[Prevention and treatment of undernutrition in hospitals and institutions. Cross-sectional study in 116 health facilities in Haute-Normandie (France), 2003].
BACKGROUND
The elderly, especially the institutionalized elderly, are at risk of undernutrition, which institutions do not appear to identify or treat adequately.


OBJECTIVE
To identify activities undertaken to manage and prevent undernutrition in the elderly in institutions in Haute-Normandy (France).


METHODS
In February 2003, all institutions in Haute-Normandy likely to house the elderly received questionnaires for this cross-sectional study: public hospitals (PH) responded, private hospitals (PRH), and retirement homes, classified into two groups according to the medical services provided (RH, retirement homes, NH, nursing homes).


RESULTS
Slightly more than half the institutions responded: 34/36 PH, 20/28 PRH, and 62/161 RH and NH. Half Only 22% reported specific protocols for undernutrition; this figure ranged from 30.3% for PH to 13.6% for RH (p=0.22). Patients' food intake was tracked at 67% of the institutions - from 81.8% of the PH to 45.5% of the retirement homes (p=0.10). Meal choices were offered at 54% of the institutions: 85.0% of PRH hospitals offered a choice, but only 45.4% of the PH and of the RH (p=0.01). Overall, 51% asked about eating habits and preferences at admission. Nurses' aides provided help during meals in 46.9% of institutions, and 49% considered they had sufficient staff to help patients during meals: 95.5% in RH, but only 20.7% in PH (p<0.001).


CONCLUSIONS
Institutions for the elderly are well aware of the problems of undernutrition, but not enough of them appear to have a specific protocol to deal with it. Earlier screening for undernourishment would be useful. The study also shows the important role of nurses' aides in this area.


CONCLUSIONS
Institutions in Haute-Normandy agree about the need to screen for and treat undernutrition, but their interventions are not effective. Better organization and special training of health workers could improve this screening and treatment.
Bailly
Laurent
L
Département d'Epidémiologie et de Santé Publique, CHU, Hôpitaux de Rouen.
Ladner
Joël
J
Petit
André
A
Carpentier
Marie-Claude
MC
Baude
Claire
C
Bohic-Peneau
Nicole
N
Dechelotte
Pierre
P
Czernichow
Pierre
P
D000368:Aged; D002391:Catchment Area, Health; D003430:Cross-Sectional Studies; D004282:Documentation; D002149:Energy Intake; D005247:Feeding Behavior; D005602:France / Q000453:epidemiology; D006282:Health Personnel / Q000193:education; D006301:Health Services Needs and Demand; D006761:Hospitals; D006801:Humans; D008403:Mass Screening / Q000379:methods; D009735:Nursing Homes; D009748:Nutrition Disorders / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy*; D017149:Private Sector / Q000706:statistics & numerical data; D017150:Public Sector / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods; D015431:Weight Loss