Abstract
Objective
A positive attitude is assumed to be important in nursing staff’s help and support of elderly people during meals. As there is no specific tool for measuring staff’s attitudes regarding important issues within eating and nutrition, the SANN (Staff Attitudes to Nutritional Nursing Care) scale was developed. The scale was developed and tested in nursing staff working at resident homes, and the number of items was reduced from 63 to 19 with five underlying factors. The aim of this study was to describe how the SANN scale was adapted and tested in nursing staff working in different types of elderly care. Design: The raw 63-item version went through minor changes, and one unclear worded item was excluded. The changed raw 62-item version was answered by 188 nursing staff working at six hospital care clinics and 64 staff working at one resident home.
Results
The analysis reduced the 62 items to 18, and the adapted scale was named the SANN-G scale, G standing for “geriatric care”. A rotated factor analysis gave a five-factor solution, explaining 54% of the variance. The scale achieved good internal reliability, with a Cronbach’s alpha of 0.83. Fourteen items fulfilled inclusion criteria in both the SANN and the SANN-G scales.
Conclusion
The SANN-G scale is practicable for use in staff working in different types of elderly care. It can be used to explore existing attitudes and identify areas with a low degree of prevailing positive attitudes as well as to evaluate whether and how attitudes change after nutritional education and intervention.
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References
Cederholm T, Mossberg T. Nutritional state — terminology. In: Nutritional problems in health care and human service. Prevention and treatment, (The National Board of Heath and Welfare), 2000 pp. 15–17 Stockholm. (In Swedish).
Christensson L, Ek A-C, Unosson M. Malnutrition in elderly people newly admitted to a community resident home. J Nutr Health & Aging 1999;3:133–139.
Bachrach-Lindström M, Unosson M, Ek A-C, Arnqvist HJ. Assessment of nutritional status using biochemical an anthropometric variables in a nutritional intervention study of women with hip fracture. J Clin Nutr 2001;20:217–223.
Akner G, Cederholm T. Treatment of protein-energy malnutrition in chronic nonmalignant disorders. Am J Clin Nutr 2001;74:6–24.
Persson MD, Brismar KE, Katzarski KS, Nordenström J, Cederholm T. Nutritional status using Mini Nutritional Assessment and Subjective Global Assessment Predict Mortality in Geriatric Patients. J Am Geriatr Soc 2002;50:1996–2002.
Whitney EN & Rolfes SR (1999): Understanding Normal and Clinical Nutrition. 4th Ed. St. Paul: West Publishing Company, 1999.
Wilson M, Vaswani S, Liu D, Morley J, Miller D. Prevalence and causes of undernutrition in medical outpatients. Am J of Med 1998;104:56–63.
Fishbein M, Ajzen I. Belief, attitude, intention and behaviour. An introduction to theory and research. London: Addison-Wesley Publishing Company, 1975.
Barnes KE. An examination of nurses’ feelings about patients with specific feeding needs. J Adv Nurs 1990;15:703–711.
Athlin E, Norberg A. Caregivers attitudes to and interpretations of the behaviour of severely demented patients during feeding in a patient assignment care system. Int J Nurs Stud 1987;2:145–153.
Faxén-Irving G, Andrén-Olsson B, Cederholm T. Nutritional and cognitive status in elderly subjects living in service flats, and the effect of nutrition education on personnel. Gerontology 1999;45:187–194.
Sidenvall B, Fjellström C, Ek A-C. Ritualized practices among caregivers at meals in geriatric care. Scand. J Caring Sci 1996;10:53–61.
Christensson L, Unosson M, Bachrach-Lindström M, Ek A-C (2003) Attitudes of nursing staff towards nutritional nursing care. Scand. J Caring Sci 2003;17,223–231.
Ajzen I, Fishbein M. (1980) Understanding attitudes and predicting social behaviour. New Jersey: Prentice-Hall, 1980.
Lickert R. A technique for the measurement of attitudes. Appendix. Archives of psychology 1932;140:44–53.
Himmelstrand U. Measurement of attitudes and psychological scales. In: Psychological methods. (Karlsson G, ed.) 2nd edn. pp. 303–352, Stockholm: Scandinavian University Books. Svenska bokförlaget/Nordstedts-Bonniers, 1 1965 (In Swedish).
Polit DF, Beck CT. Nursing research. Principles and method. 2nd edn. Philadelphia: Lippincott Williams & Wilkins, 2004.
Bachrach-Lindström M, Jensen S, Lundin R, Christensson L. Attitudes of nursing staff working with older people towards nutritional nursing care. J Clin Nurs 2007;16,2007–2014.
Lundström S, Särndal C-E. Estimation in the presence of noresponse and frame imperefections. Stockholm: Statistiska Centralbyrån, 2001.
NNF (Northern Nurses’ Federation). Ethical guidelines for nursing research in the Nordic countries, 2005.
Streiner DL, Norman GR. Health measurement scales: a practical guide to their development and use, 3rd edn. Oxford: Oxford University Press, 2003.
Thompson B, Daniel LG. Factor analysis evidence for the construct validity of scores: a historical overview and some guidelines. Edu Psychol Meas 1996;56:197–208.
Sidenvall B. Meal procedures in institutions for elderly people: a theoretical interpretation. J Adv Nurs 1999;30:319–328.
Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. ESPEN Guidelines for Nutrition Screening 2002. Clin Nutr 2003;4:415–421.
Elia M, Zellipour, Stratton RJ. To screen or not to screen for adult malnutrition? Clin Nutr 2005;6:867–884.
Milne AC, Potter J, Avenell A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Systematic 2005, Review 18, CD003288.
Lorefält B, Wissing U, Unosson M. Smaller but energy and protein-enriched meals improve energy and nutrient intakes in elderly patients. J Nutr Health Aging 2005;9:243–247.
Christensson L, Ek A-C, Unosson M. Individually adjusted meals for older people with protein-energy malnutrition: a single-case study. J Clin Nurs 2001;10,491–502.
Council of Europe. Food and nutritional care in hospitals: How to prevent undernutrition. Public Health Committee of experts on nutrition, food safety and consumer health, 6th meeting, February, 2 rev. 2002.
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Christensson, L., Bachrach-Lindström, M. Adapting “The Staff Attitudes to Nutritional Nursing Care scale” to geriatric nursing care. J Nutr Health Aging 13, 102–107 (2009). https://doi.org/10.1007/s12603-009-0015-z
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DOI: https://doi.org/10.1007/s12603-009-0015-z