Fishing for understanding: nurses knowledge and attitudes in relation to nutritional care

Many studies have demonstrated that malnutrition is a significant problem amongst hospital patients, but little is known about what nurses actually do, and what factors influence this. This study aimed to explore the nutritional attitudes, knowledge base and nursing care of qualified nurses in an acute hospital. A survey of nurses' records for documented nutrition related activities was carried out for all (141) patients from five wards for two weeks, followed by a questionnaire, focused on nutrition-related attitudes, activities and knowledge, to all qualified nurses of these and a further four wards (110 nurses). Results revealed evidence of some knowledgeable and pro-active attitudes and nursing care; however, there was little association between knowledge, stated attitudes and behaviour and discrepancies were observed between questionnaire responses and documented activities. Ajzen and Fishbein's (1980) theory relating beliefs, attitudes, intentions and behaviour was not supported although this might be attributed, in part at least, to nurses not regarding weighing patients as nutritional assessment. Behaviour appeared to have been influenced by a variety of factors and relationships between attitudes, knowledge and activities seemed far from straightforward.