| BackgroundDue to various factors such as physiological,psychological and dietary factors,a relatively high percentage of elderly people in Chinese elderly institutions suffer from malnutrition,and their nutritional status deserves attention.Various actions(e.g.,arriving,eating,waiting socializing)that occur during meals produce a series of intermediate outcomes including food intake,and final outcomes(e.g.,nutritional status,quality of life).By improving the dining environment at mealtime makes it possible to improve the nutritional status of the elderly in institutions.However,there are few quality or quantity of current scientific evidence exploded the effects of changing dietary environment on nursing home residents in China.There is an urgent need for more in-depth research in these areas.ObjectiveThe study aimed to investigate the effects of buffet-style dining foodservice on dietary energy of elderly people compared with the traditional canteen-style meals in nursing home,and also explore its effectiveness on nutrition status and health-related quality of life.MethodsThis was a quasi-experimental study.From October 2021 to March 2022,a large pension institution included four nursing homes in Suzhou was selected as the research site.Two nursing homes were randomly selected,with one as the study site for the intervention group and the other as the study site for the control group.The intervention group implemented buffet-style dining foodservice for 12 weeks,while the control group maintained their traditional canteen-style dinners.The outcomes included dietary intake,nutritional status and HRQo L of the older nursing home residents.Self-designed general information questionnaire and scales were used as research tools,scales included the Mini-Nutrition Assessment Scale(NANA-SF)and the 36-item Short-Form Health Survey(SF-36).Meanwhile,three-day diet record,the weighing data of kitchen food for three days and the nutritional status(including weight,body mass index,upper arm circumference and calf circumference)of older nursing home residents in two groups were collected.SPSS 24.0 was used for statistical analysis of the data.Results1.Baseline data comparison results: No significant differences were observed in general demographic data between two groups.Such as age,gender,education level,living conditions,monthly income,number of children and number of chronic diseases(P>0.05).At the same time,there were no significant differences in energy intake,macronutrient intake,nutritional status and quality of life between the two groups(P>0.05),indicating comparability.2.Effectiveness of buffet-style dining foodservice on energy and macronutrient intake: After 12 week-intervention,the results showed that the energy and macronutrient intakes in the buffet-style dining foodservice group was significantly higher than that in the canteen-style group.And the intervention group’s energy,protein intake and carbohydrate intake were closer to the recommended energy intake.Compared with baseline,the results of intra-group analysis showed that the intake of macronutrient as well as the energy supply ratio of fat and carbohydrate were significantly increased in the buffet-style dining foodservice(P<0.05).Compared with the baseline,the results of intra-group analysis showed that in the intervention group fat intake was decreased(P<0.05),and other scores were not significantly changed compared with baseline(P>0.05).3.Effectiveness of the buffet-style dining foodservice on nutritional status of the elderly: After 12 week-intervention,the results of inter-group comparison showed that the weight of the buffet-style dining foodservice group was higher than that of the canteen-style dining foodservice group,with statistical significance(P<0.05).No significant difference was found BMI,upper arm circumference,calf circumference and the scores of MNA-SF.The results of intra-group analysis showed that the body weight,BMI,upper arm circumference,calf circumference and the scores of MNA-SF in the intervention group were significantly increased(P<0.05),but the ratio of MANSF with different nutritional status was not significantly changed(P>0.05).There were no significant changes in the scores of all aspects of the control group compared with baseline(P>0.05).4.Effectiveness of the buffet-style dining foodservice on HRQo L of the older nursing home residents: After 12 week-intervention,compared with the control group,the buffet-style dining foodservice group had significantly higher scores in the areas of physical health(P=0.002)and mental health(P=0.001).On specific dimensions,the buffet-style dining foodservice group showed significant improvements in body pain(P=0.006),social functioning(P=0.063),and role-emotional functioning(P=0.009).There were no significant differences in physical function,physical role function,general health,vitality and mental health between two groups(P>0.05).The results of intra-group analysis showed that the scores of SF-36 dimensions in the intervention group were significantly improved(P<0.05).Compared with the baseline,the results of intra-group analysis showed that there were no significant changes in SF-36 scores of the control group(P>0.05).Conclusion1.Compared with traditional canteen-style dinners,buffet-style dining foodservice can help increase the daily energy intake of nursing home residents,and the intake of protein,carbohydrate,energy and protein energy intake ratio were closer to that of DRIs.2.Compared with traditional canteen-style dinners,buffet-style dining foodservice help nursing home residents gain weight and improve their nutritional status.3.Compared with traditional canteen-style dinners,buffet-style dining foodservice was more conducive in improving the quality of life of elderly nursing home residents.4.The older nursing home residents have a high compliance to the buffet-style dining foodservice,which can provide an alternative strategy for the management staff to improve the health status of the elderly population in nursing homes. |
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