Malnutrition screening of community living older adults: A content analysis of enablers and barriers to screening practice

The wellbeing of community living older adults (CLOAs) can be influenced by diet. Although many older people can maintain a reasonable diet, those who do not are at nutritional risk. Left unaddressed, nutritional risk can lead to the state of malnutrition, a harmful condition that is difficult to treat. Malnutrition screening can lead to improved nutritional status by identifying and addressing risk factors. However, malnutrition is often overlooked in this population as indicated by an estimated prevalence of 10-30%. Accredited Practising Dietitians were invited to complete an online survey regarding screening practices. At the end of the survey, dietitians were presented with two open questions asking them to specify perceived enablers and barriers to malnutrition screening within their organisation. Responses to these questions yielded considerable data that warranted separate reporting which is presented here. Ninety-two dietitians provided written comments to the open-ended survey questions. Textual data were analysed and reviewed by two authors using content analysis, resulting in four key categories of organisational, staff, screening and CLOA factors. Although the majority of dietitians (80%) indicated screening occurred within their organisation, a higher proportion of responses related to barriers. Organisational factors of screening policy and procedures and the provision of education and training emerged as the strongest enablers. Insufficient time to screen and lack of knowledge by non-dietetic staff and CLOAs about malnutrition were identified as the strongest barriers. The findings from this study indicate knowledge about nutrition risk, malnutrition and the associated outcomes could be improved amongst healthcare professionals and CLOAs. Further research into perceptions about malnutrition from the perspective of non-dietetic healthcare professionals and CLOAs is warranted