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      Dietética hospitalaria y gastronomía saludable Translated title: Hospital feeding and healthy gastronomy

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          Abstract

          Resumen Introducción: en los últimos años está dándose mucha relevancia a la gastronomía dentro del campo de la dietética. La alimentación en todo tipo de colectividades es un reto para los profesionales de la salud que tienen la responsabilidad de diseñar, planificar, programar y controlar la elaboración de dietas. Existen muchos factores relacionados con la ingesta que deben tenerse en cuenta a la hora de diseñar la actuación del servicio de dietética o alimentación: recursos hospitalarios, organizativos, geográficos, culturales, etc., sin olvidar los factores nutricionales y gastronómicos; un equilibrio que logra finalmente que el acto de comer se realice de manera espontánea y satisfactoria. Objetivo: el objetivo es revisar los factores implicados en la dietética hospitalaria integrando el factor gastronómico. Métodos: se ha realizado una revisión de los principales informes publicados, artículos científicos y capítulos de libros sobre dietética hospitalaria y gastronomía. Conclusiones: la comida hospitalaria, más que ninguna otra, requiere de la colaboración de nutrición y dietética con cocina y alimentación, ya que deben ir encaminadas hacia el mismo fin: la correcta alimentación de los pacientes ingresados y de la manera culinaria más agradable posible. En los centros hospitalarios, la armonía entre cocineros, dietistas-nutricionistas y profesionales sanitarios es un reto apasionante que repercute directamente en el beneficio del paciente.

          Translated abstract

          Abstract Background: in the last years, the gastronomy is becoming very important in the field of food. Food, in all types of collectives, is a challenge for health professionals who have the responsibility of designing, planning, scheduling and controlling the elaboration of diets. There are many factors related to intake that must be taken into account when designing the performance of the dietetic or food service: hospital resources, organizational, geographical, cultural... without forgetting the nutritional and gastronomic factors, a balance that makes the act of eating happen spontaneously and satisfactorily. Objective: the objective is to review the factors involved in hospital dietetics by integrating the gastronomic factor. Methods: it has been made a review of the main published reports, scientific articles and book chapters on hospital dietetics and gastronomy. Conclusions: hospital food requires more than any other nutrition and dietetic collaboration with food and cooking since both should be directed towards the same end, the correct feeding of the patients admitted, in the most pleasant culinary way possible. In hospitals, harmony among cooks, dieticians and health professionals is an exciting challenge that has a direct impact on the patient's benefit.

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          Hospital inpatients' experiences of access to food: a qualitative interview and observational study.

          Hospital surveys indicate that overall patients are satisfied with hospital food. However undernutrition is common and associated with a number of negative clinical outcomes. There is little information regarding food access from the patients' perspective. To examine in-patients' experiences of access to food in hospitals. Qualitative semi-structured interviews with 48 patients from eight acute wards in two London teaching hospitals. Responses were coded and analysed thematically using NVivo. Most patients were satisfied with the quality of the meals, which met their expectations. Almost half of the patients reported feeling hungry during their stay and identified a variety of difficulties in accessing food. These were categorized as: organizational barriers (e.g. unsuitable serving times, menus not enabling informed decision about what food met their needs, inflexible ordering systems); physical barriers (not in a comfortable position to eat, food out of reach, utensils or packaging presenting difficulties for eating); and environmental factors (e.g. staff interrupting during mealtimes, disruptive and noisy behaviour of other patients, repetitive sounds or unpleasant smells). Surgical and elderly patients and those with physical disabilities experienced greatest difficulty accessing food, whereas younger patients were more concerned about choice, timing and the delivery of food. Hospital in-patients often experienced feeling hungry and having difficulty accessing food. These problems generally remain hidden because staff fail to notice and because patients are reluctant to request assistance.
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            Improvement in the quality of the catering service of a rehabilitation hospital.

            Malnutrition due to undernutrition or overnutrition is highly prevalent in hospital in-patients and it decisively conditions patients clinical outcome. One of the most influencing factors of malnutrition in hospitalized patients is--at least in part--the Catering Service Quality. Is to verify, over a 5 year period, the course of the quality of the institutional Catering Service, verifying the effectiveness of the quality improvement process used. Quality control was performed by objective (meal order accuracy, proper distribution of food in trolleys, route time from the kitchen to the ward and time of food distribution, food weight and temperature, waste assessment) and subjective assessment (quality was measured by giving the patients a questionnaire after meals). The survey included: 572 meals and 591 interviews. A significant amount of "qualitative" errors (lack of respect for patient preferences or at the moment of supplying the food trolley) have been found. Over the time and the amount of patients that wasted a considerable amount of the portion served was considerably reduced food temperature have been improved. Also patient satisfaction with menu variability, portion size, temperature and cooking quality improved over time. The overall ratings of meals under observation improved too in fact, positive opinions ranged from 18% in 2002 to 48.3% in 2006. Ongoing research and quality verification, which include all catering service workers, yields a constant improvement in quality. Patients in healthcare settings should receive a service they appreciates, but it should be--at the same time--correct from a nutritional point of view. For this reason, it is necessary a continuous mediation between customers satisfaction and nutritionists work, dieticians and nursing staff. From this point of view the educational approach becomes essential to feed patient compliance to dietetic treatment that will continue after discharge.
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              Exploring the mealtime experience in residential care settings for older people: an observational study.

              Improving the mealtime experience in residential care can be a major facilitator in improving care, well-being and QoL. Evidence suggests that, despite guidance on the subject of food, nutrition and hydration, there are still concerns. Although there is a range of methods to research and assess the quality of food provision, there is a challenge in capturing the experiences of those residents who are unable or unwilling to describe their feelings and experiences because of frailty, impaired communication or other vulnerability. The aim of this exploratory study was to capture and describe individual residents' mealtime experience. In spring 2011, a small-scale, observational study was carried out in seven dining settings in four residential care homes in Manchester. An adapted dementia care mapping tool was used alongside field notes. Observations showed two major differences in the way the mealtimes were organised: 'pre-plated' and 'family-style' (where either bowls of food are placed in the centre of the table or food is served directly from a hotplate by a chef). These two styles of service are discussed in relation to the emerging themes of 'task versus resident-centred mealtimes', 'fostering resident independence' and 'levels of interaction'. Although improving mealtimes alone is not enough to improve quality of life in care homes, findings showed that relatively small changes to mealtime delivery can potentially have an impact on resident well-being in these homes. Observation is a useful method of engaging residents in care settings for older people who may not otherwise be able to take part in research.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                2018
                : 35
                : spe4
                : 140-145
                Affiliations
                [1] Madrid orgnameHospital Universitario Ramón y Cajal orgdiv1Servicio de Endocrinología y Nutrición Spain
                [2] Pamplona orgnameComplejo Hospitalario de Navarra orgdiv1Unidad de Dietética Spain
                Article
                S0212-16112018000700140 S0212-1611(18)03500400140
                10.20960/nh.2140
                4dfa54c3-397c-49a9-9ac2-9d58a2bb371d

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 6
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                SciELO Spain

                Categories
                Trabajos Originales

                Malnutrition,Desnutrición,Hospital diet,Alimentación hospitalaria,Gastronomy,Gastronomía,Hospital feeding,Manual de dietas

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