Older people's experiences of dignity and nutrition during hospital stays: Secondary data analysis using the Adult Inpatient Survey

最近的一些研究、调查和询问审查了老年人在医疗保健中的待遇，发现了待遇差的令人震惊的证据：-人权联合委员会(2007年)对待遇差、忽视、虐待、歧视、缺乏对饮食的支持以及营养不良和脱水表示关切。--“联合王国年龄”(2010年)强调指出，在医院缺乏营养不良的检测和治疗是一种“国家耻辱”，并呼吁政府对营养不良实行强制性监测。-患者协会(2011年)详细说明了其帮助热线所听到的16个关于医院护理不善的描述，重点是护理沟通、获得止痛、帮助如厕以及帮助饮食。-卫生服务监察员(2011年)对国民保健制度照顾老年人的调查提出了对饮食方面缺乏援助的主要关切。-护理质量委员会(2011a)尊严和营养检查发现有证据表明，人们没有得到饮食援助，营养需要没有得到监测，没有得到足够的饮料；工作人员没有以尊重的方式对待病人；老年人没有充分参与到他们的护理中。它的结论是，在许多情况下，尊严和营养的国家最低标准没有得到遵守，在某些情况下，待遇如此之差，构成了对合法权利的侵犯。-在平等和人权委员会(2011年)对需要或接受家庭护理和支助的老年人的待遇进行的调查中发现了更令人震惊的结果。这项新的研究将建立一个定量的统计证据基础，以便制作一张关于老年人在临终关怀期间接受治疗的国家统计图片。我们将使用成人住院调查来分析老年人对尊严和营养问题的反应。成人住院调查是一项全国性调查，政府用来监测NHS的质量和表现。这项调查的参与者是在英国NHS医院至少住过一晚的成年人。他们被问及在住院期间是否感觉到他们受到了尊严和尊重，以及他们在住院期间是否得到了在饮食方面所需的帮助。这项新的研究涉及评估老年人对这些问题的反应。我们将分析老年人在2002-2011年期间住院期间对他们的治疗所说的话，以及老年人是否比年轻人面临更大的风险。这项研究将侧重于多少老年人因缺乏治疗尊严和营养支持不足而受到影响的趋势，以及谁面临的风险最大。我们还将审查老年与残疾之间的联系，以及老年与区域剥夺之间的联系，以此作为劣势和待遇不佳的途径。这项研究将为老年人在住院期间的治疗提供新的证据，并将提供比以前提供的更深入的证据。它将回答以下重要问题：--在2002-2011年期间，全国老年人报告在住院期间没有得到尊严和尊重的比例是增加了还是减少了？-与其他人口群体相比，老年人在住院期间更有可能经历得不到尊严和尊重，或者在饮食方面得不到必要的支持？-残疾、性别、种族、临终关怀的类型和地区剥夺等其他因素是否会对老年人的不利和糟糕待遇的经历产生影响？

A number of recent studies, investigations and inquires have examine the treatment of older people in healthcare and have identified shocking evidence of poor treatment: -The Joint Committee on Human Rights (2007) raised concerns about poor treatment, neglect, abuse, discrimination, lack of support for eating and drinking, and malnutrition and dehydration. -Age UK (2010) highlighted lack of detection and treatment of malnutrition in hospital as a 'national disgrace' and called on the Government to introduce compulsory monitoring of malnutrition. -Patients Association (2011) details sixteen accounts of poor hospital care heard by its Helpline focusing on care-communication, access to pain relief, assistance with toileting, and help with eating and drinking. -The Health Service Ombudsman (2011) investigation into NHS care of older people raised key concerns about lack of assistance with eating and drinking. -The Care Quality Commission (2011a) dignity and nutrition inspection identified evidence of people not being given assistance to eat, not having their nutritional needs monitored and not being given enough to drink; staff not treating patients in a respectful way; and older people not being sufficiently involved in their care. It concluded that national minimum standards of dignity and nutrition were not being complied with in many casesn and in some cases treatment was so poor that it amounted to a violation of legal rights. -Further shocking findings were identified in the Equality and Human Rights Commission (2011) inquiry into the treatment of older people requiring or recieving home-based care and support. The new research will build up a quantitative statistical evidence base in order to produce a national statistical picture on older people's treatment during hosptial stays. We will analyse older people's responses to questiosn about dignity and nutrition using the Adult Inpatient Survey. The Adult Inpatient Survey is a national survey that the Government uses to monitor quality and performance in the NHS. Participants in the survey are adults who have stayed at least one night in an NHS hospital in England. They are asked whether they feel that they were treated with dignity and respect during their hospital stay, and whether they received the help that they need with eating during their hospital stays. The new research involves evaluating older people's responses to these questions. We will be analysing what older people have said about their treatment during hospital stays over the period 2002-2011 and whether older people are at any greater risk than younger people. The research will focus on trends in how many older people are affected by lack of dignity in treatment and inadequate nutritional support, and on who is at greatest risk. We will also be examining the links between older age and disability, and older age and area deprivation, as pathways to disadvantage and poor treatment. The research will provide new evidence on older people's treatment during hospital stays and will provide more in-depth evidence in this area than has previously been provided. It will answer important questions such as: -Has the national proportion of older people reporting not being treated with dignity and respect, or not receiving the support they need with eating, during hospital stays increased or decreased over the period 2002-2011?-Are older people more or less likely to experience not being treated with dignity and respect, or not receiving the support they need with eating, during hospital stays, compared with other population sub-groups? -Do other factors such as disability, sex, ethnicity, type of hosptial and area deprivation make a difference to older people's experiences of disadvantage and poor treatment?