'It's Not About the Food'-Understanding the Lived Experience of Patients Who Developed Hospital-Acquired Malnutrition (HAM) and That of Their Carers.

Background/

Objectives

Given the limited evidence internationally, this qualitative study employed discovery interviews to explore the lived experience of patients who developed Hospital-Acquired Malnutrition (HAM) and that of their carers.

Methods

Seven (two patients [(n = 1 female] and five carers [n = 3 female]) completed discovery interviews with an experienced independent interviewer. Carers were either spouses or parents. Responses were thematically analyzed using a constant comparative approach.

Results

A key theme was 'It's not about the food, it's the hospital system' with the needs of the system dominating, including when patients were feeling at their worst. Subthemes were 'integration of care' and 'patient acuity', including symptoms that impacted food intake. Another theme was 'Who is looking out for the patient?', exploring 'reliance on carer advocacy', and 'variation in staff involvement'. One carer said, "… the girl that delivered the meal tray was the only one in our hospital stay who actually said to [the patient], 'I'm so glad you're sitting up. I was worried about you because you hadn't eaten for so long?" A persistent but comparatively less strong theme was 'When it is about the food' which explored 'the quality of the food' and 'receiving information on eating and drinking'.

Conclusions

The three key themes identified from carers and patients were hospital system impacts, care co-ordination and, less strongly, experiences with food quality and information. The key opportunities to prevent, or better support the nutritional care of patients with, HAM may be through improving systems and care co-ordination.