# Patients' Voices and Dietitians' Perspectives on Meaningful Aspects in the Nutritional Care of Patients at Risk of Malnutrition After Stroke

## TL;DR

This study explores how dietitians and stroke patients view food-related challenges and the need for better tools to assess emotional and social aspects of eating.

## Contribution

The study identifies a gap in tools for dietitians to evaluate non-practical aspects of eating, such as emotions and social factors, in post-stroke nutritional care.

## Key findings

- Dietitians focus on practical, social, and emotional aspects of eating but lack tools to measure these effectively.
- Patients experience significant changes in their relationship with food and eating after a stroke, affecting their well-being and social identity.
- Current nutritional outcome measures fail to capture the full impact of these changes on patients' lives.

## Abstract

After a stroke, patients may have complex eating difficulties that can lead to a risk for malnutrition. Individualised nutritional care could be optimised by identifying meaningful factors in the patient's relationship with food and eating. This study explored the perspectives of dietitians regarding the nutritional care of these patients and the experiences of patients in relation to food and eating in everyday life at home.

Two focus groups with five registered dietitians in each and eight individual semi‐structured patient interviews were conducted. The two data sets were analysed separately with inductive qualitative analysis using a thematic analysis approach.

In the nutritional care of these patients, the dietitians specifically highlighted: (1) Practical aspects, (2) Support and social aspects and (3) Feelings and emotions. The patient interviews revealed four themes: (1) Ability to prepare and eat food, (2) Issues affecting food enjoyment, (3) Social aspects of eating and mealtimes and (4) Emotional relationship with food.

Patients described symptoms after a stroke impacting food enjoyment, social identity, and well‐being. While dietitians reported addressing practical, social, and emotional aspects of food and eating, they lacked appropriate tools to measure these. There was a discrepancy between the focus of dietitians and that of patients; appropriate tools are needed to address these perspectives to provide high‐quality patient‐centred care.

Dietitians evaluate the nutritional care of patients at risk of malnutrition after a stroke using measures of body weight and intake, and while social and emotional aspects are described as important, appropriate tools to assess and evaluate these are lacking.Patients describe how the negative impact of symptoms after a stroke profoundly impact their everyday life in relation to food and eating.The burden to patients of the profound negative impact of their changed relationship to food and eating after a stroke are not fully captured by outcome measures currently available to dietitians.

Dietitians evaluate the nutritional care of patients at risk of malnutrition after a stroke using measures of body weight and intake, and while social and emotional aspects are described as important, appropriate tools to assess and evaluate these are lacking.

Patients describe how the negative impact of symptoms after a stroke profoundly impact their everyday life in relation to food and eating.

The burden to patients of the profound negative impact of their changed relationship to food and eating after a stroke are not fully captured by outcome measures currently available to dietitians.