DECREASING MALNUTRITION THROUGH SELF-EFFICACY

Deborah AndrewsUniversity of Central Florida

(Mueller, 2008)

Risks to the Elderly Wasting syndrome, sarcopenia, nosocomial infections, immunosuppression, inflammatory processesExacerbation of Chronic DiseaseDecrease Cognitive FunctionDepression Weakness/FallsFinancial burden

Socioeconomic CostsPatient and FamilyHealth FacilitiesHealth Care IndustryNurses

Problem StatementMalnutrition is multifactoral and often unidentified and under-treated by health care professionals. Screenings, assessments and interventions are deficient for our elderly population, putting them at greater risk of malnutrition and exacerbating the aging process.

Significance of Malnutrition in the Elderly

Independent Elders: 1% to 15% are malnourishedInstitutionalized Elders: 25% to 85% are malnourishedAdults over the age of 65 are the fastest growing demographic

Malnutrition increases: COGNITIVE PROBLEMSFALL RISKSEXACERBATION OF CHRONIC ILLNESSESHEALING TIMELENGTH OF STAYMANPOWER NEEDS

(Culp & Cacchione, 2008,)

Significance to Nursing:Increase work load- ADLs, Charting, InterventionsLess time to spend with other patients

Lazarus & Hamlyn, 2005

Specific Aims

Increase understanding of nutrition

Maintain functionality

Increase qualify of Life

Decrease work load of nurse

Decrease cost to health care system

Theory of Self-EfficacySelf-efficacy is the belief in one’s own ability to control and generate specific accomplishments. The higher one’s self-efficacy, the greater motivated one is to achieve a particular outcome. This is based on the interrelationships among person, behavior, and environment.

(Bandura, 2004 Resnick, 2003)

SELF-EFFICACY EXPECTATIONS:Enactive attainment

Vicarious experience

Verbal persuasion

Physiological feedback during the behavior

SELF-EFFICACY OUTCOMES: What will occur if a task is effectively achieved.

(Chang, Crogan, & Wong, 2007, Resnick, 2003)

APPLICATION TO CLINICAL PRACTICE

Education of nutritional needsInvolvement of patient in their nutritional careEngaged eating(sharing meal with others)Verbal encouragement Continued physical and psychological assessments

SUMMARY AND CONCLUSIONQuality of life is enhanced by proper nutrition Nurses can decrease malnutrition through Self-efficacy of patients.

.

ReferencesBandura, A. (2004). Health promotion by social cognitive means. Health education and

Behavior, 31(2), 143-164.

Chang, S., Crogan, N.L., Wung, S. (2007). The self-care self-efficacy enhancement program for chinese nursing home elders. Geriatric Nursing, 28(1), 31-36.

Culp, K.R. & Cacchione, P.Z. (2008). Nutritional status and delirium on long-term elderly individuals. Applied Nursing Research, 21, 66-74.

Lazarus, C. & Hamlyn, J. (2005). Prevalence and documentation of malnutrition in hospitals: A case study in a large private hospital setting. Nutrition & Dietetics 62(1), 41-47.

Mueller, C. (2008). Inflammation, old age, and nutritional assessment. Topics in Clinical Nutrition. 23(2), 131-138.

Resnick, B. (2003). The theory of self-efficacy. In M.J. Smith & P.R. Liehr (Eds.), Middle range theory for nursing (pp. 189-205). New York: Springer