Dietary behavioural support in Dutch nursing homes: a cross-sectional study

Dietary support among residents by nursing home nurses can enhance quality of life and mitigate risks. The extent to which this support is provided may be influenced by determinants that shape professional behaviour, such as skills, knowledge, professional role perception, emotions, attitude, self-efficacy, outcome expectancies, and priority. This explorative study described self-reported dietary support practices, determinants of practice, and additional knowledge needs among Dutch nursing home nurses. A cross-sectional design was used. Nurses completed an online, self-administered 70-item questionnaire (n = 138). Nurses reported on a 5-point Likert scale (never [1] to always [5]) frequency of healthy dietary support practice in general and of four specific practices: observing any problems, having a conversation, motivating, setting goals. Ten determinants were rated (strongly disagree [1] to strongly agree [5]). Percentage of nurses who reported performing practices often or always, and who (strongly) agreed with the determinant, were obtained. Most nurses frequently supported healthy diet in general (71%). With respect to the specific practices, almost all nurses observed any problems with eating and drinking among residents (91%), only about half of the nurses addressed diet in a conversation (48%) or motivated residents (55%), and nurses set goals rarely (19%). Sufficient skills (80%), sufficient knowledge (79%), a favourable professional role perception (77%), positive emotions (72%), and a high intent (70%) regarding general healthier dietary support was expressed by a lot of nurses. Fewer nurses indicated lack of negative emotions (63%), positive attitude (56%), high self-efficacy (55%), high outcome expectancies (34%), and lack of competing priorities (34%). Nurses expressed a broad need for additional knowledge related to nutrition and behaviour change. Nurses generally supported healthy diet among residents, but specific practices that go beyond merely observing problems are implemented less frequently. Competing priorities, belief in outcome expectancies, and knowledge related to this support require further attention.