Nutrition care practices and risk factors for malnutrition among patients in Embu level five hospital in Kenya
Abstract
Nutrition care is an important determinant in patients’ nutrition, health outcome and
adequate nutrition is required for patients to improve and maintain their health. Health
care providers have a role in ensuring patient receive adequate nutrition care while in
hospital. The objective of this study was to evaluate nutritional care practices,
malnutrition levels and the risk factors for malnutrition among hospitalized medical
patients.
The study was cross-sectional, descriptive and observational in nature and involved 98
patients admitted in medical wards in Embu Level Five hospital. A 4-item validated
patient questionnaire consisting of socio demographic, nutrition assessment, morbidity
and dietary intake was administered to each patient
A total of 98 patients of whom 48 (49%) and 50(51%) were male and females
respectively participated in the study. The mean age of the respondents was 37 ± 10.7
while the mean length of stay at the time of the study was 6.0 ± 3.7days. Nutrition status
assessment at the point of admission (within 48 hours of admission) was hardly done at
1.6%. However, biochemical tests were done for 62.2% of patients and only on doctors’
request. The prevalence of under nutrition among the study respondents was high at
53.1% based on Body Mass Index and 54.1% based Subjective Global assessment
method. The mean calorie and protein provided by the hospital food was significantly
lower at 1468.4 ± 253.9 kcal/day and 36.2 ± 17.6g/day compared to both hospital
recommendation of 2000 kcal/day and 65g/day of protein and mean patient needs of
1612 ± 209.7kcal/day and 53.2 ± 11.0 g/day (P-value, <0.000). Less than half (42.9%) of
the study respondents consumed more than three quarters (>75%) of the hospital food
Nutrition care is an important determinant in patients’ nutrition, health outcome and
adequate nutrition is required for patients to improve and maintain their health. Health
care providers have a role in ensuring patient receive adequate nutrition care while in
hospital. The objective of this study was to evaluate nutritional care practices,
malnutrition levels and the risk factors for malnutrition among hospitalized medical
patients.
The study was cross-sectional, descriptive and observational in nature and involved 98
patients admitted in medical wards in Embu Level Five hospital. A 4-item validated
patient questionnaire consisting of socio demographic, nutrition assessment, morbidity
and dietary intake was administered to each patient
A total of 98 patients of whom 48 (49%) and 50(51%) were male and females
respectively participated in the study. The mean age of the respondents was 37 ± 10.7
while the mean length of stay at the time of the study was 6.0 ± 3.7days. Nutrition status
assessment at the point of admission (within 48 hours of admission) was hardly done at
1.6%. However, biochemical tests were done for 62.2% of patients and only on doctors’
request. The prevalence of under nutrition among the study respondents was high at
53.1% based on Body Mass Index and 54.1% based Subjective Global assessment
method. The mean calorie and protein provided by the hospital food was significantly
lower at 1468.4 ± 253.9 kcal/day and 36.2 ± 17.6g/day compared to both hospital
recommendation of 2000 kcal/day and 65g/day of protein and mean patient needs of
1612 ± 209.7kcal/day and 53.2 ± 11.0 g/day (P-value, <0.000). Less than half (42.9%) of
the study respondents consumed more than three quarters (>75%) of the hospital food
Nutrition care is an important determinant in patients’ nutrition, health outcome and
adequate nutrition is required for patients to improve and maintain their health. Health
care providers have a role in ensuring patient receive adequate nutrition care while in
hospital. The objective of this study was to evaluate nutritional care practices,
malnutrition levels and the risk factors for malnutrition among hospitalized medical
patients.
The study was cross-sectional, descriptive and observational in nature and involved 98
patients admitted in medical wards in Embu Level Five hospital. A 4-item validated
patient questionnaire consisting of socio demographic, nutrition assessment, morbidity
and dietary intake was administered to each patient
A total of 98 patients of whom 48 (49%) and 50(51%) were male and females
respectively participated in the study. The mean age of the respondents was 37 ± 10.7
while the mean length of stay at the time of the study was 6.0 ± 3.7days. Nutrition status
assessment at the point of admission (within 48 hours of admission) was hardly done at
1.6%. However, biochemical tests were done for 62.2% of patients and only on doctors’
request. The prevalence of under nutrition among the study respondents was high at
53.1% based on Body Mass Index and 54.1% based Subjective Global assessment
method. The mean calorie and protein provided by the hospital food was significantly
lower at 1468.4 ± 253.9 kcal/day and 36.2 ± 17.6g/day compared to both hospital
recommendation of 2000 kcal/day and 65g/day of protein and mean patient needs of
1612 ± 209.7kcal/day and 53.2 ± 11.0 g/day (P-value, <0.000). Less than half (42.9%) of
the study respondents consumed more than three quarters (>75%) of the hospital food provided. The following factors showed an association with nutrition status; energy
intake (p=0.015), protein intake (p=0.004), length of stay (p=0.07), and the proportion of
hospital food consumed (p=0.007). The following factors were found to be predictors for
malnutrition among hospitalized patients; energy intake (p=0.028, OR=0.999, 95%CI:
0.999, 1.000) and protein intake (p=0.003, OR=1.041), 95%CI: 1.014, 1.069).
Conclusion: The nutrition care among hospitalized patients is inadequate as nutrition
status assessment at the point of admission is hardly done. The hospital diet both in
calorie and protein content is inadequate to cover for patients’ needs. Malnutrition is
highly prevalent (>50%) among hospitalized patients as determined by both BMI and
SGA. Overall food intake among patients is inadequate to cover for their body needs.
Energy intake, protein intake, length of stay and the amount of hospital food consumed
were associated with malnutrition. Energy and protein intake were found to be the risk
factors for hospital malnutrition.
Recommendation: nutrition status assessment should be done to all patients upon
admission. Malnourished patient should receive individualized care with foods tailored to
correct malnutrition. Hospital diet should be adequate so as to meet patients’ needs.
There is therefore a great need to review the whole aspect of nutrition care for all
patients. To achieve this, the implementation of clinical nutrition guidelines should be
prioritized. This will result into improvement of patient nutrition care and reduction in
hospital malnutrition.
Publisher
University of Nairobi