Patient, family and carer experiences of nutritional screening: a systematic review.
BACKGROUND
Despite recommendations for nutritional risk screening of all inpatients, outpatients and care home residents, as well as work to assess clinician's experiences and the validity of tools, little attention has been paid to the experiences of patients undergoing nutritional screening. This review aims to synthesise systematically the current evidence regarding nutritional risk screening with respect to the experiences and views of patients, their families and carers.


METHODS
A systematic search was performed in MEDLINE, Embase, PsychINFO, CINAHL, Web of Science and British Nursing Database (inception - July 2019); with screening terms related to malnutrition, screening tools and experience. Titles, abstracts and full-text papers were independently reviewed by two reviewers and then quality-appraised. Qualitative papers and quantitative surveys were included. A narrative review of surveys and a thematic framework synthesis of interviews were used to identify themes.


RESULTS
Nine studies, including five qualitative interview papers, were included. Qualitative and quantitative study results were combined using a matrix chart to allow comparison. Surveyed participants reported processes of nutritional screening as acceptable. Three key themes emerged from qualitative data: (i) experience of nutritional screening; (ii) misunderstanding of malnutrition: of causes, role of screening and poor self-perception of risk; and (iii) barriers to and opportunities for change.


CONCLUSIONS
Although the screening process is acceptable, patients' misunderstanding and poor knowledge regarding causes and consequences of malnutrition result in reduced risk perception and disbelief or disregard of nutritional screening results. Findings should inform policy and clinical practice, as well as highlight the known paucity of data regarding the effectiveness of screening on clinical outcomes.
['Bullock|A F|AF|0000-0002-4065-3925', 'Greenley|S L|SL|0000-0002-3788-6437', 'Patterson|M J|MJ|', 'McKenzie|G A G|GAG|', 'Johnson|M J|MJ|']
D001294:Attitude to Health D017028:Caregivers D000076862:Diagnostic Screening Programs D004032:Diet D005190:Family D005260:Female D006801:Humans D008297:Male D044342:Malnutrition D015596:Nutrition Assessment D009752:Nutritional Status D010361:Patients
nutritional screening systematic review malnutrition qualitative quantitative patient experience