Summary: The aim of this study was to explore the prevalence of eating difficulties and malnutrition among persons in hospitals and among those living in special accommodations (long-term care). In addition the aim was to, within special accommodations, explore how different interventions could affect the precision in nutritional care and the occurrence of underweight/overweight, both from a short as well as a long-term perspective.

Methods: Nurse students collected the data during their clinical education at hospitals and in special accommodations in years 2005, 2007, and 2009. Staff and clinical teachers participated also with the data collection. By participating in the study the students got training in how to provide information to the staff and patients/residents, collect data, and compile results and to give feed-back about the findings to the department. Underweight and overweight was assessed from BMI. Undernutrition risk was assessed based on: unintentional weight loss, low BMI, and/or the occurrence of eating difficulties. Assessments were also made regarding what nutritional care the care recipients got. In the special accommodations interventions with study circles (two municipalities), nutritional care policy (one municipality) and in four municipalities no specific intervention was made. The prevalence of overweight was 39-42%.

Results: In hospitals the prevalence of moderate/high undernutrition risk was 27-28% and if also those with little risk were included the prevalence was 60-63%. Between 4-7% were provided with protein- and energy enriched food, 25-30% got oral supplements or similar and 12-13% needed eating assistance.

In special accommodations the prevalence of moderate/high undernutrition risk was 27-35% and if also those with little risk were included the prevalence was 65-70%. The prevalence og overweight was 30-33%. Between 4-14% were provided with protein- and energy enriched food, 11-19% got oral supplements or similar and 47-50% needed eating assistance. Within the special accommodations it was shown that the intervention with study circles lead to improvements in the precision of nutritional care (protein- and energy enriched food and/or oral supplements) and a lower prevalence of underweight was seen, at least shortly after that the intervention was finished. In the same way the anchoring and implementation of the nutritional care policy resulted in improvement in the nutritional care. These improvements remained however also a long time after the implementation. 

Most of the students (81%) experienced that they did get better understanding for research by participating in the study, more than half (53%) thought that their interest in assessment of eating and nutrition increased and 67% that their knowledge about eating and nutrition increased.

Conclusion: Many patients and residents are at risk of becoming undernourished. This demands that adequate measures are taken to prevent or treat undernutrition. Such measures can be protein- and energy-dense food and oral supplements or similar. In the special accommodations can study circles for the staff lead to improvements in the nutritional care for more residents in a short-term perspective and by implementing a nutritional care policy also long-term positive effects are likely to be achieved. Combining study circles with implementation of nutritional care policies can be the focus for new studies.

In general the nursing students experience it as positive to participate in a real research project.