Summary: | 碩士 === 國立陽明大學 === 公共衛生碩士學位學程 === 107 === Discharged patients would need home care if they are frail and disabled to go out for medical care. At the stage of home care, the patients may have insufficient food intake, unintended weight loss, and risks of malnutrition. This qualitative study aimed to explore the home care patients’ nutritional status and dietary intakes, and the facilitators and barriers for a healthy nutritional status. Seven patients were recruited based on intentional sampling from a regional hospital in Taipei City, who had received nutritional care in hospital in the past two years before the interview.
In the first home care visit, five patients had general diet, one had puree test meal, one was on tube feeding. Four of the five patients eating general diet had reduced body weight (BW)0.15〜6.5 kg /month after discharged. Receiving nutrition education and intervention after the first home care visit, at the second visit, three of the five patients eating general diet had gained BW from 0.4 to 1.9 kg /month, and 2 reduced 0.4 to 1.0 kg / month. The 24-hour dietary recall showed that the patients had protein intake 0.73 ~ 1.05 g/kg BW, caloric intake 17.5 ~ 28.0 kcal / kg BW, vegetable consumption less than 2 portions/day. Mini-nutrition assessment (MNA) at the first visit showed that 3 patients were malnourished, 4 had malnutrition risk, and the MNA at the second visit showed that 5 patients had risk of malnutrition, and 1 had normal nutritional status.
After discharge, the patients eating general diet had slowly and continuously reduced body weights, and their nutritional diagnosis included unplanned weight loss, difficulty in chewing and swallowing. These issues may be due to the lack of dietary knowledge regarding food texture, food size or type. This study demonstrated the need of nutritional evaluation for the home care patients.
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