Nutrient intake, diet satisfaction and nutrition status of adult surgical orthopaedic patients admitted at university teaching hospital in Lusaka, Zambia
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Orthopaedic injuries are common globally with the highest prevalence reported in the sub-Saharan region. In hospitals, malnutrition is a significant problem in both developed and developing countries, its prevalence ranging from 20 – 60%. Malnutrition is reported to be common among orthopaedic patients due to disease, inadequate nutrient intake and low diet satisfaction associated with quality of hospital food. Untreated malnutrition is detrimental to individuals, societies and economies of countries. Despite the high prevalence of malnutrition, the condition is under-diagnosed. There is limited literature on the nutrient intake, diet satisfaction and nutrition status of adult surgical orthopaedic patients. The purpose of this study was therefore to determine the nutrient intake, diet satisfaction and nutrition status of adult surgical orthopaedic patients admitted at the University Teaching Hospital in Lusaka, Zambia. It was a cross-sectional analytical study that collected both quantitative and qualitative data on a sample of 98 surgical orthopaedic patients. A researcher-administered questionnaire was used to collect data from individual patients. Key informant interviews were conducted with three hospital staff. Anthropometric measurements of mid-upper arm circumference were taken on admission and during data collection. Statistical Package for Social Sciences version 21.0 was used to analyze quantitative data. Nutrient intake data was first analyzed using Nutri- Survey software (2005) based on recommended dietary intakes, then exported to SPSS for further analysis. P-values less than 0.05 were considered statistically significant. The findings on nutrient intake indicated that mean energy, protein, calcium, sodium, iron, zinc, folic acid, dietary fiber and vitamin C intake were all below the recommended values (1,919cal, 61.67g, 160.05mg, 222.91mg, 10.19mg, 2.55mg, 165.98μg, 20.09g and 22.60mg respectively). Further, 24.4%, 8.5%, 26.7%, 5.5% and 15.2% of the participants met the Recommended Dietary Intakes of energy, protein, iron, vitamin C and dietary fiber respectively. Hospital food contributed more than 60% of the total nutrient intake of energy, protein, folic acid and dietary fiber. With a mean overall satisfaction score of 2.33±0.61, the majority of orthopaedic patients were satisfied with the hospital diet on aspects of portion size, temperature and time of meal distribution (67.3%, 94.9%, and 56.1% respectively), while 76.5%, 96.9%, 71.4% and 65.3% were dissatisfied with the hospital diet on aspects of type, variety, taste and appearance respectively. Majority of the participants had normal nutrition status on admission (86.7%) and during data collection (82.7%). There was a significant difference between mid-upper arm circumference on admission and during data collection (Paired t-test; p<0.001). There was no significant association between nutrient intake of the selected nutrients and nutrition status (MUAC) among adult surgical orthopaedic patients (Pearson correlation; p>0.05), between nutrient intake of the nutrients and diet satisfaction (Pearson correlation; p>0.05) as well as between diet satisfaction and nutrition status (MUAC) (Pearson correlation, p>0.228). In conclusion, the mean consumption intake for all the selected nutrients was below the recommended dietary intakes and the majority of orthopaedic patients were not satisfied with hospital food. It is recommended that the Ministry of Health increase funding towards provision of nutritious meals at the University Teaching Hospital and that routine screening of hospitalized patients for malnutrition be done as standard practice.