title: Nutritional care after critical illness: a qualitative study of patients' experiences.
abstract: BACKGROUND
  The present qualitative study aimed to explore the factors influencing nutritional recovery in patients after critical illness and to develop a model of care to improve current management of nutrition for this patient group.
  
  
  METHODS
  Patients were recruited into the study on discharge from a general intensive care unit (ICU) of a large teaching hospital in central Scotland. Semi-structured interviews were carried out after discharge from the ICU, weekly for the duration of their ward stay, and at 3 months post ICU discharge. Observations of ward practice were undertaken thrice weekly for the duration of the ward stay.
  
  
  RESULTS
  Seventeen patients were recruited into the study and, using a grounded theory approach, 'inter-related system breakdowns during the nutritional recovery process' emerged as the overarching core category that influenced patients' experiences of eating after critical illness. This encompassed the categories, 'experiencing a dysfunctional body', 'experiencing socio-cultural changes in relation to eating' and 'encountering nutritional care delivery failures'.
  
  
  CONCLUSIONS
  The findings from the present study provide a unique contribution to knowledge by offering important insights into patients' experiences of eating after critical illness. The study has identified numerous nutritional problems and raises questions about the efficacy of current nutritional management in this patient group. Adopting a more individualised approach to nutritional care could ameliorate the nutritional issues experienced by post ICU patients. This will be evaluated in future work.
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh, UK.|The University of Edinburgh, Edinburgh, UK.
authors.forename: J L
authors.initials: JL
authors.lastname: Merriweather
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh, UK.|School of Health in Social Science, The University of Edinburgh, Edinburgh, UK.
authors.forename: L G
authors.initials: LG
authors.lastname: Salisbury
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh, UK.|The University of Edinburgh, Edinburgh, UK.
authors.forename: T S
authors.initials: TS
authors.lastname: Walsh
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh, UK.|School of Health in Social Science, The University of Edinburgh, Edinburgh, UK.
authors.forename: P
authors.initials: P
authors.lastname: Smith
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000628:therapy*; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D044623:Nutrition Therapy; D010351:Patient Discharge; D036301:Qualitative Research; D012606:Scotland; D055815:Young Adult
keywords: critical care; grounded theory; interviews; nutritional care; observations