Malnutrition in older adults: how interprofessional teams see it? A systematic review of the qualitative research

Abstract

Background The understanding of health care providers’ experiences involved in malnutrition treatment is a key component that should be explored. Objective This systematic review aimed to explore the views and perceptions of community health care providers related to malnutrition and its management for older adults, through synthesizing the qualitative studies. Methods Six electronic databases were used to search relevant articles. Qualitative research synthesis using Sandelowski and Barroso’s method and thematic synthesis were used to broaden the range of methodology in this study. Joanna Briggs Institute (JBI) Critical Appraisal Tools for Qualitative Research was used to enable judgement about the strength of qualitative research. Results A total of four qualitative studies of health care providers’ views and perceptions related to malnutrition in older adults were analysed. The results showed that there are three main themes that reflect their malnutrition experiences: (i) knowledge and skills about malnutrition, (ii) management of malnutrition and (iii) the need for collaborative teams. Conclusion While health care professionals understand about the aetiology of malnutrition, however screening for malnutrition is not routine in their practice. Proper education and training about nutritional care is needed. Dietary changes and public education are preferable over oral nutritional supplements. Some solution and recommendations for management of malnutrition in older adult such as supportive interventions include environmental changes, nutritional counselling, food modification, oral nutrition supplement and pharmacotherapy if needed, routine screening and multidisciplinary approach.

Healthcare professionals’ experiences with practice for managing disease‐related malnutrition in general practice and proposals for improvement: A qualitative study

“…The health professionals only randomly and to a lower degree provide nutritional guidance to patients with DRM. Studies found, that when health professionals in general practice identified patients as malnourished, they would refer them to a dietitian [36,47]. In this study, most of the health professionals do not have the option of using a dietitian.…”

“…Barriers mentioned in this study are consistent with barriers found in other studies [36,37], including the low recognition of malnutrition. Overwhelming workload and lack of educational opportunities and nutritional skills are mentioned in other studies as well [32,36,47,55–59]. This indicate that an intervention should include education of the health professionals [31,36,55].…”

“…An individual nutritional guidance with telephone contact and visit from a nutrition consultant can help to increase weight over three months in elderly patients, who had been admitted to a rehabilitation institution [54]. Furthermore, some of the health professionals mention that it is necessary with more communication with the hospital about nutrition, which other health professionals have mentioned too [55] or more collaboration with the community nurses regarding to identification of malnutrition or risk of it among patient [47].…”

Interprofessional Treatment of Malnutrition and Sarcopenia by Dietitians and Physiotherapists: Exploring Attitudes, Interprofessional Identity, Facilitators, Barriers, and Occurrence

“…While health care professionals understand the etiology of malnutrition, screening for malnutrition is not routine in many practices. 40 The Meta-Model of Interprofessional Development 21–23 theorizes that professional identity also includes perceptions on professional relevance of problem domains and determines professional engagement as well as the application of relevant professional competencies. In other words, professional identity is a meta-competence and a prerequisite of interprofessional collaboration, which guides professional contributions.…”

Malnutrition during the journey of ageing

“…In contrast to other risk factors such as underlying diseases, a decreased food intake is something that can be optimized. Physicians, nurses, and dietitians tend to prescribe oral nutritional supplements as one of the first options [335,336]. The use of oral nutrition support is, in the short term, effective in increasing energy/protein intake [337] but fits not well in experienced-oriented care, is expensive [338] and does not increase life expectancy [275].…”