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Mealtime challenges in patients with chronic obstructive pulmonary disease: Who is responsible?

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  • Dorthe Sørensen
  • Anna Rottensten Wieghorst
  • Johanne Andersen Elbek
  • Camilla Askov Mousing

Abstract

Aims To explore experiences of, and practices related to, mealtime challenges in patients with chronic obstructive pulmonary disease (COPD). Background Nutritional status is a significant indicator of prognosis and outcome in patients with COPD. Preventing unintended weight loss and helping patients regain weight are important nursing tasks. Dietary supplements have been effective in treating underweight in cases of stable COPD. However, compliance with long‐term interventions is quite low. Improving nutritional intake through knowledge of meal‐related challenges is the key to making further progress in preventing unintended weight loss. Design This study employed an ethnographic design using the go‐along method. Methods From September 2018–June 2019, 34 hr of meal‐related observations and informal conversations with purposefully selected patients (n = 15) were completed at a Danish respiratory medicine ward and in patients’ homes. We analysed the empirical data using a Ricoeur‐inspired method. Reporting adheres to the COREQ Checklist. Findings In this study, we identified the absence of professional responsibility as a main challenge. Mealtimes appeared to be relegated to a matter of nutrition, and common practices surrounding mealtimes were no longer observed. Patients became dependent individuals who had to settle for the food available. In addition, physiological challenges often resulted in patients re‐evaluating the benefits of eating, concluding that it was not worth the effort and therefore not eating. Furthermore, patients were hesitant to communicate their needs, which left a number of nonverbalised challenges unattended. Conclusions Overall, meal‐related challenges pose a risk of unintended weight loss, and the health professionals’ work with mealtimes lacks a coordinated, systematic approach. Further research is needed to develop or implement interventions that can accommodate mealtimes. Relevance to clinical practice This study contributes valuable knowledge that can be used to improve the quality of nursing care and prevent unintended weight loss in patients with COPD.

Suggested Citation

  • Dorthe Sørensen & Anna Rottensten Wieghorst & Johanne Andersen Elbek & Camilla Askov Mousing, 2020. "Mealtime challenges in patients with chronic obstructive pulmonary disease: Who is responsible?," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(23-24), pages 4583-4593, December.
  • Handle: RePEc:wly:jocnur:v:29:y:2020:i:23-24:p:4583-4593
    DOI: 10.1111/jocn.15491
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    References listed on IDEAS

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    1. Sandra Ullrich & Helen McCutcheon & Barbara Parker, 2011. "Reclaiming time for nursing practice in nutritional care: outcomes of implementing Protected Mealtimes in a residential aged care setting," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(9‐10), pages 1339-1348, May.
    2. Chenfan Xia & Helen McCutcheon, 2006. "Mealtimes in hospital – who does what?," Journal of Clinical Nursing, John Wiley & Sons, vol. 15(10), pages 1221-1227, October.
    3. Sigrid Odencrants & Kersti Theander, 2013. "Assessment of nutritional status and meal‐related situations among patients with chronic obstructive pulmonary disease in Primary health care – obese patients; a challenge for the future," Journal of Clinical Nursing, John Wiley & Sons, vol. 22(7-8), pages 977-985, April.
    4. Malene Beck & Bente Martinsen & Ingrid Poulsen & Regner Birkelund, 2016. "Mealtimes in a neurological ward: a phenomenological‐hermeneutic study," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(11-12), pages 1614-1623, June.
    5. Sue M Green & Helen J Martin & Helen C Roberts & Avan Aihie Sayer, 2011. "A systematic review of the use of volunteers to improve mealtime care of adult patients or residents in institutional settings," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(13‐14), pages 1810-1823, July.
    6. Helen C Roberts & Sanet De Wet & Kirsty Porter & Gemma Rood & Norma Diaper & Judy Robison & Anna L Pilgrim & Marinos Elia & Alan A Jackson & Cyrus Cooper & Avan Aihie Sayer & Sian Robinson, 2014. "The feasibility and acceptability of training volunteer mealtime assistants to help older acute hospital inpatients: the Southampton Mealtime Assistance Study," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(21-22), pages 3240-3249, November.
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