Nutritional focus is key: a qualitative study exploring a primary care perspective on nutrition efforts for elderly malnourished patients transitioning from hospital to home

Aims
This study explored the primary health care providers' perspectives on the current nutritional practice for elderly malnourished patients in the transition between hospital and home care.
Methods
We employed a qualitative phenomenologically inspired approach and conducted semi-structured individual interviews with 10 health professionals from 5 Danish municipalities in Region Zealand and the Capital Region. All interviews were audio-recorded and transcribed verbatim and were analysed using systematic text condensation.
Results
The study identified 4 themes and 8 subthemes: (a) ‘Prioritising nutritional interventions’: lack of political and managerial prioritisation; competing priorities among non-nutritional health professionals. (b) ‘Organisation’: silos can hinder cross-sectoral nutritional interventions; lack of knowledge and understanding between sectors. (c) ‘Communication and Collaboration’: insufficient and random information complicates collaboration on nutrition efforts; structural and IT frameworks complicate the flow of information. (d) ‘Knowledge, Competencies and Capabilities’: limited nutritional knowledge and skills among primary health care providers; limited nutritional tools in primary care can work as a barrier to nutritional efforts.
Conclusion
Cross-sectoral nutritional interventions are very complex. Key challenges involve an overall lack of focus on nutrition as well as low nutritional knowledge and competencies amongst the primary health care providers. Future cross-sectoral nutritional practice may be improved with greater political and managerial prioritisation, including nutritional education and competence development, employment of more dietitians, as well as improved collaboration and communication across sectors and health care professionals.