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Open AccessArticle

Effect of Nutritional Intervention Programs on Nutritional Status and Readmission Rate in Malnourished Older Adults with Pneumonia: A Randomized Control Trial

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Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Department of Nutritional Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
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Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
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Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
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Center for Physical and Health Education, National Sun Yat-sen University, Kaohsiung 804, Taiwan
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Ph.D. Program in Biomedical Engineering, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(23), 4758; https://doi.org/10.3390/ijerph16234758
Received: 11 October 2019 / Revised: 23 November 2019 / Accepted: 25 November 2019 / Published: 27 November 2019
(This article belongs to the Special Issue Nutrition for Older People)
Pneumonia leads to changes in body composition and weakness due to the malnourished condition. In addition, patient family caregivers always have a lack of nutritional information, and they do not know how to manage patients’ nutritional intake during hospitalization and after discharge. Most intervention studies aim to provide nutritional support for older patients. However, whether long-term nutritional intervention by dietitians and caregivers from patients’ families exert clinical effects—particularly in malnourished pneumonia—on nutritional status and readmission rate at each interventional phase, from hospitalization to postdischarge, remains unclear. To investigate the effects of an individualized nutritional intervention program (iNIP) on nutritional status and readmission rate in older adults with pneumonia during hospitalization and three and six months after discharge. Eighty-two malnourished older adults with a primary diagnosis of pneumonia participated. Patients were randomly allocated to either a nutrition intervention (NI) group or a standard care (SC) group. Participants in the NI group received an iNIP according to energy and protein intake requirements in addition to dietary advice based on face-to-face interviews with their family caregivers during hospitalization. After discharge, phone calls were adopted for prescribing iNIPs. Anthropometry (i.e., body mass index, limb circumference, and subcutaneous fat thickness), blood parameters (i.e., albumin and total lymphocyte count), hospital stay, Mini-Nutritional Assessment-Short Form (MNA-SF) score, target daily calorie intake, total calorie intake adherence rate, and three-major-nutrient intakes were assessed during hospitalization and three and six months after discharge. Both groups received regular follow-up through phone calls. Furthermore, the rate of readmission resulting from pneumonia was recorded after discharge. During hospital stay, the NI group showed significant increases in daily calorie intake, total calorie intake adherence rate, and protein intake compared with the SC group (p < 0.05); however, no significant difference was found in anthropometry, blood biochemical values, MNA-SF scores, and hospital stay. At three and six months after discharge, the NI group showed significantly higher daily calorie intake and MNA-SF scores (8.2 vs. 6.5 scores at three months; 9.3 vs. 7.6 scores at six months) than did the SC group (p < 0.05). After adjusting for sex, the readmission rate for pneumonia significantly decreased by 77% in the NI group compared with that in the SC group (p = 0.03, OR: 0.228, 95% CI: 0.06–0.87). A six-month iNIP under dietitian and patient family nutritional support for malnourished older adults with pneumonia can significantly improve their nutritional status and reduce the readmission rate. View Full-Text
Keywords: nutritional intervention; malnutrition; hospital stay; family care; caregiver; respiratory disease nutritional intervention; malnutrition; hospital stay; family care; caregiver; respiratory disease
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MDPI and ACS Style

Yang, P.-H.; Lin, M.-C.; Liu, Y.-Y.; Lee, C.-L.; Chang, N.-J. Effect of Nutritional Intervention Programs on Nutritional Status and Readmission Rate in Malnourished Older Adults with Pneumonia: A Randomized Control Trial. Int. J. Environ. Res. Public Health 2019, 16, 4758. https://doi.org/10.3390/ijerph16234758

AMA Style

Yang P-H, Lin M-C, Liu Y-Y, Lee C-L, Chang N-J. Effect of Nutritional Intervention Programs on Nutritional Status and Readmission Rate in Malnourished Older Adults with Pneumonia: A Randomized Control Trial. International Journal of Environmental Research and Public Health. 2019; 16(23):4758. https://doi.org/10.3390/ijerph16234758

Chicago/Turabian Style

Yang, Pei-Hsin; Lin, Meng-Chih; Liu, Yi-Ying; Lee, Chia-Lun; Chang, Nai-Jen. 2019. "Effect of Nutritional Intervention Programs on Nutritional Status and Readmission Rate in Malnourished Older Adults with Pneumonia: A Randomized Control Trial" Int. J. Environ. Res. Public Health 16, no. 23: 4758. https://doi.org/10.3390/ijerph16234758

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