A nutritional intervention program improves the nutritional status of geriatric patients at nutritional risk-a randomized controlled trial.

OBJECTIVES: To investigate the effect of a nutrition intervention program for geriatric nutritional at-risk patients. DESIGN: A randomized controlled trial. SETTING: Department of geriatric medicine in a university hospital and in the primary healthcare sector, Copenhagen. SUBJECTS: Geriatric patients ( N = 144) at nutritional risk. INTERVENTION: The intervention consisted of an individual dietary plan for home, including pre-discharge advice on nutritional intake, combined with three follow-up visits after discharge (one, four, and eight weeks). MAIN MEASURES: Change in body weight, Barthel Index, hand-grip strength and self-rated health from baseline (discharge) to three months after discharge, readmission, and mortality (90 and 120 days). RESULTS: The mean (SD) age in total sample was 87.2 (6.2) years. Sample size in the intervention group (IG) was N = 72, and in the control group (CG), N = 72. IG had a mean (SD) weight gain of 0.9 (4.2) kg compared to a weight loss of 0.8 (3.6) kg in the CG ( P = 0.032). In addition, an improvement in self-rated health was seen in the IG compared to CG (IG: 23 (47%) vs. CG: 12 (24%); P = 0.021). No significant difference between groups was found in functional status, mortality, or readmission rates. CONCLUSION: An individual dietary plan based on everyday food, combined with three follow-up visits (one, four, and eight weeks) after discharge, led to an improvement in nutritional status and self-rated health in geriatric patients.

Effect of Home Care Nursing on Patients Discharged From Hospital With Self-Reported Signs of Constipation: A Randomized Trial.

Constipation is a common health problem in relation to hospitalization. This randomized controlled trial aimed to investigate whether advice from a home care nurse after discharge had an effect on self-reported signs of constipation. A total of 59 patients were included in the study on the basis of their self-reported signs of constipation evaluated using the Constipation Assessment Scale. Advice from the home care nurses was given on the intake of fiber and liquid and mobilization related to scorings on the Constipation Risk Assessment Scale, the administration of laxatives, and referral to a physician when needed. Results showed a tendency toward the visits being effective, but a more complex intervention might be needed.

Constipation--prevalence and incidence among medical patients acutely admitted to hospital with a medical condition.

AIMS AND OBJECTIVES: To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients. BACKGROUND: Constipation is a common medical problem with severe consequences, and most people suffer from constipation at some point in their lives. In the general population, constipation is one of the most common complaints and is a significant personal and public health burden. Alteration in patients' patterns of elimination while in hospital has long been identified as either a potential or an actual problem that requires attention. Knowledge of the prevalence and incidence of constipation during hospitalisation is only sporadic. DESIGN: The study was descriptive and a prospective cohort design was chosen. METHODS: The Constipation Assessment Scale was translated into Danish and was used for the assessment of patient-reported bowel function. Five nurses made the assessments at admission to the acute medical ward and three days after admission. Three hundred and seventy-three patients participated in this study. RESULTS: Thirty-nine percent of the patients showed symptoms of constipation at admission. Of the patients who did not have the symptoms at admission, 43% developed the symptoms during the first three days of their stay in hospital. Significantly more of the older patients developed symptoms of moderate constipation. The incidence rate was 143 new cases per 1000 patient days. CONCLUSIONS: In this study, symptoms of constipation were common among patients acutely admitted to hospital due to different medical conditions. Symptoms of constipation were also developed during the first three days of the stay in hospital. RELEVANCE TO CLINICAL PRACTICE: The study highlights the need to develop both clinical guidelines towards treating constipation, and preventive measures to ensure that patients do not become constipated while staying in hospital.

Difficulties in avoiding exposure to allergens in cosmetics.

The aim of the study is to describe the ability of patients with allergic contact dermatitis to avoid exposure to allergens in cosmetics. The study is a questionnaire survey among 382 patients with contact allergy to preservatives and fragrances, included from 3 dermatological clinics. The questionnaire included questions about the level of difficulty in reading labels of ingredients on cosmetics and about patients' strategies to avoid substances they were allergic to. It also included questions about eczema severity as well as about educational level. 46% of the patients found it difficult or extremely difficult to read the ingredient labelling of cosmetics, and this finding was significantly related to low educational level. Patients allergic to formaldehyde and methyldibromo glutaronitrile experienced the worst difficulties, while patients with fragrance allergy found ingredient label reading easier than patients with preservative allergy. Reading of ingredient labels is a major problem for patients with contact allergy to allergens in consumer products. It is a general problem for all patients and not restricted to a small group with multiple allergies.

Compliance in contact allergy with focus on cosmetic labelling: a qualitative research project.

Elimination of the allergen is an effective remedy in allergic contact dermatitis. When contact allergy to a preservative is diagnosed, the patient is instructed to read the labelling of contents and to avoid the use of products containing the allergens. The present study, using qualitative research methods, was performed to examine how socially different groups of patients handle everyday life with allergic contact dermatitis caused by preservatives in consumer products. 8 women were interviewed about reading the ingredient labelling on cosmetic products. Observational studies were carried out as well. The study illustrates that the patients experienced problems when trying to read the labelling of contents. The problems were related to social status and ranged from not being able to read the chemical names of the preservatives to doubting the accuracy of the ingredient labelling. The study indicates that non-compliance with instructions on reading the ingredient labelling is not only a question of patients' lack of knowledge, but also the result of patients not possessing the resources necessary to act in accordance with the medical instructions. The present study is, to our knowledge, the first to apply qualitative research methods to contact dermatitis. The study points out interesting observations about social status and resources in relation to compliance. Further research on this area is necessary to expose the extent of the problem.