[The role of the coordinating nurse in a transverse clinical nutrition unit]. / Rôle de l'infirmier de coordination dans une unité transversale de nutrition clinique.

Malnutrition is a common pathology, often underdiagnosed, and is associated with numerous chronic diseases. Transversal clinical nutrition units (TCNU) are being implemented to improve the screening and management of malnutrition. The coordinating nurse plays a key role within a TCNU: organizing and coordinating personalized care pathways for malnourished patients, especially those with complex pathologies requiring multidisciplinary care. This article outlines the responsibilities of the coordinating nurse based on the experience of the TCNU established at the Pitié-Salpêtrière Hospital (Assistance Publique-Hôpitaux de Paris).

Nutrition-related care needs of older patients in hospital: A qualitative multimethod study.

PURPOSE: To investigate the nutrition-related care needs of older patients in hospitals. METHODS: A qualitative multimethod study was performed. By purposive sampling, older patients were included for observations of the nutrition process and interviews from a perioperative unit, an internal Medicine unit, and one acute geriatric care ward of an acute care hospital. Preliminary findings were discussed, validated, and further explored in two focus group discussions with interprofessional nutritional healthcare experts. FINDINGS: Seventeen women and five men with a mean age of 86 years participated in patient observations and interviews. Eight experts with at least 10 years of professional experience who were employed in this setting for 3 years or more participated in interviews. Three themes of nutrition-related care needs were elaborated: The need to assess and address older patients' attitudes toward life, the need for nutrition-related education, and the need for food intake support. These care needs added to the development and validation of a new nursing diagnosis "risk for inadequate protein energy nutrition" and in consequence to develop a complex nursing intervention to optimize the nutrition of older patients. CONCLUSIONS: It is crucial to assess and understand the patients' attitudes toward life, which affect purposes of treatment, diet, and menu choices. IMPLICATIONS FOR NURSING PRACTICE: Implementation of assessing nutrition-related care needs of older inpatients is needed. Addressing these care needs within the Advanced Nursing Process can lead to appropriate nursing diagnoses, nursing outcomes, and interventions, which enhance person-centered care, patients' self-care abilities, and consequently patients' nutritional status.

ZIEL: Untersuchung der ernährungsbezogenen Pflegebedürfnisse älterer Patient*innen im Krankenhaus. METHODE: Es wurde eine qualitative Multimethodenstudie durchgeführt. Mittels zielgerichteter Rekrutierung wurden ältere Patient*innen aus den Abteilungen allgemeine Chirurgie, innere Medizin und universitäre Klinik für Akutgeriatrie eines Krankenhauses für Beobachtungen des Ernährungsprozesses und Interviews einbezogen. Die vorläufigen Ergebnisse wurden in zwei Fokusgruppengesprächen mit Expert*innen aus verschiedenen Berufsgruppen diskutiert, validiert und weiter analysiert. ERGEBNISSE: Siebzehn Frauen und fünf Männer mit einem Durchschnittsalter von 86 Jahren nahmen an Patient*innenbeobachtungen und -interviews teil. Es wurden drei Themen ernährungsbezogener Pflegebedürfnisse herausgearbeitet: Das Bedürfnis, die Lebenseinstellung älterer Patient*innen zu erfassen; das Bedürfnis, ernährungsbezogene Informationen zu erhalten und das Bedürfnis nach Unterstützung bei der Nahrungsaufnahme. Diese Pflegebedürfnisse unterstützten die Entwicklung und Validierung einer neuen Pflegediagnose "Risiko für inadequate Protein-Energie-Ernährung" und infolgedessen einer komplexen pflegerischen Intervention zur Optimierung der Ernährung älterer Patient*innen. SCHLUSSFOLGERUNG: Es ist von entscheidender Bedeutung, die Lebenseinstellung der Patient*innen einzuschätzen und zu verstehen, da sich diese auf die Behandlungsziele, die Ernährung und die Menüwahl auswirkt. AUSWIRKUNGEN AUF DIE PFLEGEPRAXIS: Die Erfassung der ernährungsbezogenen Pflegebedürfnisse älterer stationärer Patient*innen muss implementiert werden. Die Berücksichtigung dieser Pflegebedürfnisse im Rahmen des Advanced Nursing Process kann zu angemessenen Pflegediagnosen, Pflegeergebnissen und Interventionen führen, welche die personenzentrierte Versorgung, Selbstpflegefähigkeiten der Patient*innen und damit deren Ernährungszustand verbessern.

Effects of using the MyFood decision support system on hospitalized patients' nutritional status and treatment: A randomized controlled trial.

BACKGROUND & AIMS: Compliance to guidelines for disease-related malnutrition is documented as poor. The practice of using paper-based dietary recording forms with manual calculation of the patient's nutritional intake is considered cumbersome, time-consuming and unfeasible among the nurses and does often not lead to appropriate nutritional treatment. We developed the digital decision support system MyFood to deliver a solution to these challenges. MyFood is comprised of an app for patients and a website for nurses and includes functions for dietary recording, evaluation of intake compared to requirements, and a report to nurses including tailored recommendations for nutritional treatment and a nutritional care plan for documentation. The study aimed to investigate the effects of using the MyFood decision support system during hospital stay on adult patients' nutritional status, treatment and hospital length of stay. The main outcome measure was weight change. METHODS: The study was a parallel-arm randomized controlled trial. Patients who were allocated to the intervention group used the MyFood app during their hospital stay and the nurses were encouraged to use the MyFood system. Patients who were allocated to the control group received routine care. RESULTS: We randomly assigned 100 patients (51.9 ± 14 y) to the intervention group (n = 49) and the control group (n = 51) between August 2018 and February 2019. Losses to follow-up were n = 5 in the intervention group and n = 1 in the control group. No difference was found between the two groups with regard to weight change. Malnutrition risk at discharge was present in 77% of the patients in the intervention group and 94% in the control group (p = 0.019). Nutritional treatment was documented for 81% of the patients in the intervention group and 57% in the control group (p = 0.011). A nutritional care plan was created for 70% of the intervention patients compared to 16% of the control patients (p < 0.001). CONCLUSIONS: The intervention had no effect on weight change during hospital stay. A higher proportion of the patients in the control group was malnourished or at risk of malnutrition at hospital discharge compared to the patients in the intervention group. The documentation of nutritional intake, treatment and nutritional care plans was higher for the patients using the MyFood system compared to the control group. This trial was registered at clinicaltrials.gov (NCT03412695).

Malnutrition in community-dwelling older people: lessons learnt using a new procedure.

This article reports the implementation of a new procedure for screening and treatment of malnutrition in a community NHS trust in England. The barriers and facilitators to implementation were assessed with staff from Integrated Community and Older People's Mental Health teams. Data from interviews and surveys were collected at baseline, 2 months after initial training and 16 months after initial training as well as following deployment of a nutrition lead to embed new developments for nutritional care. The adoption of the procedure made screening and treatment of malnutrition simpler and more likely to be actioned. The benefit of a nutrition lead and local nutrition champions to support and empower staff (avoiding reliance on training alone) was shown to drive change for nutritional care across the community. Prioritisation and commitment of leadership at the organisational level are needed to embed and sustain malnutrition screening and treatment in routine practice.

Using intervention mapping to develop an outpatient nursing nutritional intervention to improve nutritional status in undernourished patients planned for surgery.

BACKGROUND: Undernutrition in surgical patients leads to a higher risk of postoperative complications like infections and delayed recovery of gastrointestinal functions, often resulting in a longer hospital stay and lower quality of life. Nurses at outpatient clinics can deliver nutritional care during outpatient preoperative evaluation of health status to ensure that patients are properly fed in preparation for hospital admission for surgery. However, nutritional nursing care was not determined in research yet. This paper describes the structural development of an Outpatient Nursing Nutritional Intervention (ONNI). METHODS: A project group followed the steps of the Intervention Mapping. The needs assessment included assessment of delivery of nutritional care and nutritional care needs at two anaesthesia outpatient clinics of an academic and a teaching hospital. Also, outpatient clinic nurses and patients at risk for undernutrition were interviewed. Determinants resulted from these methods were matched with theories on behaviour change and nutritional support. RESULTS: Both patients and nurses were unaware of the consequences of undernutrition, and nurses were also unaware of their roles with regard to nutritional support. The intervention goals were: 1) enabling surgical patients to improve or maintain their nutritional status before hospital admission for surgery, and 2) enabling nurses to deliver nutritional support. The ONNI was developed for outpatients at risk for or with undernutrition. A training was developed for nurses. The ONNI included the five following components: 1) identification of the causes of undernutrition; 2) provision of a nutritional care plan including general and individually tailored advice; 3) self-monitoring of nutrient intake; 4) counselling and encouragement; and 5) support during a telephone follow-up meeting. The intervention and training were tested. A multifaceted implementation strategy was used to deliver the intervention in daily practice. CONCLUSIONS: Despite the unique position of the nurses at outpatient clinics, nurses were unaware of their role with regard to nutritional care. The ONNI was developed and implemented along with a training program for nurses. The test confirmed that the training can improve nurses' knowledge, skills, and sense of responsibility for nutritional support. The intervention may empower patients to actively improve their nutritional status.

Community nutrition nurse specialist role: a service improvement.

This article describes the introduction of a community nutrition specialist nurse role in Buckinghamshire. The need for this role arose from issues experienced by the large but busy district nursing team (caseload of >300 patients per day) in home enteral feeding management and troubleshooting. The post holder was appointed to support community, hospital, dietitians and industry home care nurses with nutritional screening in the community and home enteral feeding, with a greater focus on the former. The post holder was involved in the development of a community version of MUST along with a care pathway and the design of a training programme to improve district nurses' knowledge and confidence in managing malnutrition in the community. The post holder is also involved providing patients personalised advice for managing malnutrition and in referrals to the community dietetics team. Such innovations in staffing are vital if the negative impact of malnutrition on patients and the health service is to be curtailed.

An outpatient nursing nutritional intervention to prehabilitate undernourished patients planned for surgery: A multicentre, cluster-randomised pilot study.

BACKGROUND & AIMS: To improve the nutritional status of surgical patients before hospital admission, an Outpatient Nursing Nutritional Intervention (ONNI) was developed. The ONNI comprehends five components: determining causes of undernutrition, performing a nutritional care plan including tailored and general advice, self-monitoring of nutritional intake and eating patterns, counselling and encouragement, and conducting a follow-up telephone call to discuss improvements in nutritional behaviour. Here, we evaluate the feasibility and effectiveness of the ONNI. METHODS: In a multi-centred, cluster-randomised pilot study, nurses from outpatient clinics were randomly allocated to usual care (UC) or the ONNI. Patients planned for elective surgery were included if they were at increased risk for undernutrition based on the Malnutrition Universal Screening Tool (MUST) and hospital admission was not planned within seven days. Feasibility outcomes included participation rate, extent of intervention delivery, and patient satisfaction. Nutritional intake was monitored for two days before admission. Body weight, BMI and MUST scores at hospital admission were compared to measurements from the outpatient clinic visit. Data were analysed on an intention-to-treat basis by researchers who were blinded for patients and caregivers. RESULTS: Forty-eight patients enrolled the feasibility phase. Participation rate was 72%. Nurses delivered all intervention components adequately in the end of the implementation period. Finally, 152 patients (IG: n = 66, 43%) participated in the study. A significant difference in mean energy intake (870 kcal/d, 95%CI:630-1109 p < 0.000) and mean protein intake (34.1 g/d, 95%CI: 25.0-43.2; p < 0.000) was observed in favour of the IG. Nutritional energy requirements were achieved in 74% (n = 46) of the IG and in 17% (n = 13) of the UC group (p < 0.000), and protein requirements were achieved in 52% (n = 32) of the IG, compared to 8% (n = 6) of the UC group (p < 0.000). Body weight, BMI and MUST scores did not change in either group. CONCLUSIONS: The ONNI is a feasible and effective intervention tool for nurses at outpatient clinics. Patients in the IG had more nutritional intake and fulfilled nutritional requirements significantly more often than patients receiving UC. Further research is required to determine the optimal pre-operative timing of nutritional support and to measure its effect on other patients groups. CLINICAL TRIAL REGISTRATION: The study protocol was registered at the ClinicalTrial.gov website with the following identifier: NCT02440165.

'Prevent undernutrition and prescribe oral nutritional supplements correctly': an educational intervention for district nurses.

AIM: The aim of this study was to evaluate district nurses' (DN) perceived nutritional care and actual level of knowledge about nutritional care before and after a continuing educational intervention. BACKGROUND: Nutritional treatment is an important part of nursing care, and health professionals responsible for nutritional care for older adults must therefore have sufficient understanding of nutritional problems to provide appropriate support. Previous research has shown that nutritional problems frequently go unrecognized and that health care personnel often lacks knowledge about nutritional care and relevant methods of assessing nutritional status. However, little is known about DNs' knowledge about nutritional care. METHODS: An evaluative study with a study-specific questionnaire administered before and after a 2.5-day continuing educational course for DNs in primary health care in Stockholm County, Sweden. The course was given over a period of two to three months. The questionnaire measured DNs' perceived nutritional care and actual level of knowledge about nutritional care. FINDINGS: A total of 456 DNs completed the questionnaire both before and after the intervention. Participants' mean age was 50 years. They had worked a mean of 26 years in health care and 10 years as DNs. Before the intervention, many DNs reported that they did not work with nutritional care in an optimal way. After the intervention, significant improvements were found in perceived nutritional care and actual level of knowledge about the topic. However, not all DNs achieved the learning objectives of the course, so work remains to be done to ensure that DNs have sufficient knowledge of nutritional care to provide appropriate support and correctly prescribe oral nutritional supplements. CONCLUSIONS: The study provides new information on DNs' perceived nutritional care and actual level of knowledge. The result of the intervention helps lay the foundation for good nutritional care for older patients in primary care.

Dietary and Feeding Modifications for Older Adults.

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aim to help nurses provide caregivers with the tools they need to manage their family member's health care at home.The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers. This article is the second of two that explain the nutritional principles nurses should consider and reinforce with caregivers. Each article includes an informational tear sheet-Information for Family Caregivers-that contains links to the instructional videos. To use this series, nurses should read the article first, so they understand how best to help family caregivers, and then encourage caregivers to watch the videos and ask questions. For additional information, see Resources for Nurses.

Clinical and Economic Value of Nutrition in Healthcare: A Nurse's Perspective.

In the US healthcare system, malnutrition is a common condition, yet it remains underreported and underdiagnosed. The financial costs of disease-associated malnutrition are substantial; hospital-acquired conditions, readmissions, and prolonged lengths of stay are reported to cost as much as $150 billion per year. By contrast, nutrition-focused quality improvement programs for inpatients can help reduce the negative impact of disease-associated malnutrition. Such programs include systematic screening for malnutrition risk on admission, timely malnutrition diagnoses, and prompt nutrition interventions, which have been shown to lower rates of hospital-acquired infections, shorten lengths of stay, reduce readmissions, and lessen costs of care. Nurses are ideally positioned to play critical roles in nutrition-related care-screening for malnutrition on admission, monitoring for and addressing conditions that impede nutrition intake, and ensuring that prescribed nutrition interventions are delivered and administered or consumed. Such nursing support of multidisciplinary nutrition care contributes to better patient outcomes at lower costs.

Lack of focus on nutrition and documentation in nursing homes, home care- and home nursing: the self-perceived views of the primary care workforce.

BACKGROUND: Malnutrition is a comprehensive challenge for the nursing home, home care- and home nursing sector. Nutritional care and the subsequent documentation are a common and multifaceted healthcare practice that requires that the healthcare professionals possess complex combinations of competencies in order to deliver high-quality care and treatment. The purpose of this study was to investigate how a varied group of healthcare professionals' perceive their own competencies within nutrition and documentation and how organizational structures influence their daily work and the quality of care provided. METHODS: Two focus groups consisting of 14 healthcare professionals were conducted. The transcribed focus group interviews was analyzed using the qualitative content analysis approach. RESULTS: Six categories were identified: 1) Lack of uniform and systematic communication affect nutritional care practices 2) Experience-based knowledge among the primary workforce influences daily clinical decisions, 3) Different attitudes towards nutritional care lead to differences in the quality of care 4) Differences in organizational culture affect quality of care, 5) Lack of clear nutritional care responsibilities affect how daily care is performed and 6) Lack of clinical leadership and priorities makes nutritional care invisible. CONCLUSIONS: The six categories revealed two explanatory themes: 1) Absent inter- and intra-professional collaboration and communication obstructs optimal clinical decision-making and 2) quality deterioration due to poorly-established nutritional care structure. Overall, the two themes explain that from the healthcare professionals' point of view, a visible organization that allocates resources as well as prioritizing and articulating the need for daily nutritional care and documentation is a prerequisite for high-quality care and treatment. Furthermore, optimal clinical decision making among the healthcare professionals are compromised by imprecise and unclear language and terminology in the patients' healthcare records and also a lack of clinical guidelines and standards for collaboration between different healthcare professionals working in nursing homes, home care or home nursing. The findings of this study are beneficial to support organizations within these settings with strategies focusing on increasing nutritional care and documentation competencies among the healthcare professionals. Furthermore, the results advocate for the daily involvement and support of leaders and managers in articulating and structuring the importance of nutritional care and treatment and the subsequent documentation.

What more can community nurses do to manage adult malnutrition.

This article gives an outline of the key groups at risk of malnutrition in the community and the effects and clinical consequences of not identifying and managing these groups. It outlines the potential health and social costs of not identifying and treating malnutrition in the community and advises how malnutrition arises in these 'at-risk' groups. As 93% of those affected by malnutrition are living in our communities, advice is given on how community nurses can play a pivotal role in identifying malnutrition by initiating conversations about dietary intake with patients and integrating screening and nutritional care into pathways of care.

Nutrition-Related Clinical Decision Making of Pediatric Oncology Nurses.

Children with a cancer diagnosis have risk factors leading to unique nutritional challenges. Malnutrition in this population is correlated with worse patient outcomes. Nurses are responsible for providing holistic care to their patients; however, the quality of nutritional assessments by pediatric oncology nurses is unknown. The purpose of this study was to investigate staff nurses' clinical decision making regarding nutritional assessment of children with cancer. A web-based survey composed of a demographic form, vignettes of patients with diverse nutritional status and the New General Self-Efficacy Scale, was distributed to members of the Association of Pediatric Hematology Oncology Nurses. Participants were also asked to rate their confidence in responses as well as select key nutritional cues. Nurses were significantly more likely to under-rate the nutritional status and select far fewer cues than the experts. Further research regarding nutritional assessment is warranted. Evidenced-based guidelines for nutritional assessment of children with cancer should be developed to ensure the highest quality of care is provided to this patient population.

Improving oncology nurses' knowledge, self-confidence, and self-efficacy in nutritional assessment and counseling for patients with cancer: A quasi-experimental design.

OBJECTIVE: Our objective was to assess the effectiveness of a structured educational program on improving oncology nurses' knowledge, self-confidence, and self-efficacy in nutritional assessment and counseling for patients with cancer. METHODS: A pretest-posttest quasi-experimental design was used. A sample of 60 nurses from oncology units participated as an experimental group (n = 30) and a control group (n = 30). The participants completed a knowledge test before completing the educational program. Self-confidence and self-efficacy also were assessed pre- and postintervention. RESULTS: There was a significant difference between the experimental (mean [M] = 26.00, SD = 8.00) and control (M = 10.00, SD = 3.75) groups regarding knowledge after the interventional sessions (t = -16.00, P = 0.001). Furthermore, the results indicated a significant difference (t = -24.00, P = 0.001) between the experimental group (M = 60.50, SD = 13.10) and the control group (M = 36.50, SD = 7.60) regarding self- confidence in managing cancer patients. Finally, there was a significant difference between the experimental group (M = 33.50, SD = 3.10) and control group (M = 23.25, SD = 2.75) regarding self-efficacy (t = -10.25, P = 0.001). CONCLUSIONS: The educational program improved the oncology nurses' knowledge, self-confidence, and self-efficacy in relation to nutritional assessment and counseling. Improving nurses' competencies will improve the quality of care provided to the patients and patient health outcomes.

El cribado nutricional como parte de los cuidados enfermeros / Nutritional screening as part of nursing care

Objetivo: explorar el conocimiento y las actitudes de las enfermeras en relación con la valoración o cribado nutricional en pacientes hospitalizados. Método: se llevó a cabo una narrativa entre noviembre de 2017 y enero de 2018, mediante el diseño de estrategias de búsqueda en lenguaje libre y controlado en las bases de datos Pubmed, Cinahl, Cuiden, Cochrane Library, Sicelo, Dialnet Plus, Lilacs y la Colección principal de la Web of Science. Se emplearon los operadores booleanos "AND" y "OR" y se aplicó el limitador temporal de los últimos 10 años. Se contemplaron como variables la evaluación y el estado nutricional y las actitudes y conocimientos de las enfermeras. Los artículos fueron revisados por todas las autoras. Resultados: de los 1.054 artículos recuperados se seleccionaron 17. Si bien las/os enfermeras/os perciben la valoración nutricional y el cribado como importante, son varias las barreras que dificultan su realización: la falta de conocimientos y de entrenamiento en la utilización de las herramientas, la preferencia por el empleo del juicio personal para realizar esta actividad, la percepción de que han de ser otros profesionales quienes la efectúen, la falta de tiempo o la priorización de otras actividades de cuidados, entre otras. Se excluyeron aquellos artículos que se referían a pacientes no hospitalizados, con trastornos de la conducta alimentaria, mujeres embarazadas y pacientes paliativos. Conclusiones: ante la escasez de bibliografía se hace necesario realizar estudios de investigación que permitan visibilizar los factores que dificultan la implantación de las herramientas de cribado y la evaluación nutricional de los pacientes hospitalizados

Objective: to explore the knowledge and attitudes of nurses regarding nutritional assessment or screening in hospitalized patients. Method: a narrative study was conducted between November, 2017 and January, 2018, through the design of search strategies in free and controlled language in the following databases: Pubmed, Cinahl, Cuiden, Cochrane Library, Sicelo, Dialnet Plus, Lilacs, and the Web of Science Core Collection. The Boolean operators "AND" and "OR" were used, and there was a time limitation for the past 10 years. The variables observed were nutritional assessment and status, and attitudes and knowledge by nurses. Articles were reviewed by authors. Results: seventeen (17) articles were selected of the 1,054 articles retrieved. Even though nurses perceived nutritional assessment and screening as important, there are various barriers that render difficult its implementation: lack of knowledge and training in the use of tools, preference for using personal judgment for this activity, the perception that other professionals must be the ones to conduct it, lack of time, or prioritizing other care activities, among others. The study excluded those articles that dealt with non-hospitalized patients, those with eating disorders, pregnant women, and palliative care patients. Conclusions: given the lack of bibliography, it is necessary to conduct research studies which allow to visualize the barriers for the implementation of screening tools and nutritional assessment of hospitalized patients

Estado nutricional en las personas con insuficiencia cardíaca crónica y/o enfermedad pulmonar obstructiva crónica. Impacto en la calidad de vida y en las exacerbaciones / Nutritional status in people with chronic heart failure and / or chronic obstructive pulmonary disease. Impact on quality of life and exacerbations

Objetivo: Conocer el estado nutricional de los pacientes con Insuficiencia cardiaca (IC) y/o Enfermedad pulmonar obstructiva crónica (EPOC) atendidos en un centro de atención primaria de la ciudad de Barcelona y describir las características clínicas y sociodemográficas que puedan tener relación con el estado nutricional.Método: Estudio descriptivo transversal, durante los meses del 2014. En las visitas realizadas por enfermería, se recogieron las siguientes variables: en el caso de la IC grado de funcionalidad mediante la escala NYHA, en el caso de la EPOC, Grado de disnea mediante la escala BMRC. En ambos se determina el IMC, se administra la escala MNA, se valora el nivel de actividad física y la calidad de vida a través de la escala EQ-5D.Resultado: De los 192 participantes, el 59,4% eran Hombres y la media de edad de 77,64 años(ds10,12). De las enfermedades estudiadas el 40,1% eran IC, el 45,8% EPOC y ambas enfermedades el 14,1%. El riesgo de malnutrición fue del 11,4% de las personas con EPOC, el 16,9% de las personas con IC y el 33,3% de las personas con ambas patologías.(P 0,028)Al hacer la regresión logística con el resto de variables, el único factor asociado es el sexo, obteniendo los Hombres un OR 3 (1,008-8,95).Conclusiones El estado nutricional empeora cuando se padecen las dos patologías de manera concomitante.En la malnutrición o en el riesgo de padecerla, el sexo juega un papel muy importante

Targets: To know the nutritional status in patients with heart failure (HF) and with chronic obstructive pulmonary disease (COPD), cared in a Barcelona's primary health center and to describe the clinical and socio-demographic characteristics which may be related with the nutritional status.Method: A transversal descriptive study was performed during de year 2014. In nursing visits the following variables were collected: in HF patients, levels of functionality based in NYHA scale, in COPD patients, dyspnea grade based in BMRC scale. In both cases the body mass index (BMI) was determined; MNA scale is used, and also the physical activity and quality of life is evaluated by the EQ-5D scale.Results: Of the 192 participants, 59, 4% were men and had a mean age of 77, 64 years (ds10, 12. Of the studied diseases, 40, 1% were HF, 45, 8% COPD and 14, 1% both diseases). The risk of malnutrition was 11, 4% in COPD patients, 16, and 9% in people with HF and 33, 3% in both HF and COPD patients. (P 0,028)With the logistic regression with the other variables, the only associated factor was gender, having men an OR 3 (1,008-8, 95)Conclusions: The nutritional status gets worse in people with both pathologies in concomitantly way. Gender plays a crucial role in malnutrition or risk of the disease