Self-care ability and sense of coherence in older nutritional at-risk patients.

OBJECTIVE: To investigate self-care ability and sense of coherence in geriatric rehabilitation patients nutritionally screened using the Nutritional Form For the Elderly and to relate the patients' perceived health to self-care ability and sense of coherence. DESIGN: Cross-sectional study. SETTING: A geriatric rehabilitation ward in a hospital in western Sweden. SUBJECTS: A sample of 172 consecutively recruited patients (65+ years) fulfilled the inclusion criteria. One hundred forty-four patients were included in the study because 16 patients refused to take part and 12 could not complete the entire data collection procedure. METHODS: Interviews, using one instrument for nutritional screening and other instruments measuring self-care ability and sense of coherence and one question about perceived health, were performed. RESULTS: Patients at medium or high risk for undernutrition had lower self-care ability (P<0.001) and weaker sense of coherence (P=0.007) than patients at low risk for undernutrition. Lower self-care ability, being single and admitted from another hospital ward was found to be predictors for being at medium or high risk for undernutrition. Patients who perceived good health had higher self-care ability (P<0.001) and stronger sense of coherence (P<0.001) than patients who perceived ill health. CONCLUSIONS: There is an indication that older patients at low risk for undernutrition have a greater capability to care for themselves than patients at medium or high risk for undernutrition. Perceived ill health in older patients is associated with lower self-care ability and weaker sense of coherence.

Developing and testing the Nutritional Form For the Elderly.

Undernutrition among elderly patients is a significant problem in nursing care. The aims of this study were to develop and test an instrument for identifying actual and potential undernutrition among elderly patients in clinical nursing care. A Likert-type scale consisting of 15 items was constructed. A consecutive sample of 56 elderly patients (>65 years) in a geriatric rehabilitation ward in western Sweden were interviewed with the instrument. The data were mainly analysed with non-parametric statistical methods. The results showed that the instrument was a fairly reliable scale with a Cronbach's alpha coefficient of 0.72. Evidence of validity concerning face validity, criterion-related validity-including concurrent and predictive validity-and construct validity was shown in the study group. Further testing is required if the instrument is to be used in clinical nursing care and research.