A multi-faceted,family-centred nutrition intervention to optimise nutrition intake of critically ill patients: The OPTICS feasibility study |
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| Institution: | 1. NHMRC Centre for Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University and Gold Coast Health, Australia;2. Gold Coast Health, 1 Hospital Dr., Southport, QLD 4215, Australia;3. Nepean Hospital, Derby Street, Kingswood, NSW 2747, Australia;4. Metabolic Syndrome Canada, Canada;5. Clinical Evaluation Research Unit, Kingston General Hospital, 76 Stuart Street, Suite 5-416, Kingston, Ontario, Canada K7L 2V7;6. Queen''s University, 99 University Avenue, Kingston, Ontario, Canada K7L 3N6;1. Department of Clinical Biochemistry, Medical College, University Children''s Hospital of Cracow, Jagiellonian University, Cracow, Poland;2. Department of Cardiovascular Surgery and Transplantology, Medical College, John Paul II Hospital, Jagiellonian University, Cracow, Poland;1. Department of Cellular and Molecular Medicine, Cleveland, Ohio;2. Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio;1. School of Nursing, Fujian Medical University, China;2. Faculty of Nursing, University of Alberta, Canada;1. School of Psychology and Counselling, University of Southern Queensland, Toowoomba, Australia;2. School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Australia;3. Griffith Health Institute (GHI) & Institute for Resilient Regions (IRR), Australia;4. School of Behavioural Sciences, Netanya Academic College, Netanya, Israel;5. University of Queensland, Brisbane, Australia;6. School of Business and Law, Central Queensland University, Melbourne, Australia |
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| Abstract: | BackgroundCritically ill patients are at risk of developing malnutrition which contributes to functional decline and hospital re-admission. Strategies to promote nutritional intake have had a modest effect on protein-calorie intake. None have addressed the recovery trajectory of critical illness or incorporated family as advocates.ObjectivesWe evaluated the feasibility and acceptability of a family-centred intervention designed to optimise nutrition during and following recovery from critical illness.DesignA prospective cohort study.SettingTwo Australian adult intensive care units.ParticipantsA convenience sample of 49 patients and their families was recruited. Patients ≥18 years of age anticipated to require mechanical ventilation for at least 2 days were eligible, provided their family visited regularly and were able to communicate in English. Health care professionals including doctors (n = 4), nurses (n = 20) and dietitians (n = 2) also participated.MethodsDemographic data were obtained from participants. Recruitment and retention informed study feasibility. Individual and group interviews informed participant views on the acceptability, perception of and experience with the intervention. Inductive analysis was used to analyse qualitative data.Results187 (15.8%) patients met the eligibility criteria; 49 patients and 51 family members consented to participate for a 20.3% consent failure rate. We interviewed 33 (67.3%) family members and 13 (43.4%) patients, all of whom considered the intervention acceptable and who would participate in a similar intervention again, given the opportunity. Inductive analysis of qualitative data from all participants identified three themes: variability in in-hospital nutrition support, families as advocates for optimal nutrition, and partnering with health care providers.ConclusionWe described a feasible and acceptable family centred intervention that may be effective in promoting nutrition intake in critically ill patients. Further research is required to examine contextual factors impacting implementation of family-centred interventions, particularly those that involve active family participation and advocacy. |
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| Keywords: | Nutrition Critical illness Family Partnership |
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