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High feeding dependence prevalence in residents living in Italian nursing homes requires new policies: findings from a regionally based cross-sectional study

Palese, Alvisa; Grassetti, Luca; Bandera, Davide; Zuttion, Ranieri; Ferrario, Barbara; Ponta, Sandra; Hayter, Mark; Watson, Roger

Authors

Alvisa Palese

Luca Grassetti

Davide Bandera

Ranieri Zuttion

Barbara Ferrario

Sandra Ponta



Abstract

Objectives: An increased amount of functional dependence has been reported among residents living in nursing homes. Among others, feeding dependence is one of the most complex needs to satisfy: behind the attempt to personalise meals with individual preferences and clinical regimens, all residents require help at the same moment and for long periods of time, three or more times a day. With the intent of debating policy implications, the aims of this study were to advance the knowledge in the field of feeding dependence prevalence and predictors in Italy, a country where life expectancy is among the highest in the World.
Method: A large retrospective regionally-based study approaching all nursing homes (n=105) was performed in 2014; all residents (n=10,900) were eligible and those with a completed assessment recorded in the regional database and aged > 65 years (n=8,875) were included.
Results: 1,839 residents (20.7%) were in total need of help in feeding on a daily basis. At the multilevel analysis, predictors were moderate/severe dementia (OR 4.044, CI 95% 3.213–5.090); dysphagia (OR 4.003 CI 95% 3.155–5.079); pressure sores (OR 2.317 CI 95% 1.803–2.978); unintentional weigh loss (OR 2.197 CI 95% 1.493–3.233); unsociability (OR 1.561 CI 95% 1.060–2.299); and clinical instability (OR 1.363 CI 95% 1.109–1.677).
Conclusions: The feeding dependence prevalence emerged seem to be unique compared to that documented at the international levels. Modifiable and unmodifiable predictors found require new policies regarding workforce skills-mix and shifts schedules; as well as alliances with families, associations and communities’ stakeholders. According to the complexity of the resident profile emerged, staff education and training is also recommended.

Citation

Palese, A., Grassetti, L., Bandera, D., Zuttion, R., Ferrario, B., Ponta, S., …Watson, R. (2018). High feeding dependence prevalence in residents living in Italian nursing homes requires new policies: findings from a regionally based cross-sectional study. Health Policy, 122(3), 301-308. https://doi.org/10.1016/j.healthpol.2018.01.011

Journal Article Type Article
Acceptance Date Jan 15, 2018
Online Publication Date Feb 2, 2018
Publication Date 2018-03
Deposit Date Jan 15, 2018
Publicly Available Date Feb 3, 2019
Journal Journal of advanced nursing
Print ISSN 0168-8510
Electronic ISSN 1872-6054
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 122
Issue 3
Pages 301-308
Series Title Health Policy
DOI https://doi.org/10.1016/j.healthpol.2018.01.011
Keywords Feeding dependence; Elderly; Health-care workforce; Nursing home; Policy; Predictors
Public URL https://hull-repository.worktribe.com/output/539750
Publisher URL https://www.sciencedirect.com/science/article/pii/S0168851018300265
Copyright Statement © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Additional Information This is the accepted version of an article published in Health Policy, 2018. The published version can be accessed at the DOI link.

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Copyright Statement
© 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/





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