Development and evaluation of nutrition resource kit for malnourished and at-risk elderly in health clinic setting

Abstract

Elderly population is at risk for malnutrition due to various factors. To address this issue, the elderly needs to be screened for malnutrition and received an appropriate care plan if necessary. The use of nutrition resource is useful as part of a care plan due to its ability to provide nutrition education for malnourished and at-risk elderly. Therefore, this thesis aimed to develop and evaluate a nutrition resource kit for nutrition intervention among malnourished and at-risk elderly in health clinic setting. This multiphase, action research study was conducted in four selected health clinics in Kuantan, Pahang. A mixed-method approach was taken to achieve the research objective: (Phase I: Plan) qualitatively assessed the types of nutrition resource kit needed by community living elderly; (Phase II: Act) development of nutrition resource kit and educational video for malnourished and at-risk elderly and (Phase III: Observe and Reflect) qualitatively explored the acceptability towards the newly developed nutrition resource kit and educational video and improvisation of it. Phase I aimed to demonstrate the types of nutrition resource kit needed by community living elderly in health clinic setting. Twenty-one elderly participants with a mean age of 67.24 ± 6.98 years were purposively recruited for individual in-depth interview. Thematic analysis of the interview identified five themes; 1) provision of nutrition resource kit, 2) preference needed to solve this issue (Webb et al., 2018). Favourable outcomes for printed version, 3) eye-friendly, 4) facilitate understanding with diagram and 5) support for technology-based materials. In phase II, a nutrition resource kit with incorporation of an educational video in a QR code were developed based on the integration of findings in phase I and the scoping review which had been performed to identify the suitable topics to be included. This newly developed kit and video then had undergone validation by experts and elderly. Six experts involved in content and face validation of the kit and video. Both resources achieved excellent content validity. Suggestions by experts were considered and revision was done accordingly. The revised kit and video was further assessed by twelve elderly for face validation. All elderly positively evaluated both resources. Amendment was done according to the elderly’s suggestions for further improvement. Then, assessment on acceptability towards the developed kit and video among malnourished and at-risk elderly was conducted in phase III. Twenty-two elderly participants (mean age = 68.82 ± 5.33 years) were purposively selected for individual in-depth interview and triangulation was performed using a questionnaire. Interviews were thematically analysed and descriptive statistic was used for data triangulation. Four themes emerged; 1) positive acceptance, 2) elderly-friendly, 3) valuable and 4) individual preference. Additional suggestions given by elderly were reviewed and revised accordingly. To conclude, this newly developed nutrition resource kit both in the printed format and electronically was well-accepted by the malnourished and at-risk elderly. Provision of nutrition resource kit tailored to the need of elderly could help to deliver nutritional guidance effectively and serve as an important reference for them to prevent and overcome malnutrition.