Therapeutic Diet Assessment and Modifications Improve Nutritional Status, Dietary Intake and Patient Satisfaction among In-Patients at AL-khor Hospital - State of Qatar

Abstract

Background has been recognized that hospital food service could be improved, with malnutrition a particular concern. The problem of patients obtaining adequate nutrition in hospital is complex with many constraints at ward level. The hypothesis of this study is that patients’ food intake and improved nutritional status is correlated with patient satisfaction with his/her diet. Aims: 1. assess patient food intake and risk of malnutrition 2. assess patient satisfaction of the therapeutic diet menu.

Methods: This is quality improvement cross-sectional study was conducted into two phases, over 12 months phase one from Jan – June (pre-diet modifications) and phase two from July- Dec. 2023(post diet modifications), at AL-Khor hospital – Hamad Medical Corporation (HMC) – the State of Qatar. Seven satisfaction dimensions with menus were included mainly taste, texture, temperature, appearance, quantity, service timelines, and food choices. Food intake was assessed based on plate leftovers. The risk of malnutrition was assessed based on Nutrition Risk Index (NRI) and Geriatric Nutrition Risk Index (GNRI). The satisfaction level was categorized into four categories: excellent, very good, good, and need improvement. Excellent and very good patient response considered as satisfied, while good and need improvement response considered as not satisfied.  Food intake was classified as adequate (≥80%) and inadequate intake (<80%) of patient’s requirements. Malnutrition risk was classified as: severe, moderate, mild and no risk, while Geriatric Nutrition Risk Index (GNRI)was classified as: severe, moderate, mild and no risk. Dietary modifications were carried out after phase one of this study based on assessment of patient satisfaction, food intake and malnutrition risk assessment. Diet modifications include four components: egg, protein source (meat, fish, chicken), cooked vegetables and soups. Data was gathered, managed, tabulated, and statistically analyzed to deduce results using SPSS (Statistical Package for Social Sciences, version 24, Chicago, IL, USA. Results: The results of overall satisfaction indicated that significantly improved during phase two (88.2%) compared with phase one (78.1%), (P = 0.03).  The overall Nutritional intake was significantly improved in phase two (74.3%) compared with phase one (69.0%), (p =0.02). There was no significant difference between participant age, weight difference, nutritional risk index (NRI), albumin, and osmolarity pre- and post-diet modifications (P > 0 .05).  After the dietary modifications, Body Mass Index (BMI) and Geriatric Nutritional Risk Index (GNRI), were improved significantly (P= 0.03 and 0.04) respectively. Conclusion: There are opportunities to improve the meal and foodservice experience for this patient group to meet their nutritional requirements and expectations. To enhance nutrition care for inpatients on therapeutic diets, demographics, investigation of the best foodservice system, and sufficient dietetic resources are required.

Keywords: satisfaction, food intake, diet, requirements, modifications.

DOI: 10.7176/FSQM/123-08

Publication date: November 30th 2024