Factors associated with food choice values among older hemodialysis patients in selected dialysis centres in Selangor, Malaysia
Hemodialysis (HD) among the elderly has unique clinical features, where these patients have more co-morbidity, require more frequent hospitalization and use more drugs and health services compared to the younger populations. In addition, poor nutritional status may impede their appetite, food...
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| Format: | Thesis |
| Language: | English |
| Published: |
2019
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| Subjects: | |
| Online Access: | http://psasir.upm.edu.my/id/eprint/85484/1/FPSK%28m%29%202019%2068%20UPMIR.pdf |
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| Summary: | Hemodialysis (HD) among the elderly has unique clinical features, where these
patients have more co-morbidity, require more frequent hospitalization and use
more drugs and health services compared to the younger populations. In
addition, poor nutritional status may impede their appetite, food accessibility, and
preparation. With individual’s social lives mainly focused around food, the foodrelated
activities (e.g., shopping, cooking and dining out) become of greater
significance to the elderly but are more difficult to achieve. Thus, this study aimed
to determine the factors associated with food choice values (FCVs) among HD
elderly in selected dialysis centres.
A cross-sectional study was conducted among 119 elderly, aged 60 years and
above on maintenance HD. By using simple random sampling, nine HD centres
were selected from Petaling and Hulu Langat districts, Selangor as the study
locations. Socio-demographic, dietary intake, malnutrition risk, depression,
health-related quality of life (HRQOL) and FCVs were assessed via interview
session. Dialysis Malnutrition Score (DMS) was used to evaluate nutritional
status while Patient Health Questionnaire-9 (PHQ-9) used to assess the severity
of depressive symptoms. HRQOL was assessed by using the Kidney Disease
Quality of Life-36 (KDQOL-36) questionnaire. The medical profile and dry weight
were obtained from the subjects' medical records. Anthropometric assessments
such as height, pre-dialysis weight, and post-dialysis weight were also
conducted. The variables associated with FCVs were tested with Pearson
Correlation and Multiple Linear Regression (MLR). The mean age of the subjects was 67±6 years. The subjects comprised of
approximately equal number of males (50.4%) and females (49.6%). Majority of
the subjects were Malay (60.5%). Hypertension (87.4%) and diabetes mellitus
(71.4%) were the major co-morbidities among subjects. There were 49.6% of the
subjects who did not achieve the desirable serum albumin of ≥40 g/L, 58.0% had
high serum phosphate (>1.6 mmol/L) while 61.3% of the subjects had low
hemoglobin level. About 6.7% of the subjects were underweight. Majority of the
subjects had inadequate energy and protein intakes (91.6%), were moderately
malnourished (71.4%), non-depressed (84.0%) and obtained better HRQOL
score in terms of symptoms/problems (73.37±17.01) and effects of kidney
disease (72.63±19.74) subscales. Safety, sensory appeal, and organic factors
were the strongest perceived of FCVs. There was a significant negative
correlation between age (p<0.05), energy intake (p<0.05), protein intake
(p<0.01) and fat intake (p<0.01) with total FCVs score. The MLR model
suggested that 12.1% of the variance in the FCVs was explained by age and fat
intake.
In conclusion, this research found that health was not the main factor in
determining the FCVs among HD elderly. Instead, safety, sensory appeal, and
organic factors were deemed to be more important when assessed by FCVs
questionnaire. Subject who experienced aging and increased in total energy,
protein and fat intakes felt that food choice was no longer important. Age and fat
intake also had an impact on FCVs of HD elderly. Thus, these findings could be
taken into account for dietitians to understand the factors associated with FCVs
when designing and delivering nutritional intervention regarding healthy choices
of fat intake targeting HD elderly. |
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