title: [Between intent and inability-management of malnutrition on medical wards of a centre hospital in Switzerland: patients' experience and perceptions].
abstract: BACKGROUND
  Malnutrition is a common phenomenon in acute care institutions accounting for many negative health consequences for the patient. In many hospitals, therefore, malnutrition risk screening and nutrition management programs were established; however, programs were commonly developed without integrating the patients' perspective. It is unknown if the program covers the patients' needs and if the interventions are worthwhile.
  
  
  OBJECTIVE
  Because patient experience is known solely from everyday conversations, the aim of the study was to explore affected patients' experience regarding nutrition management.
  
  
  METHODS
  The study has a qualitative, inductive approach. From September 2011 till May 2012, seven women and one man were interviewed. To analyse the guided interviews, content analysis was used.
  
  
  RESULTS
  The analysis shows that patients find themselves between ‘to want but not be able to eat’. Patients at risk encounter barriers due to their physical condition, such as swallowing- and chewing pain, nausea and dysgeusia and barriers associated with the system when ordering meals, such as fixed mealtimes, a limited variety of the menu and non-tasting supplements. To overcome these barriers patients are left to develop self-management strategies and to be in charge of their nutrition.
  
  
  CONCLUSIONS
  Therefore, targeted training for caregivers is a key, enabling them to support patients individually in their nutrition management. At the same time, institutional barriers must be removed.
authors.affiliation: 1 Fachbereich Gesundheit, Hochschule für Angewandte Wissenschaften, FHS St. Gallen.|2 Departement Public Health, Pflegewissenschaft, Universität Basel.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Haldemann-Jenni
authors.affiliation: 2 Departement Public Health, Pflegewissenschaft, Universität Basel.
authors.forename: Katharina
authors.initials: K
authors.lastname: Fierz
authors.affiliation: 2 Departement Public Health, Pflegewissenschaft, Universität Basel.|3 Abteilung Praxisentwicklung, Universitätsspital Basel.
authors.forename: Irena Anna
authors.initials: IA
authors.lastname: Frei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000193:education / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D017060:Patient Satisfaction; D011502:Protein-Energy Malnutrition / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology; D013557:Switzerland
keywords: Malnutrition; Patientenerfahrung; Qualitative Forschung; Selbstmanagement; malnutrition; patients experience; qualitative research; self-management