title: Direct and indirect effects of everyday emotions on food intake of elderly patients in institutions.
abstract: BACKGROUND
  Decreased food intake is an important risk factor for malnutrition, which is highly prevalent among geriatric patients. The emotional nature of the hospitalization experience and the complex organizational setting involved in meal production and delivery services in institutions increase the risk for decreased food intake. Everyday emotions are known to have a particularly strong influence on decision-making and behavior in the elderly, and have also been shown, in younger populations, to influence food intake and its psychological antecedents, such as quality perception and satisfaction judgments. The objective of this paper is to study the direct impact of elderly patients' everyday emotions on food intake and their indirect effects mediated by quality perceptions and satisfaction judgments.
  
  
  METHODS
  Thirty patients (20 women, 10 men, 65-92 age range) in a geriatric rehabilitation unit were observed on repeated meal episodes (average of 46 care episodes per patient) where they provided self-reports for emotions (positive emotions, anger, anxiety, and mild depressed feelings), perceived meal quality, and satisfaction. Food intake was measured in terms of energy and protein content.
  
  
  RESULTS
  The impact on food intake was favorable, and both direct and indirect for positive emotions, direct and negative for anxiety, direct and positive for mild depressed feelings, and indirect and negative for anger. Indirect effects were mediated by quality perception judgments but not by satisfaction, which was not significantly related to food intake.
  
  
  CONCLUSIONS
  Results suggest that, given their impact on food intake, measuring and monitoring patients' everyday emotions may be an important innovative strategy to improve food intake of elderly patients in institutions.
authors.affiliation: Faculty of Management, McGill University, Montreal, Quebec, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Paquet
authors.forename: Danielle
authors.initials: D
authors.lastname: St-Arnaud-McKenzie
authors.forename: Marie-Jeanne
authors.initials: MJ
authors.lastname: Kergoat
authors.forename: Guylaine
authors.initials: G
authors.lastname: Ferland
authors.forename: Laurette
authors.initials: L
authors.lastname: Dubé
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology*; D003657:Decision Making; D004435:Eating; D004644:Emotions / Q000502:physiology*; D002149:Energy Intake; D005260:Female; D005518:Food Preferences; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009735:Nursing Homes; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011336:Probability; D018570:Risk Assessment; D012307:Risk Factors; D012494:Sampling Studies; D012680:Sensitivity and Specificity