Navigating Person-Centred Nutrition and Mealtime Care in Rehabilitation: A Conceptual Model

IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS
Hannah T. Olufson, Ella Ottrey, Theresa L. Green, Adrienne M. Young
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Abstract

Background

Person-centred care impacts individual and organisational outcomes in rehabilitation and nutrition services. However, there is little evidence regarding person-centred nutrition and mealtime care within rehabilitation settings. We aimed to develop a conceptual model to guide nutrition and mealtime care in rehabilitation, focusing on factors associated with person-centred care and interprofessional practice.

Methods

Employing an interpretivist research approach, we conducted 58 h of ethnographic field work, including observations and interviews with 165 patients, support persons, and staff across three rehabilitation units from September 2021 to April 2022. Data were analysed iteratively using reflexive thematic analysis, with key factors inductively and deductively identified and mapped onto the Nutrition Care Process to create the conceptual model. The model was then refined in collaboration with staff (n = 10) and consumers (previous patients and support persons; n = 7) in expert panel sessions.

Results

The Person-Centred Nutrition and Mealtime Care in Rehabilitation model conceptualises person-centred nutrition and mealtime care through the steps of Nutrition Assessment, Priorities, Intervention, and Monitoring and Evaluation. These steps highlight consumer, team, and organisational factors influencing person-centred nutrition and mealtime care. The representation and communication of these factors within the model were refined with staff and consumers.

Conclusions

This study presents an evidence-informed conceptual model to guide person-centred nutrition and mealtime care in rehabilitation. By sharing this conceptual model, we welcome its use and adaptation by dietetic staff/managers to support advancing person-centred nutrition services. This model is designed to support enhanced quality of rehabilitation and nutrition services in line with existing evidence.

Abstract Image

导航以人为中心的营养和餐时护理康复:一个概念模型
背景:以人为本的护理影响康复和营养服务的个人和组织成果。然而,关于康复环境中以人为本的营养和用餐时间护理的证据很少。我们的目标是建立一个概念模型来指导康复中的营养和用餐时间护理,重点关注与以人为本的护理和跨专业实践相关的因素。方法采用解释主义研究方法,从2021年9月至2022年4月,我们进行了58小时的民族志实地工作,包括对三个康复单位的165名患者、支持人员和工作人员进行观察和访谈。使用反思性主题分析对数据进行迭代分析,通过归纳和演绎识别关键因素并将其映射到营养护理过程中以创建概念模型。然后与工作人员(n = 10)和消费者(以前的患者和支持人员;N = 7)在专家小组会议。结果康复中以人为本的营养与用餐护理模式通过营养评估、优先级、干预、监测与评价等步骤将以人为本的营养与用餐护理概念化。这些步骤强调了影响以人为本的营养和用餐时间护理的消费者、团队和组织因素。这些因素在模型中的表示和沟通与员工和消费者进行了改进。结论本研究提出了一个循证的概念模型来指导康复中以人为本的营养和用餐时间护理。通过分享这一概念模式,我们欢迎营养工作人员/管理人员使用和调整这一模式,以支持推进以人为本的营养服务。该模式旨在根据现有证据支持提高康复和营养服务的质量。
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来源期刊
CiteScore
5.30
自引率
15.20%
发文量
133
审稿时长
6-12 weeks
期刊介绍: Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on: - Clinical nutrition and the practice of therapeutic dietetics - Clinical and professional guidelines - Public health nutrition and nutritional epidemiology - Dietary surveys and dietary assessment methodology - Health promotion and intervention studies and their effectiveness - Obesity, weight control and body composition - Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments. - Appetite, Food intake and nutritional status - Nutrigenomics and molecular nutrition - The journal does not publish animal research The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.
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