Eating Disorders: Southampton Mealtime Assistance Study: Design and Methods.

Southampton mealtime assistance study: design and methods.

Filed under: Eating Disorders

BMC Geriatr. 2013 Jan 7; 13(1): 5
Roberts HC, Pilgrim AL, Elia M, Jackson AA, Cooper C, Aihie Sayer A, Robinson SM

ABSTRACT: BACKGROUND: Malnutrition is common in older people in hospital and is associated with adverse clinical outcomes including increased mortality, morbidity and length of stay. This has raised concerns about the nutrition and diet of hospital in-patients. A number of factors may contribute to low dietary intakes in hospital, including acute illness and cognitive impairment among in-patients. The extent to which other factors influence intake such as a lack of help at mealtimes, for patients who require assistance with eating, is uncertain. This study aims to evaluate the effectiveness of using trained volunteer mealtime assistants to help patients on an acute medical ward for older people at mealtimes.Methods/designThe study design is quasi-experimental with a before (year one) and after (year two) comparison of patients on the intervention ward and parallel comparison with patients on a control ward in the same department. The intervention in the second year was the provision of trained volunteer mealtime assistance to patients in the intervention ward. There were three components of data collection that were repeated in both years on both wards. The first (primary) outcome was patients’ dietary intake, collected as individual patient records and as ward-level balance data over 24 hour periods. The second was clinical outcome data assessed on admission and discharge from both wards, and 6 and 12 months after discharge. Finally qualitative data on the views and experience of patients, carers, staff and volunteers was collected through interviews and focus groups in both years to allow a mixed-method evaluation of the intervention. DISCUSSION: The study will describe the effect of provision of trained volunteer mealtime assistants on the dietary intake of older medical in-patients. The association between dietary intake and clinical outcomes including malnutrition risk, body composition, grip strength, length of hospital stay and mortality will also be determined. An important component of the study is the use of qualitative approaches to determine the views of patients, relatives, staff and volunteers on nutrition in hospital and the impact of mealtime assistance.Trial registrationTrial registered with NCTO1647204.
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Therapeutical options in sigmoid diverticulitis. When should we operate?

Filed under: Eating Disorders

Chirurgia (Bucur). 2012 Nov-Dec; 107(6): 715-21
Pätrascu T, Doran H, Catrina E, Mihalache O

Colonic diverticulosis is a benign disease whose incidence has been steadily increasing throughout the world, especially in the economically developed countries in Western Europe. This increase is connected to the population ageing process, the diverticulosis being characteristic in the elderly, and with nowadays’ eating habits. Frequently, colonic diverticuli may cause complications, such as hemorrhage or diverticulitis, with pericolic abscesses or peritonitis. Consequently, efforts are being made to set up a therapeutic algorithm appropriate for the diverticular disease, the predominance of the conservative or surgical attitude being continuously adjusted. We have analyzed the therapeutic options, their advantages and their limitations, based on both the experience of the “Prof. I. Juvara” Surgical Department of the “Dr. I. Cantacuzino” Clinical Hospital and the latest data in medical literature.
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Health promotion in mental health care: perceptions from patients and mental health nurses.

Filed under: Eating Disorders

J Clin Nurs. 2013 Jan 7;
Verhaeghe N, De Maeseneer J, Maes L, Van Heeringen C, Annemans L

AIMS AND OBJECTIVES: To gain insight into the factors influencing the integration of physical activity and healthy eating into the daily care of individuals with mental disorders (MD) living in sheltered housing and to increase the understanding of the relationships between and complexities of these factors. BACKGROUND: Growing attention is given to the implementation of health promotion activities in mental health care. By improving the understanding of perceptions of patients and mental health nurses, health promotion programmes targeting physical activity and healthy eating can be developed that better meet the patients’ needs. DESIGN: A descriptive qualitative study. METHODS: Based on a purposive sampling strategy, three focus groups including 17 mental health nurses and individual interviews with 15 patients were conducted. RESULTS: Although physical and mental health benefits of physical activity and healthy eating were identified, several barriers to integrate healthy lifestyles into the daily life of patients were reported. Important barriers identified by the patients consisted of lack of energy and motivation as a result of the MD, side effects of psychotropic drug use, and hospitalisation. Lack of time and personal views and attitudes towards health promotion were reported by the mental health nurses as important elements influencing the way in which they integrate health promotion in the care provided. Support from the mental health nurse was considered important by the patients in changing their unhealthy lifestyle behaviour. CONCLUSIONS: The results of the study provide insight into important factors influencing the integration of health promotion activities targeting physical activity and healthy eating in individuals with MD living in sheltered housing. RELEVANCE TO CLINICAL PRACTICE: The information derived from this study is useful and relevant in the design and implementation of health promotion interventions targeting physical activity and healthy eating in people with MD living in sheltered housing.
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