Document Detail

Multiple morbidity is associated with increased problems of food access in hospital: a cross-sectional survey utilising the Cumulative Illness Rating Scale.
MedLine Citation:
PMID:  20807300     Owner:  NLM     Status:  MEDLINE    
BACKGROUND:   Problems of undernutrition are common in hospital in-patients. Multiple morbidity increases with age and may contribute to nutritional risks. This research aimed to determine whether increased burden of long-term conditions is associated with patients' difficulties gaining access to food in hospital.
METHODS:   A survey was implemented in 29 wards at four hospitals using a questionnaire measure of patients' experiences of food access and the Cumulative Illness Rating Scale (CIRS) to evaluate the burden of long-term illness in each patient. Experiences of food access were evaluated in relation to CIRS score category using random effects logistic regression to adjust for age group, sex and clustering by ward.
RESULTS:   Data were analysed for 764/1154 (66%) eligible participants, including 384 women. The median age was 60 years (range 18-96 years). CIRS scores were analysed using the categories 0 (104 patients), 1-3 (197), 4-6 (285), 7-9 (144) and ≥10 (34). When the CIRS was zero, 10% of patients experienced physical problems with food access, whereas, when the CIRS was ≥10, 41% experienced physical barriers to food access, adjusted odds ratio 3.65 (1.14-11.7, P = 0.029). Problems with food quality were experienced by 13% with CIRS = 0 and 32% with CIRS ≥ 10 (adjusted odds ratio 3.97, 1.35-11.6, P = 0.012). Participants with greater morbidity were more likely to report that depression, breathing difficulties or chewing and swallowing difficulties affected the amount of food that they ate at mealtimes.
CONCLUSIONS:   Patients with multiple morbidities are more vulnerable to experiencing physical barriers to accessing food and increased concerns with food quality. Assessing barriers to food access is particularly important in multiple morbidity.
S Naithani; K Whelan; J E Thomas; M C Gulliford
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-27
Journal Detail:
Title:  Journal of human nutrition and dietetics : the official journal of the British Dietetic Association     Volume:  23     ISSN:  1365-277X     ISO Abbreviation:  J Hum Nutr Diet     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-10-29     Completed Date:  2011-01-28     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  8904840     Medline TA:  J Hum Nutr Diet     Country:  England    
Other Details:
Languages:  eng     Pagination:  575-82     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Journal compilation © 2010 The British Dietetic Association Ltd.
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MeSH Terms
Aged, 80 and over
Cross-Sectional Studies
Deglutition Disorders
Food Service, Hospital
Malnutrition / epidemiology*,  etiology
Middle Aged
Respiration Disorders
Severity of Illness Index*

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