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.