-901
    CrossrefPubMedSearch in Google Scholar
  • 5 Hiesmayr M, Schindler K, Pernicka E et al. Decreased food intake is a risk factor for mortality in hospitalised patients: The NutritionDay survey 2006. Clin Nutr 2009; 28: 484-491
    CrossrefPubMedSearch in Google Scholar
  • 6 Kaiser MJ, Bauer JM, Rämsch C et al. Frequency of malnutrition in older adults: a multinational perspective using the Mini Nutritional Assessment. JAGS 2010; 58: 1734-1738
    CrossrefPubMedSearch in Google Scholar
  • 7 Verbrugghe M, Beeckman D, Van Hecke A et al. Malnutrition and associated factors in nursing home residents: a cross-sectional, multi-centre study. Clin Nutr 2013; 32: 438-443
    CrossrefPubMedSearch in Google Scholar
  • 8 Meijers JMM, Halfens RJG, van Bokhorst-de van der Schueren MAE et al. Malnutrition in Dutch health care: Prevalence, prevention, treatment and quality indicators. Nutrition 2009; a 25: 512-519
    CrossrefPubMedSearch in Google Scholar
  • 9 Valentini L, Schindler K, Schlaffer R et al. The first nutritionDay in nursing homes: Participation may improve malnutrition awareness. Clin Nutr 2009; 28: 109-116
    CrossrefPubMedSearch in Google Scholar
  • 10 Stratton RJ, Green CJ, Elia M. Disease-related malnutrition: an evidence-based approach to treatment. Cambridge: CABI Publishing; 2003
    Search in Google Scholar
  • 11 Bartholomeyczik S, Reuther S, Luft L et al. Prävalenz von Mangelernährung, Maßnahmen und Qualitätsindikatoren in deutschen Altenpflegeheimen – erste Ergebnisse einer landesweiteren Pilotstudie. Gesundheitswesen 2010; 72: 868-874
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Schönherr S, Halfens RJG, Meijers JMM et al. Structural and process indicators of nutritional care: a comparison between Austrian hospitals and nursing homes. Nutrition 2012; 28: 868-873
    CrossrefPubMedSearch in Google Scholar
  • 13 Kowanko I. The role of the nurse in food service: A literature review and recommendations. Int J Nurs Pract 2008; 3: 73-78
    PubMedSearch in Google Scholar
  • 14 Kruizenga HM, Van Tulder MW, Seidell JC et al. Effectiveness and cost-effectiveness of early screening and treatment of malnourished patients. Am J Clin Nutr 2005; 82: 1082-1089
    PubMedSearch in Google Scholar
  • 15 Kondrup J, Allison SP, Elia M et al. ESPEN Guidelines for Nutrition Screening 2002. Clin Nutr 2003; 22: 415-421
    CrossrefPubMedSearch in Google Scholar
  • 16 Porter J, Raja R, Cant R et al. Exploring issues influencing the use of the Malnutrition Universal Screening Tool by nurses in two Australian hospitals. J Hum Nutr Diet 2009; 22: 203-209
    CrossrefPubMedSearch in Google Scholar
  • 17 Council of Europe-Committee of Ministers. Resolution ReAP on food and nutritional care in hospitals. Council of Europe; 2003
    Search in Google Scholar
  • 18 Tannen A, Schütz T, Dassen T et al. Malnutrition in German nursing homes and hospitals – care dependency and nursing interventions. Aktuel Ernahrungsmed 2008; 33: 177-183
    Thieme ConnectPubMedSearch in Google Scholar
  • 19 Deutsches Netzwerk für Qualitätsentwicklung in der Pflege (DNQP). Expertenstandard Ernährungsmanagement zur Sicherstellung und Förderung der oralen Ernährung in der Pflege. Osnabrück: Schriftenreihe des Deutschen Netzwerks für Qualitätsentwicklung in der Pflege; 2009
    Search in Google Scholar
  • 20 Bjerrum M, Tewes M, Pedersen P. Nurses’ self-reported knowledge about and attitude to nutrition – before and after a training program. Scand J Caring Sci 2012; 26: 81-89
    CrossrefPubMedSearch in Google Scholar
  • 21 Lindorff-Larsen K, Rasmussen HH, Kondrup J et al. Management and perception of hospital undernutrition – A positive change among Danish doctors and nurses. Clin Nutr 2007; 26: 371-378
    CrossrefPubMedSearch in Google Scholar
  • 22 Mowe M, Bosaeus I, Rasmussen HH et al. Insufficient nutritional knowledge among health care workers?. Clin Nutr 2008; 27: 196-202
    CrossrefPubMedSearch in Google Scholar
  • 23 Raja R, Gibson S, Turner A et al. Nurses’ views and practices regarding use of validated nutrition screening tools. Aust J Adv Nurs 2008; 26: 26-33
    PubMedSearch in Google Scholar
  • 24 Polit DF, Beck CT. Nursing Research – Generating and Assessing Evidence for Nursing Practice. 9th. Edition. Philadelphia: Lippincott, Williams & Wilkin; 2012
    Search in Google Scholar
  • 25 Meijers JMM, Candel MJMM, Schols JMGA et al. Decreasing trends in malnutrition prevalence rates explained by regular audits & feedback. J Nutr 2009; b 139: 1381-1386
    CrossrefPubMedSearch in Google Scholar
  • 26 van Nie-Visser NC, Schols JMGA, Meesterberends E et al. An international prevalence measurement of care problems: study protocol. J Adv Nurs 2013; 69: e18-e29
    CrossrefPubMedSearch in Google Scholar
  • 27 Banks M, Ash S, Bauer J et al. Prevalence of malnutrition in adults in Queensland public hospitals and residential aged care facilities. Nutr Diet 2007; 64: 172-178
    CrossrefPubMedSearch in Google Scholar
  • 28 Sobotka L, Schneider SM, Berner YN et al. ESPEN Guidelines on Parenteral Nutrition: Geriatrics. Clin Nutr 2009; 28: 461-466
    CrossrefPubMedSearch in Google Scholar
  • 29 Volkert D, Berner YD, Berry E et al. ESPEN Guidelines on Enteral Nutrition: Geriatrics. Clin Nutr 2006; 25: 330-360
    CrossrefPubMedSearch in Google Scholar
  • 30 Lohrmann C, Dijkstra A, Dassen T. Care dependency: testing the German version of the care dependency scale in nursing homes and on geriatric wards. Scand J Caring Sci 2003; 17: 51-56
    CrossrefPubMedSearch in Google Scholar
  • 31 Meijers JMM, van Bokhorst-de van der Schueren MAE, Schols JMGA et al. Defining malnutrition: Mission or mission impossible?. Nutrition 2010; 26: 432-440
    CrossrefPubMedSearch in Google Scholar
  • 32 Van der Veer SN, de Keizer NF, Ravelli ACJ et al. Improving quality of care. A systematic review on how medical registries provide information feedback to health care providers. Int J Med Inform 2010; 79: 305-323
    CrossrefPubMedSearch in Google Scholar
  • 33 Jamtvedt G, Young JM, Kristoffersen DT et al. Does telling people what they have been doing change what they do? A systematic review of the effects of audit and feedback. Qual Saf Health Care 2006; 15: 433-436
    CrossrefPubMedSearch in Google Scholar