Eating difficulties among stroke patients in the acute state: a descriptive, cross-sectional, comparative study

Aims and objectives. To examine eating difficulties among stroke patients - a comparison between women and men. Background. Gender differences have been reported in studies of stroke, but the findings are inconclusive and few of these studies have specifically focused on gender differences in eating difficulties. Design. This study was a descriptive, cross-sectional, comparative study. Method. Patients with stroke were recruited at a general hospital in Sweden. To detect eating difficulties, individual observations of the patients were made during one meal using a structured observation protocol. Assessment also included measurements of nutritional and oral status, degree of independence, stroke severity, neglect and well-being. Results. One hundred and four patients (53.8% women) were included in the study. The proportion of stroke patients with one or more eating difficulties was 81.7%. The most common eating difficulties were 'managing food on the plate' (66.3%), 'food consumption' (54.8%) and 'sitting position' (45.2%). Women had lower 'food consumption', more severe stroke (p = 0.003), worse functional status (p = 0 001) and lower quality of life (QoL) (p = 0 038) than men. More women than men were malnourished and living alone. After adjustment for functional status and motor arm, the odds ratio of having difficulties with food consumption was four times higher among women than men (1.7-9.4, confidence interval 95%). Conclusions. More women than men with stroke suffered from inadequate food consumption. The women had more severe strokes, experienced poorer QoL and showed lower functional status than the men. In the rehabilitation process of women with stroke, these factors should be taken into consideration. Relevance to clinical practice. Structured observation of meals, including assessment of food consumption, might be necessary in acute stroke care to detect patients, especially women, who might need closer supervision and nutritional intervention.