Unintentional weight loss is a common and significant problem among nursing home residents and an important indicator of malnutrition. Nursing home residents who lose more than 5% of their body weight in one month or 10% of body weight in six months are at increased risk for morbidity and mortality. Licensed nurses, who are responsible for maintaining the health and well-being of nursing home residents, have been shown to be deficient in nutrition knowledge. Little is known about the relationship between nurse nutrition knowledge and unintentional weight loss in nursing home residents.The purpose of this study was to revise a nurse nutrition questionnaire to reduce respondent burden and to examine the psychometric properties of the revised instrument. The revised instrument was then used to describe the relationship between nurse nutrition knowledge and unintentional weight loss in nursing homes across Northeast Indiana.A descriptive, correlational, and non-experimental design was used to describe the relationship between nurse nutrition knowledge and unintentional weight loss (UWL) in nursing home residents in Northeast Indiana. Licensed nurses (N = 101) from nine nursing homes were recruited for this study. Nurse nutrition knowledge was measured using a revised nutrition questionnaire (NKQ-R) and weight loss data was obtained from the Nursing Home Compare Database.Content validity of the NKQ-R was acceptable. Item analysis demonstrated six items below the acceptable point biserial of .15, and one question demonstrated a very high P value of 98 and had a nonfunctioning distracter response. Four of these problematic items were in subscale `3' (nutritional deficiencies of institutionalized older adults). Consistent with findings from previous studies, nurses scored below average on the nurse nutrition questionnaire, however relationships between nurse nutrition knowledge and unintentional weight loss were not supported. Level of nurse education was positively correlated with NKQ-R scores. Nursing home ownership type was significantly related to NKQ-R scores and unintentional weight loss; nurses working in not-for-profit nursing homes scored higher on the NKQ-R than nurses working in not-for-profit nursing homes, and not-for-profit nursing homes had a lower incidence of UWL than the for-profit nursing homes in this study.

The population of elderly people in the United States is predicted to increase in large numbers within the next few decades. Many of them will be admitted to long-term-care centers in the waning years of their lives. Health care professionals will need to be prepared for this influx of the elderly into these institutions and for their demands of improved quality of life in these centers. Unplanned weight loss has become one of the major predictors of mortality in long-term-care residents. The purpose of the study was to compare the use of liberalized diets with the traditional therapeutic diets long advocated in long-term-care facilities in the United States. The objectives were to conduct a randomized clinical trial with a treatment group (subjects who consumed liberalized diets) and a control group (subjects who continued with their usual therapeutic diets), and to compare outcomes between the two groups. The randomized clinical trial was conducted for 18 weeks from April to August 2009 at a long-term-care facility in rural North Mississippi. Twenty-two persons ranging in age from 54 to 100 years were approved by their physicians for participation in the trial. All of these persons participated and completed the trial. Eleven of the participants received their prescribed therapeutic diet and 11 participants received a liberalized diet for the length of the trial study. At the end of the study, there were no significant differences (p>0.05) in mean body weights and laboratory values between the two groups. However, there was a trend of weight loss in the therapeutic diet group (mean weight loss of 2% (1.4 kg) during the 18-week trial), and although it was not significant (p>0.05), this supports the growing belief of those who advocate liberalized geriatric diets to improve quality of life and prevent unintentional weight loss. Participants in the liberalized diet group did not experience weight loss and gained 0.5 kg by the end of the study.