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Eating difficulties, need for assisted eating, nutritional status and pressure ulcers in patients admitted for stroke rehabilitation

Westergren, Albert LU ; Karlsson, Siv ; Andersson, Pia ; Ohlsson, Ola and Rahm Hallberg, Ingalill LU (2001) In Journal of Clinical Nursing 10(2). p.257-269
Abstract
The aim of this study was to describe the types and extent of eating difficulties, the need for assistance when eating, the nutritional status and pressure ulcers in consecutive patients (n = 162) admitted for stroke rehabilitation over a period of 1 year. Structured observations and assessments of eating, nutritional status (subjective global assessment of nutritional status), pressure ulcers and activities in daily living (Katz ADL-index) were performed by a nurse who also trained the staff to perform these assessments. Difficulties in eating were found in 80%, and 52.5% were unable to eat without assistance. Eating difficulties were: 'eats three-quarters or less of served food' (60%), difficulties in 'manipulating food on the plate'... (More)
The aim of this study was to describe the types and extent of eating difficulties, the need for assistance when eating, the nutritional status and pressure ulcers in consecutive patients (n = 162) admitted for stroke rehabilitation over a period of 1 year. Structured observations and assessments of eating, nutritional status (subjective global assessment of nutritional status), pressure ulcers and activities in daily living (Katz ADL-index) were performed by a nurse who also trained the staff to perform these assessments. Difficulties in eating were found in 80%, and 52.5% were unable to eat without assistance. Eating difficulties were: 'eats three-quarters or less of served food' (60%), difficulties in 'manipulating food on the plate' (56%), 'transportation of food to the mouth' (46%), 'sitting position' (29%), 'aberrant eating speed' (slow or forced) (26%), 'manipulating food in the mouth' (leakage, hoarding, chewing difficulties) (24%), 'swallowing difficulties' (18%), 'opening and/or closing the mouth' (16%), and 'alertness' (9%). Thirty-two percent were undernourished (49% of patients needing assisted eating and 13% of those not needing assistance, P < 0.0005). Among patients who were dependent in one or more functions according to the Katz ADL-index, 15% had pressure ulcers. The strongest eating variables for predicting nutritional status were 'alertness', 'swallowing difficulties', 'eats three-quarters or less of served food', and 'aberrant eating speed'. Nutritional status could in turn significantly predict pressure ulcers. Eating difficulties among patients with stroke are complex and the patient's situation before stroke adds to this complexity, especially among those dependent on assisted eating. As difficulties occur both among patients needing and not needing assisted eating, all patients with stroke admitted for rehabilitation need to be systematically assessed for eating difficulties and action needs to be taken to facilitate eating, especially as patients with eating difficulties risk becoming undernourished and in turn developing pressure ulcers. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
eating, nursing, nutritional status, pressure ulcer, rehabilitation, stroke
in
Journal of Clinical Nursing
volume
10
issue
2
pages
257 - 269
publisher
Wiley-Blackwell
external identifiers
  • pmid:11820347
  • scopus:0035296362
ISSN
1365-2702
DOI
10.1111/j.1365-2702.2001.00479.x
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: The Vårdal Institute (016540000), Caring Sciences (Closed 2012) (016514020)
id
7793ae28-fb00-47f7-b1c7-b60aeba26c1c (old id 1121604)
date added to LUP
2016-04-01 15:17:42
date last changed
2024-01-25 14:38:30
@article{7793ae28-fb00-47f7-b1c7-b60aeba26c1c,
  abstract     = {{The aim of this study was to describe the types and extent of eating difficulties, the need for assistance when eating, the nutritional status and pressure ulcers in consecutive patients (n = 162) admitted for stroke rehabilitation over a period of 1 year. Structured observations and assessments of eating, nutritional status (subjective global assessment of nutritional status), pressure ulcers and activities in daily living (Katz ADL-index) were performed by a nurse who also trained the staff to perform these assessments. Difficulties in eating were found in 80%, and 52.5% were unable to eat without assistance. Eating difficulties were: 'eats three-quarters or less of served food' (60%), difficulties in 'manipulating food on the plate' (56%), 'transportation of food to the mouth' (46%), 'sitting position' (29%), 'aberrant eating speed' (slow or forced) (26%), 'manipulating food in the mouth' (leakage, hoarding, chewing difficulties) (24%), 'swallowing difficulties' (18%), 'opening and/or closing the mouth' (16%), and 'alertness' (9%). Thirty-two percent were undernourished (49% of patients needing assisted eating and 13% of those not needing assistance, P &lt; 0.0005). Among patients who were dependent in one or more functions according to the Katz ADL-index, 15% had pressure ulcers. The strongest eating variables for predicting nutritional status were 'alertness', 'swallowing difficulties', 'eats three-quarters or less of served food', and 'aberrant eating speed'. Nutritional status could in turn significantly predict pressure ulcers. Eating difficulties among patients with stroke are complex and the patient's situation before stroke adds to this complexity, especially among those dependent on assisted eating. As difficulties occur both among patients needing and not needing assisted eating, all patients with stroke admitted for rehabilitation need to be systematically assessed for eating difficulties and action needs to be taken to facilitate eating, especially as patients with eating difficulties risk becoming undernourished and in turn developing pressure ulcers.}},
  author       = {{Westergren, Albert and Karlsson, Siv and Andersson, Pia and Ohlsson, Ola and Rahm Hallberg, Ingalill}},
  issn         = {{1365-2702}},
  keywords     = {{eating; nursing; nutritional status; pressure ulcer; rehabilitation; stroke}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{257--269}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Clinical Nursing}},
  title        = {{Eating difficulties, need for assisted eating, nutritional status and pressure ulcers in patients admitted for stroke rehabilitation}},
  url          = {{http://dx.doi.org/10.1111/j.1365-2702.2001.00479.x}},
  doi          = {{10.1111/j.1365-2702.2001.00479.x}},
  volume       = {{10}},
  year         = {{2001}},
}