Development and Validation of a Nutritional Health Education Program for Health Care Providers in Geriatric Homes

Document Type : Original Article

Authors

1 Community, Environmental and Occupational Medicine department

2 Geriatrics and Gerontolongy department, Faculty of medicine, Ain-Shams University, Egypt.

3 Community, Environmental and Occupational Medicine department,

Abstract

Objectives: To develop and implement a health education program for health care providers (HCPs) in geriatric homes about nutrition in Elderly and to evaluate the program in terms of: HCP‘s knowledge before and after the program, and to assess nutritional status of elderly served by HCP before and after the program and also to measure the frequency of different malnutrition risk factors in elderly at geriatric homes. Subjects and methods: Randomized Clustered Controlled Clinical Trial was conducted on 240 elderly residing in 6 geriatric homes randomly selected. Three homes were assigned randomly to study group and three for control group. Elderly residing in the assessd geriatric homes aged between 60-75 years were included in the study. Health care providers (HCP) recruited was subdivided into 2 groups; study group and control group. HCP in the study group were subjected to a nutrition education program that was not administered to the control group. Results: There was improvement in knowledge of HCPs after the intervention health education program regarding elderly nutrition compared to the baseline knowledge and also to control group (p<0.005). There was a statistical significant difference in the rate of weight loss which was declined over a period of 4 months from the beginning of the study on June 2012 till October 2012 in both groups (p <0.001), but the rate of weight loss had declined after the intervention at the end of the study in the study group compared to the control group. Most of the elderly were overweight BMI >30 (67.1%). Nearly half of the elderly (52.9%) were at risk of malnutrition with the MNA (Mini Nutritional Assessment) score (17.1-23.5). The majority of the elderly 98.8 % were at risk of significant weight loss of at least 5% within 6 months by using the Appetite Assessment tool score with sum of score <=14. The majority of the elderly (98.3%) had a dental problem as(loss of teeth, eating difficulty, dry mouth or lesions) that may affect health and nutritional well-being with a score of >=2 by using Dental screening tool. There was improvement in physical aspect of quality of life in terms of activities and instrumental activities of daily living after implementation of the nutrition health education program in the study group compared to control group (p<0.001) Conclusion: Geriatric homes need continuous monitoring and reinforcement of health education of the health care providers and this will be reflected on the nutritional status and well being of the elderly residing in these Geriatric homes. Raising the awareness of the elderly is needed to improve not only the nutritional state but also the physical and psychological aspects of quality of life to have better health outcomes and good healthy elders.

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