Hospital diet from the perspective of those involved in its production and planning
Keywords:
institutional feeding, malnutrition, diet, nutritional status, food service hospitalarAbstract
Objective
To know the objective and subjective reasons, material and symbolic, which act as the foundation of the
attitude of hospital institutions towards meals, considered as a social construction, a product of the conceptions
and practices of professionals who determine and reproduce them directly or indirectly.
Methods
A qualitative survey was carried out involving 32 intensity, half-structured interviews, applied to individuals
participating in the process of producing hospital diets - cooks, maids, nutritionists, doctors (medical), nurses
and their auxiliaries and clinical and administrative directors - and field observation in two kinds of hospital,
private and public.
Results
The analysis of the content of the interviews and of the field observation data was organized into two categories: nutritional aspects separate from those of the food - in which a valorization of the nutritional aspect was noted, principally in nutritional support actions, in detriment of the sensory and symbolic aspects of the hospital food; and the hospital diet - in which a lack of technical information about available hospital diets was observed; the actual hospitalization, as referring to the conditions of control and discipline and the limited autonomy and right to speak of the patients, were reflected in their social representation. The importance given to hospital diets is limited and the attention given to nutrition embryonic.
Conclusion
Attempts must be made to change the hospital food culture in order to install the idea of hospital nutritional
assistance in which the hospital diet and attention to nutrition become an important part of the patient’s
treatment, collaborating with the quality of the hospitalization experience.
References
McKee M, Healy J. The significance of hospital: an introduction. In: McKee M, Healy J, editores. Hospitals in a changing Europe. Buckingham: Open University Press; 2002. p.3-13.
Poulain JP, Saint-Sevin B. La Restauration Hospitalière. Des attentes alimentaires du malade hospitalisé à la conception du système de restauration. Paris: Editions Cristal; 1990.
Kandela P. Hospital food. Lancet. 1999; 353(9154): 763.
Bollet JB, Owens S. Evaluation of nutritional status of selected hospitalized patients. Am J Clin Nutr. 1973; 26(9):931-8.
Bristian BR, Blackburn GL, Hallowell E, Heddle R. Protein status of general surgical patients. JAMA. 1974; 230(6):858-60
Correia MITD, Waitzberg D. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003; 22(3):235-9
Kruizenga HM, Van Tulder MW, Seidell JC, Thijs A, Ader HJ. Van Bokhorst-de van der Schueren MA. Effectiveness and cost-effectiveness of early screening and treatment of malnourished patients. Am J Clin Nutr. 2005; 82(5):1082-9.
van Bokhorst-de van der Schueren MA, Klinkenberg M, Thijs A. Profile of the malnourished patient. Eur J Clin Nutr. 2005; 59(10):1129-35.
Lassen KO, Kruse F, Bjerrum M. Nutritional care of Danish medical inpatients-patients’ perspectives. Scand J Caring Sci. 2005; 19(3):259-67.
Dickinson A, Welch C, Ager L, Costar A. Hospital mealtimes: action research for change? Proc Nutr Soc. 2005; 64(3):269-75.
Gallagher-Allred CR, Voss AC, Finn SC, McCamish MA. Malnutrition and clinical outcomes: the case for medical nutrition therapy. J Am Diet Assoc. 1996; (4):361-6, 369.
McMahon K, Decker G, Ottery FD. Integrating proactive nutritional assessment in clinical practices to prevent complications and cost. Semin Oncol. 1998; 25(2 Suppl 6):20-7.
Waitzberg DL, Caiaffa WT, Correia MI. Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4000 patients. Nutrition. 2001; 17(7-8):573-80.
Berger PL, Luckmann T. A construção social da realidade. Petrópolis: Vozes.
Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. São Paulo: Hucitec; 1999.
Lefèvre F, Lefèvre AMC, Teixeira JJV. O discurso do sujeito coletivo. Caxias do Sul: Educs; 1999.
Schraiber LB. Pesquisa qualitativa em saúde: reflexões metodológicas do relato oral e produção de narrativas em estudo sobre a profissão médica. Rev Saúde Pública. 1995; 29(1):63-74.
Bosi MLM. Profissionalização e conhecimento: a nutrição em questão. São Paulo: Hucitec; 1996.
Adam P, Herzlich C. O hospital como organização e lugar de produção do trabalho médico. In: Adam P, Herzlich C. Sociologia da doença e da medicina. Bauru: Edusc; 1996. p.105-20.
Flandrin JL, Montanari M. Da dietética à gastronomia, ou a libertação da gula. In: Flandrin JL, Montanari M. História da alimentação. São Paulo: Estação Liberdade; 1998. p.667-88.
Poulain JP. A sociologia da gastronomia francesa. In: Poulain JP. Sociologias da alimentação. Florianópolis: UFSC; 2004. p.223-42.
Boog MCF. Dificuldades encontradas por médicos e enfermeiros na abordagem de problemas alimentares. Rev Nutr. 1999; 12(3):261-72.
Farias LO, Vaitsman J. Interação e conflito entre categorias profissionais em organizações hospitalares públicas. Cad Saúde Pública. 2002;18(5):1229-41.
Sousa AA, Proença, RPC. Tecnologias de gestão dos cuidados nutricionais: recomendações para qualificação do atendimento nas unidades de alimentação e nutrição hospitalares. Rev Nutr. 2004; 17(4):425-36.
Maes G. La soupe à l’hôpital. Témoignage. In: Assistance Publique: Hôpitaux Paris, Láppétit vient en mangeant! Histoire de lálimentation à l’hôpital. XV – XX siècle. Paris: Edoin Editeurs e Musée de Ássistence Publique; 1998. p.83-100.
McWhirter JP, Pennington CR. A Comparison between oral and nasogastric nutritional supplements in malnourished patients. Nutrition. 1996; 12(7-8):502-6.
Corbeau JP. S’alimenter à l´hôpital: les dimensions caches de la commensalité. In: Assistance Publique: Hôpitaux Paris, Láppétit vient en mangeant! Histoire de lálimentation à l’hôpital. XV – XX siècle. Paris: Edoin Editeurs e Musée de l’ Ássistence Publique; 1998. p.101-14.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Rosa Wanda Diez GARCIA
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.