Beyond Desires: The Role of Nurse-Patient Dialogue in Identifying Needs to improve patients dietary intake

Background
Addressing nutritional needs in older, multimorbid patients is insufficiently emphasized. Studies highlight nurses' challenges in initiating a comprehensive nutrition dialogue beyond screening, often adopting a lay perspective centred on patients' desire to eat.
Aim
Explore the impact of nurse-patient dialogue on eating abilities by shifting focus from 'the desire to eat' to “uncovering needs” to enhance patients' eating ability.
Methods
Employing an exploratory observational design. The study unfolded in the Department of Medicine during the nurse-patient interaction at breakfast and lunch. Eight nursing students engaged in patient interactions, posing questions focused either on the desire to eat ("What do you feel like eating?") or on addressing patients' needs for optimal eating conditions ("What can I do to help you eat?"). They attended to patients' expressed needs, with one student exploring preferences while the other observed responses, encompassing nutritional intake, nursing interventions, and interaction duration. Following the interactions, the nursing students documented their observations in a logbook, followed by reflection using the FOC framework.
Results
Forty-three observations occurred, spanning 1 to 35 minutes. The preliminary analysis found the dialogues in the 'desire' group (N=22), to be marked by brief statements, shorter durations, fewer the nursing interventions, and a rapid conclusion without motivating the patient to eat. Conversely, the 'needs' group (N=21) demonstrated relationship-building with nursing interventions focusing on toileting, oral care, and mobilisation to a proper eating position. Asking about needs correlated with increased patient eating and facilitated motivation to eat.
Conclusion
Reflections gave insights into challenges related to nutritional care, the lack of professional knowledge about nutrition, and practical skills. The FoC framework aided reflections on dialogue outcomes and the ability to engage meaningfully with patients in dialogue. The concept in this experiment must be explored and described in detail to assess the effects on learning outcomes.