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Selected Publication:
Bauer, S.
Malnutrition in Austrian Hospitals and Nursing Homes - Structure, Process and Outcome
Doktoratsstudium der Sozial- und Wirtschaftswissenschaften; Gesundheits- und Pflegewissenschaft; [ Dissertation ] ; 2015. pp.
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- Authors Med Uni Graz:
- Bauer Silvia
- Advisor:
- Lohrmann Christa
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- Abstract:
- Malnutrition is a complex and highly prevalent phenomenon that must be identified early and adequately treated. The international literature provides some insight into deficits in structural (e.g., knowledge and attitudes of nursing staff), process (e.g., nutritional screening) and outcome (e.g., prevalence of malnutrition) indicators in hospitals and nursing homes. The overall aims of this doctoral thesis are: (1) to describe structural and process indicators of nutritional care in hospitals and nursing homes; (2) to describe changes in nutritional status in nursing home residents; and (3) to assess knowledge and attitudes of nursing staff in nursing homes towards malnutrition. In this context, a series of studies was conducted in Austrian hospitals and nursing homes. The first chapter provides background information and describes the theoretical framework used in this doctoral thesis. Additionally, the research gaps in the international literature and, on this basis, the overall aims are presented. In the second chapter, methodological aspects of the studies conducted in terms of design, sample, setting, data collection and analysis are briefly described. Chapters three to six present the results of the three studies conducted as part of the doctoral thesis. These have been published, accepted or submitted for publication in international peer-reviewed journals. Chapter three describes the structural and process indicators of nutritional care in hospitals and nursing homes. This study identified deficits in structural (use of guideline for prevention and treatment of malnutrition) and process indicators (nutritional screening) both in hospitals and in nursing homes, and led to the conclusion that there is a need for improvement in nutritional care. Chapter four illustrates the changes in nutritional status and factors associated with a decline in nutritional status in nursing home residents over a period of one year. The results revealed that being at risk of malnutrition at baseline is the biggest risk factor for a decline in nutritional status in nursing home residents. Therefore, risk of malnutrition should be identified early and preventive actions taken as soon as possible thereafter. Chapter five describes the development and psychometric evaluation of a questionnaire to assess knowledge of malnutrition care among nursing staff in nursing homes. The newly developed Knowledge of Malnutrition-Geriatric (KoM-G) questionnaire showed acceptable psychometric properties that cover a wide range of items surrounding malnutrition and can be applied in nursing practice, education and research. Chapter six presents the assessment of knowledge and attitudes of registered nurses and nurse aides towards malnutrition care in nursing homes. The study found areas of knowledge deficits (regarding professions involved in malnutrition treatment) and negative attitudes (in the ‘Norms’ subscale) among registered nurses and nurse aides. These results will enable the development of adequate and tailored nutritional training programs, which may improve nutritional care in the long run. Chapter seven briefly summarises and discusses the main results of the three studies conducted. A methodological reflection on the applied methods including the strengths and limitations is also given. Finally, recommendations for nursing research and nursing practice are presented.