Stanje prehranjenosti in apetit pri hospitaliziranih bolnikih z akutnim srčnim popuščanjem : magistrsko delo

Somi, Tatjana (author), Farkaš-Lainščak, Jerneja (mentor), Kvas, Andreja (comentor), Pandel Mikuš, Ruža (reviewer)

Uvod: Slab apetit in podhranjenost sta pogosto prisotna pri bolnikih s srčnim popuščanjem. Prepoznavanje in boljše razumevanje obeh problemov zagotavljata podporo pri izboljšanju apetita in preprečevanju podhranjenosti. Medicinske sestre so prve, ki pri bolnikih prepoznajo težave z apetitom in prehranjenostjo. Z zdravstveno vzgojo lahko zagotovijo potrebno znanje, spretnosti in veščine, ki jih bolniki potrebujejo za izboljšanje apetita in prehrane. Namen: Namen magistrskega dela je proučiti apetit in stanje prehranjenosti hospitaliziranih bolnikov z akutnim srčnim popuščanjem in opisati izvedbo njihove zdravstvene vzgoje. Metode dela: Uporabili smo kvantitativno metodo dela. V Splošni bolnišnici Murska Sobota smo v obdobju od 8. 3. 2022 do 1. 2. 2023 med hospitaliziranimi bolniki z akutnim srčnim popuščanjem izvedli presečno raziskavo. Podatke smo zbrali z uporabo različnih anketnih vprašalnikov. Z analizo bioelektrične impedance smo ocenili telesno sestavo bolnikov. Rezultati: V vzorec smo vključili 53 bolnikov, med katerimi je bila večina moških (55 %), s povprečno starostjo 73,4 ± 9,1 let in povprečno vrednostjo iztisnega deleža levega prekata 39 ± 14 %. 64 % bolnikov je imelo slab apetit in pomembno tveganje za izgubo vsaj 5 % telesne mase v naslednjih 6 mesecih. Slabši apetit je bil povezan s starostjo (r = –0,433; p = 0,001), prisotnimi simptomi depresije (r = –0,552; p < 0,001), z zdravjem povezano kakovostjo življenja (r = –0,309; p = 0,024), samooceno lastnega zdravstvenega stanja (r = 0,298; p = 0,030) in koncentracijo NT-proBNP (r = –0,429; p = 0,002). 45 % bolnikov je bilo normalno prehranjenih, 47 % jih je imelo tveganje podhranjenosti in 8 % je bilo podhranjenih. Razprava in zaključek: Z raziskavo smo ugotovili, da ima skoraj dve tretjini hospitaliziranih bolnikov z akutnim srčnim popuščanjem slab apetit, skoraj ena desetina pa jih je podhranjenih. V njihovo obravnavo bi bilo smiselno vključiti sistematično ocenjevanje apetita in stanja prehranjenosti kot del negovalne anamneze ob sprejemu v bolnišnico. Zdravstvena vzgoja hospitaliziranih bolnikov z akutnim srčnim popuščanjem mora vključevati tudi napotke za izboljšanje apetita, preprečevanje podhranjenosti, vzdrževanje optimalne telesne mase in vsebine o zdravi in uravnoteženi prehrani.

• Language: Slovenian
• Keywords: magistrska dela, zdravstvena nega, vnos hrane, prehranska ocena, srčno-žilne bolezni, zdravstvena vzgoja, medicinske sestre
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [T. Somi]
• Year: 2023
• Number of pages: 64 str., [16] str. pril.
• PID: 20.500.12556/RUL-148737
• UDC: 616-083
• COBISS.SI-ID: 162832899
• Publication date in RUL: 31.08.2023

Secondary language

• Language: English
• Title: Nutritional status and appetite in hospitalized patients with acute heart failure : master thesis

Abstract

Introduction: Poor appetite and malnutrition are present in many patients with heart failure. Recognizing and better understanding of both problems provides support in improving appetite and preventing malnutrition. Nurses are the first to identify these problems in the patients. Through patient education they can provide the necessary knowledge, skills and abilities that the patients need to improve appetite and nutrition. Purpose: The purpose of the master’s thesis is to study the appetite and nutritional status of hospitalized patients with acute heart failure and to describe the patient education for these patients. Methods: We used the quantitative method. At Murska Sobota General Hospital, in the period from 8th of March 2022 to 1st of February 2023, we conducted a cross-sectional study among hospitalized patients with acute heart failure. Data was collected using various questionnaires. The body composition of the patients was assessed using bioelectrical impedance analysis. Results: The sample included 53 patients. The majority were male (55 %) with a mean age of 73,4 ± 9,1 years and a mean left ventricular ejection fraction of 39 ± 14 %. 64 % of patients had a poor appetite and a significant risk of at least 5 % weight loss in the next 6 months. Worse appetite was associated with age (r = –0,433; p = 0,001), present symptoms of depression (r = –0,552; p < 0,001), health-related quality of life (r = –0,309; p = 0,024), self-assessment of own health status (r = 0,298; p = 0,030) and NT-proBNP concentration (r = –0,429; p = 0,002). 45 % of patients were normally nourished, while 47 % were at risk of malnutrition and 8 % were malnourished. Discussion and conclusion: Through research, we found that almost two-thirds of hospitalized patients with acute heart failure have a poor appetite, and almost one-tenth of patients are malnourished. It would be reasonable to include a systematic assessment of appetite and nutritional status as part of the nursing history upon admission to the hospital. Patient education of these patients should also include instructions for improving appetite, prevention of malnutrition, maintenance of optimal body weight and healthy diet.

• Keywords: master's theses, nursing care, food intake, nutritional assessment, cardiovascular diseases, patient education, nurses