Patient perceptions of the role of nutrition for pressure ulcer prevention in hospital: an interpretive study

Abstract

PURPOSE: The aims of this study were to explore (a) patients' perceptions of the role of nutrition in pressure ulcer prevention; and (b) patients' experiences with dieticians in the hospital setting. DESIGN: Interpretive qualitative study. SUBJECTS AND SETTING: The sample comprised 13 females and 7 males. Their mean age was 61.3 +/- 12.6 years (mean +/- SD), and their average hospital length of stay was 7.4 +/- 13.0 days. The research setting was a public health hospital in Australia. METHODS: In this interpretive study, adult medical patients at risk of pressure ulcers due to restricted mobility participated in a 20 to 30 minute interview using a semi-structured interview guide. Interview questions were grouped into 2 domains; perceptions on the role of nutrition for pressure ulcer prevention; and experiences with dieticians. Recorded interviews were transcribed and analyzed using content analysis. RESULTS: Within the first domain, 'patient knowledge of nutrition in pressure ulcer prevention,' there were varying patient understandings of the role of nutrition for prevention of pressure ulcers. This is reflected in 5 themes: (1) recognizing the role of diet in pressure ulcer prevention; (2) promoting skin health with good nutrition; (3) understanding the relationship between nutrition and health; (4) lacking insight into the role of nutrition in pressure ulcer prevention; and (5) acknowledging other risk factors for pressure ulcers. Within the second domain, patients described their experiences with and perceptions on dieticians. Two themes emerged, which expressed differing opinions around the role and reputation of dieticians; they were receptive of dietician input; and displaying ambivalence towards dieticians' advice. CONCLUSIONS: Hospital patients at risk for pressure ulcer development have variable knowledge of the preventive role of nutrition. Patients had differing perceptions of the importance and value of information provided by dieticians.