1. DECREASING MALNUTRITION THROUGH SELF-EFFICACY Deborah Andrews University of Central Florida

2. (Mueller, 2008)

3. Risks to the Elderly  Wasting syndrome, sarcopenia, nosocomial infections, immunosuppression, inflammatory processes  Exacerbation of Chronic Disease  Decrease Cognitive Function  Depression  Weakness/Falls  Financial burden

4. Socioeconomic Costs  Patient and Family  Health Facilities  Health Care Industry  Nurses

5. Problem Statement Malnutrition is multifactoral and often unidentified and under-treated by health care professionals. Screenings, assessments and interventions are deficient for our elderly population, putting them at greater risk of malnutrition and exacerbating the aging process.

6. Significance of Malnutrition in the Elderly  Independent Elders: 1% to 15% are malnourished  Institutionalized Elders: 25% to 85% are malnourished  Adults over the age of 65 are the fastest growing demographic Malnutrition increases: COGNITIVE PROBLEMS FALL RISKS EXACERBATION OF CHRONIC ILLNESSES HEALING TIME LENGTH OF STAY MANPOWER NEEDS (Culp & Cacchione, 2008,)

7. Significance to Nursing: Increase work load- ADLs, Charting, Interventions Less time to spend with other patients Lazarus & Hamlyn, 2005

8. Specific Aims  Increase understanding of nutrition  Maintain functionality  Increase qualify of Life  Decrease work load of nurse  Decrease cost to health care system

9. Theory of Self-Efficacy Self-efficacy is the belief in one’s own ability to control and generate specific accomplishments. The higher one’s self-efficacy, the greater motivated one is to achieve a particular outcome. This is based on the interrelationships among person, behavior, and environment. (Bandura, 2004 Resnick, 2003)

10. SELF-EFFICACY EXPECTATIONS:  Enactive attainment  Vicarious experience  Verbal persuasion  Physiological feedback during the behavior SELF-EFFICACY OUTCOMES:  What will occur if a task is effectively achieved. (Chang, Crogan, & Wong, 2007, Resnick, 2003)

11. APPLICATION TO CLINICAL PRACTICE  Education of nutritional needs  Involvement of patient in their nutritional care  Engaged eating(sharing meal with others)  Verbal encouragement  Continued physical and psychological assessments

12. SUMMARY AND CONCLUSION  Quality of life is enhanced by proper nutrition  Nurses can decrease malnutrition through Self-efficacy of patients.

13. . References Bandura, A. (2004). Health promotion by social cognitive means. Health education and Behavior, 31(2), 143-164. Chang, S., Crogan, N.L., Wung, S. (2007). The self-care self-efficacy enhancement program for chinese nursing home elders. Geriatric Nursing, 28(1), 31-36. Culp, K.R. & Cacchione, P.Z. (2008). Nutritional status and delirium on long-term elderly individuals. Applied Nursing Research, 21, 66-74. Lazarus, C. & Hamlyn, J. (2005). Prevalence and documentation of malnutrition in hospitals: A case study in a large private hospital setting. Nutrition & Dietetics 62(1), 41-47. Mueller, C. (2008). Inflammation, old age, and nutritional assessment. Topics in Clinical Nutrition. 23(2), 131-138. Resnick, B. (2003). The theory of self-efficacy. In M.J. Smith & P.R. Liehr (Eds.), Middle range theory for nursing (pp. 189-205). New York: Springer