Sf. Simmons et al., An intervention to increase fluid intake in nursing home residents: Prompting and preference compliance, J AM GER SO, 49(7), 2001, pp. 926-933
Citations number
18
Categorie Soggetti
Public Health & Health Care Science","General & Internal Medicine
OBJECTIVE: To evaluate a three-phase, behavioral intervention to improve fl
uid intake in nursing home (NH) residents.
DESIGN: Controlled clinical intervention trial.
SETTING: Two community NHs.
PARTICIPANTS: Sixty-three incontinent NH residents
INTERVENTION: Participants were randomized into intervention and control gr
oups. The intervention consisted of three phases for a total of 32 weeks: (
1) 16 weeks of four verbal prompts to drink per day, in between meals; (2)
8 weeks of eight verbal prompts per day, in between meals; and (3) 8 weeks
of eight verbal prompts per day, in between meals, plus compliance with par
ticipant beverage preferences.
MEASUREMENTS: Between-meal fluid intake was measured in ounces by research
staff during all three phases of the intervention. Percentage of fluids con
sumed during meals was also estimated by research staff for a total of nine
meals per participant (3 consecutive days) at baseline and at 8 and 32 wee
ks into the intervention. Serum osmolality, blood urea nitrogen, and creati
nine values were obtained for all participants in one of the two sites at t
he same three time points.
RESULTS: The majority (78%) of participants increased their fluid intake be
tween meals in response to the increase in verbal prompts (phase 1 to 2). A
subset of residents (21%), however, only increased their fluid intake in r
esponse to beverage preference compliance (phase 3). There was a significan
t reduction in the proportion of intervention participants who had laborato
ry values indicative of dehydration compared with the control participants.
Cognitive and nutritional status were predictive of residents' responsiven
ess to the intervention.
CONCLUSIONS: A behavioral intervention that consists of verbal prompts and
beverage preference compliance was effective in increasing fluid intake amo
ng most of a sample of incontinent NH residents. Verbal prompting alone was
effective in improving fluid intake in the more cognitively impaired resid
ents, whereas preference compliance was needed to increase fluid intake amo
ng less cognitively impaired NH residents.