ESPEN Congress Barcelona 2012 Nursing session Strategies to improve food intake in hospitalized patients: the nurse's role (OP028) M. Holst (Denmark)
Dining in virtual companymotivation to increase food intake Mette Holst Head of Clinical Nutrition Research, RN, MCN, Phd Centre for Nutrition and Bowel Disease Aalborg University Hospital, Denmark
The Living Lab Food&Nutrition Centre for Nutrition and Bowel Diseases CET Department of Computer Sciences
Background Reduced nutrition intake compromises recovery in hospitalized patients Eating together with someone seems to prolong the meal and increase food intake In Hematology, infectious disease and Gastroenterology (Short Bowel) departments at Aalborg University Hospital, patients suffered from long term stay and isolation and.. Staff found it difficult to motivate patients to eat A master student at Aalborg University, Department of Computer Science, came up with the idea to use Skype
Long term hospital stay Perceived impact of long stay on the patient Participants identified issues such as missing their family and tiredness due to disturbed sleep. A problem for participants who had disturbed sleep during the night was that they slept more during the day. This included meal times and therefore compromised their nutrition intake and possibly increased their recovery time. Patient concerns included:.. their recent loss of appetite and associated weight loss Johnson A et al. Aust Health Rev 2005: 29(2): 235 240
Patients in Isolation Physical isolation often leads to emotional isolation (Cohen eia/2001). Patients with mental disturbances as a result of isolation may be at increased risk of physical distress, including infection (Sasaki etal 2000). It is also commonly perceived that patients nursed in isolation experience significant psychological distress as a result of decreased interaction and support (Zerbe etal 1994, Campbell 1999, Oldman-Pritchard 2003). Food intake? Duffy L (2009) Care of immunocompromised patients in hospital. Nursing Standard. 23, 36, 35-41.
Aim To test the logistics and social function between patient and family/friends of pervasive computing around the meal, to increase motivation for food intake.
Methods Long term patients Qualitative sampling method Two laptops connected to the Internet with webcams and Skype was installed at patients and relatives
Interviews 1. Before system set up 2. After the first time the couple had used the system 3. When the couple had used the system for at least three days and finally when the study were completed
Semi structured qualitative interviews before, during and after the study, focusing on: Appetite, motivation and logistics. Interviews were analyzed by condensation of text and meaning
Results/ Participants Five patients (31-74 years) and their relatives were included. In total 37 interviews Transcripts in total; 249 pages
Findings / Themes Logistic and social function: Generally patients and relatives were very satisfied with dining together via Skype and found it informal and easy to use. Course of meal: Participants felt more motivated to eat, and had an improved general mood and willpower. Duration of meal was longer. Patients felt improved appetite, less isolation, and motivation. Communication with others, including grand children took place between meals.
Results "It has opened a new world for me! I knew nothing of Skype before I joined the project, but it has meant a lot to me to say good morning and good night to my wife and have lunch with her every day, even though she was at home in Viborg Male, 61 years
Other benefits "We had it on during rounds, and it worked really well. I tend to easily forget what has been said, but now my wife could see and hear the doctor, ask questions and so on Male, 61 years "I have been hospitalized for six months and it has just been so wonderful that I, in spite of hospitalization have been able to keep up with how things are going with my 3 month old grandson" Female, 57 years
Conclusion Findings from the study suggested, that Pervasive Computing motivates patients to eat more. Patients felt happier, not so far apart from their relative and less alone when they used Skype.
Perspectives The main study has recently begun in medical and surgery departments
Thanks to Martin Myrup, who did most of the work Thank you for your attention mette.holst@rn.dk