The Relationship between Depression/Anxiety and Food Service Satisfaction in Hospitalized Patients

Meryem Elif Öztürk; Nurcan Yabancı Ayhan

doi:10.38079/igusabder.1550218

Research Article

The Relationship between Depression/Anxiety and Food Service Satisfaction in Hospitalized Patients

Year 2025, Issue: 25, 343 - 357, 29.04.2025

Meryem Elif Öztürk , Nurcan Yabancı Ayhan

https://doi.org/10.38079/igusabder.1550218

Abstract

Aim: Mental conditions and food service satisfaction significantly affect dietary intake in hospitalized patients. However, research on this interaction is scarce. Therefore, this study had two objectives: i) determining the relationship between anxiety/depression and food service satisfaction and ii) testing the direct or indirect relationship between depression and daily energy intake mediated by food service satisfaction.
Method: This cross-sectional study was conducted in a public hospital. The sample comprised 218 adult inpatients (18-75 years of age). Data were collected using the Hospital Anxiety Depression Scale (HADS) and the Acute Care Hospital Food Service Patient Satisfaction Questionnaire (ACHFSPSQ). Dietary intake was analyzed based on 24-hour recall data. The data were analyzed using path analysis.
Results: Participants who were at risk for depression and anxiety had significantly lower mean ACHFSPSQ subscale scores than those who were not (p<0.05). There was a positive correlation between ACHFSPSQ subscale scores and daily energy and nutrient intake (p<0.05). However, participants who were at risk for anxiety and depression did not consume significantly less energy and nutrient than those who were not (p>0.05). The results showed that the risk for depression adversely affected food service satisfaction (p<0.05). However, it had no direct or indirect relationship with daily energy intake (p>0.05). The results also showed that food service quality partly mediated the risk for depression and daily energy intake (β=6.003, p<0.05).
Conclusion: Patients at risk for anxiety and depression may have negative perceptions of food services that are not reflected in their actual dietary intake. Therefore, healthcare professionals should consider hospitalized patients’ mental status before assessing their satisfaction with food services.

Keywords

Anxiety, depression, energy intake, food service, inpatients

Ethical Statement

This study was carried out with the approval of the Ethics Committee of Karamanoğlu Mehmetbey University, numbered 95728670-044-2. A signed subject consent form in accordance with the Declaration of Helsinki was obtained from each participant

References

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7. Osman NS, Nor N, Sharif MS, Hamid SBA, Rahamat S. Hospital Food Service Strategies to improve food intakes among inpatients: A systematic review. Nutrients. 2021;13(10):3649. doi: 10.3390/nu13103649.
8. AlBekairy A, AbuRuz S, Alsabani B, Alshehri A, Aldebasi T, Alkatheri A. Exploring factors associated with depression and anxiety among hospitalized patients with Type 2 diabetes mellitus. Med Princ Pract. 2017;26(6):547-553. doi: 10.1159/000484929
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29. Agarwal E, Ferguson M, Banks M, et al. Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: Results from the Nutrition Care Day Survey 2010. Clin Nutr. 2013;32:737–745.
30. Rogozinski A, Zisberg A. Associations between depressive symptoms, appetite and food ıntake among hospitalized older adults. Innov Aging. 2020;4:919–919.
31. Sieske L, Janssen G, Babel N, Westhoff TH, Wirth R, Pourhassan M. Inflammation, appetite and food intake in older hospitalized patients. Nutrients. 2019;11:1986.
32. Sahin B, Demir C, Celik Y, Teke AK. Factors affecting satisfaction level with the food services in a military hospital. J. Med Syst. 2006;30:381–387.
33. Wright ORL, Connelly LB, Capra S. Consumer evaluation of hospital foodservice quality: an empirical investigation. Int J Health Care Qual Assur. 2006;19:181–194.
34. Abdelhafez A, Al Qurashi L, Al Ziyadi R, Kuwair A, Shobki M, Mograbi H. Analysis of factors affecting the satisfaction levels of patients toward food services at general hospitals in Makkah, Saudi Arabia. Am J Med Med Sci. 2012;2:123–130.
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Hastanede Yatan Hastalarda Depresyon/Anksiyete ile Yiyecek Hizmeti Memnuniyeti Arasındaki İlişki

Year 2025, Issue: 25, 343 - 357, 29.04.2025

Meryem Elif Öztürk , Nurcan Yabancı Ayhan

https://doi.org/10.38079/igusabder.1550218

Abstract

Amaç: Psikolojik durum ve yiyecek hizmetleri memnuniyeti, hastanede yatan hastalarda besin alımı üzerinde önemli bir etkiye sahiptir. Ancak, bu faktörlerin etkileşimi bilinmemektedir. Bu nedenle çalışmanın amaçları: i) anksiyete ve depresyon riski ile yemek servisi memnuniyeti arasındaki ilişkiyi belirlemek, ii) depresyon riski ile günlük enerji alımı arasındaki doğrudan ve dolaylı ilişkiyi, yemek servisi memnuniyeti alt boyutları aracılığıyla test etmektir.
Yöntem: Bu çapraz-kesitsel çalışma, bir kamu hastanesinde yürütülmüştür. Örneklem 218 yatan hastadan olşmaktadır (18-75 yaş arası). Veriler Hastane Anksiyete Depresyon Ölçeği (HADS) Hastane Yiyecek Hizmetleri Hasta Memnuniyeti Ölçeği (ACHFSPSQ) kullanılarak toplanmıştır. Diyet alımı 24 saatlik hatırlatma yöntemiyle analiz edilmiştir. Veriler Path analizi kullanılarak analiz edilmiştir.
Bulgular: Depresyon ve anksiyete riski olan hastaların ACHFSPSQ alt puanları risk altında olmayanlara göre önemli ölçüde daha düşüktü (p<0,05). ACHFSPSQ alt puanları günlük enerji ve çoğu besin ögesi alımıyla pozitif ilişkiliydi (p<0,05). Ancak anksiyete ve depresyon riski olan hastalarla risk olmayanlar arasında enerji ve besin ögesi alımı açısından istatistiksel olarak anlamlı bir farklılık yoktu (p>0,05). Sonuçlar depresyon riskinin yiyecek hizmetleri memnuniyeti üzerinde olumsuz bir etkisi olduğunu gösterdi (p<0,05). Ancak depresyon riski ile günlük enerji alımı arasında doğrudan ve dolaylı bir ilişki bulunamadı (p>0,05). Bulgular ayrıca yemek servisi kalitesi alt puanının depresyon riski ve günlük enerji alımı arasındaki ilişkiye kısmen katkısı olduğunu gösterdi (β=6,003, p<0,05).
Sonuç: Anksiyete ve depresyon riski olan hastaların yiyecek hizmetleri ile ilgili olumsuz düşünceleri gerçek besin alımlarına yansımayabilir. Bu yüzden sağlık profesyonelleri yatan hastalarda yiyecek hizmetleri memnuniyetini değerlendirmeden önce hastaların psikolojik durumunu dikkate almalıdır.

Keywords

Anksiyete, depresyon, enerji alımı, yiyecek servisi, yatan hastalar

References

1. Korfali G, Gündoğdu H, Aydintuğ S, Bahar M, Besler T, Moral AR. Nutritional risk of hospitalized patients in Turkey. Clin. Nutr. 2009;28(5):533–537. doi: 10.1016/j.clnu.2009.04.015
2. Sökülmez Kaya P, Aydın Avci İ. Determination of nutritional risk rate in patients hospitalized in the Gastroenterology Service at Turkey hospital. Prog Nutr. 2014;16(2):136-142.
3. Altundağ Derin NZ. Hastanede yatan hastalarda malnütrisyon oranları ve buna etki eden faktörler [medical thesis]. Kırıkkale, Türkiye: Gastroenterology, Medicine Faculty; 2017.
4. Correia MIT, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003;22(3):235-239. doi: 10.1016/s0261-5614(02)00215-7.
5. Topal A, Tolunay O. Effect of malnutrition on length of hospital stay in children. Turk Arch Pediatr. 2021;56(1):37-43. doi: 10.14744/TurkPediatriArs.2020.46354
6. Lennie TA, Moser DK, Heo S, Chung ML, Zambroski CH. Factors influencing food intake in patients with heart failure: a comparison with healthy elders. J Cardiovasc Nurs. 2006;21(2):123-129. doi: 10.1097/00005082-200603000-00008
7. Osman NS, Nor N, Sharif MS, Hamid SBA, Rahamat S. Hospital Food Service Strategies to improve food intakes among inpatients: A systematic review. Nutrients. 2021;13(10):3649. doi: 10.3390/nu13103649.
8. AlBekairy A, AbuRuz S, Alsabani B, Alshehri A, Aldebasi T, Alkatheri A. Exploring factors associated with depression and anxiety among hospitalized patients with Type 2 diabetes mellitus. Med Princ Pract. 2017;26(6):547-553. doi: 10.1159/000484929
9. Fattouh N, Hallit S, Salameh P, Choueiry G, Kazour F, Hallit R. Prevalence and factors affecting the level of depression, anxiety, and stress in hospitalized patients with a chronic disease. Perspect Psychiatr Care. 2019;55(4):592-599. doi: 10.1111/ppc.12369
10. Baxter LC. Appetite changes in depression. Am J Psychiatry 2016; 173(4): 317-318. doi: 10.1176/appi.ajp.2016.16010010
11. Lopes AA, Elder SJ, Ginsberg N, Andreucci VE, Cruz JM, Fukuhara S. Lack of appetite in haemodialysis patients--associations with patient characteristics, indicators of nutritional status and outcomes in the international DOPPS. Nephrol Dial Transplant. 2007;22(12):3538-3546. doi: 10.1093/ndt/gfm453
12. Kim DM, Kim KH. Food and nutrient intake status of Korean elderly by perceived anxiety and depressive condition: data from Korean National Health and Nutrition Examination Survey 2013~2015. J Nutr Health. 2019;52(1):58-72.
13. Messina G, Fenucci R, Vencia F, Niccolini F, Quercioli C, Nante N. Patients' evaluation of hospital foodservice quality in Italy: what do patients really value? Public Health Nutr. 2013;16(4):730-737. doi: 10.1017/S1368980012003333
14. Dall’Oglio I, Nicolò R, Di Ciommo V, Bianchi N, Ciliento G, Gawronski O. A systematic review of hospital foodservice patient satisfaction studies. J. Acad. Nutr. Diet. 2015;115(4):567-584. doi: 10.1016/j.jand.2014.11.013.
15. McCray S, Maunder K, Krikowa R, MacKenzie-Shalders K. Room service improves nutritional intake and increases patient satisfaction while decreasing food waste and cost. J Acad Nutr Diet. 2018;118(2):284-293. doi: 10.1016/j.jand.2017.05.014
16. Kuperberg K, Caruso A, Dello S, Mager, D. How will a room service delivery system affect dietary intake, food costs, food waste and patient satisfaction in a paediatric hospital? A pilot study. Journal of Foodservice. 2008;19(5):255-261.
17. Mahoney S, Zulli A, Walton K. Patient satisfaction and energy intakes are enhanced by point of service meal provision. Nutr Diet. 2009;66(4):212-220.
18. Sathiaraj E, Priya K, Chakraborthy S, Rajagopal R. Patient-centered foodservice model improves body weight, nutritional intake and patient satisfaction in patients undergoing cancer treatment. Nutr Cancer. 2019;71(3):418-423.
19. Capra S, Wright O, Sardie M, Bauer J, Askew D. The acute hospital foodservice patient satisfaction questionnaire: the development of a valid and reliable tool to measure patient satisfaction with acute care hospital foodservices. Int. Food Res. J. 2005;16(1‐2):1-14.
20. Ercan G, Ok MA. Hastane yiyecek hizmetleri hasta memnuniyeti ölçeğinin türkçe formunun geçerlilik ve güvenirlilik çalışması. Turk. Klin. J. Med. Sci. 2018;3(3):187-194.
21. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-370. doi: 10.1111/j.1600-0447.1983.tb09716.x
22. Aydemir Ö, Güvenir T, Küey L, Kültür S. Hastane anksiyete ve depresyon ölçeği Türkçe formunun geçerlilik ve güvenilirliği. Turk Psıkıyatrı Derg. 1997;8(4):280-287.
23. WHO Consultation on Obesity (‎1999: Geneva, Switzerland)‎ & World Health Organization. (‎2000)‎. Obesity: preventing and managing the global epidemic : report of a WHO consultation. World Health Organization
24. Rakıcıoğlu N, Acar N, Ayaz A, Pekcan G. Yemek ve Besin Fotoğraf Kataloğu. Ankara: Ata Ofset Press; 2012.
25. BeBİS. Beslenme Bilgi Sistemi. https://bebis.com.tr/anasayfa. Yayınlanma tarihi 2010. Erişim tarihi 3 Ekim 2023.
26. Gunn JM, Ayton DR, Densley K, et al. The association between chronic illness, multimorbidity and depressive symptoms in an Australian primary care cohort. Soc Psychiatry Psychiatr Epidemiol. 2012;47(2):175-184. doi:10.1007/s00127-010-0330-z
27. Dos Santos AP, Lazzari TK, Silva DR. Health-Related Quality of Life, Depression and Anxiety in Hospitalized Patients with Tuberculosis. Tuberc Respir Dis (Seoul). 2017;80(1):69-76. doi:10.4046/trd.2017.80.1.69
28. German L, Feldblum I, Bilenko N, Castel H, Harman-Boehm I, Shahar DR. Depressive symptoms and risk for malnutrition among hospitalized elderly people. J Nutr Health Aging. 2008;12:313–318. doi: 10.1007/BF02982661.
29. Agarwal E, Ferguson M, Banks M, et al. Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: Results from the Nutrition Care Day Survey 2010. Clin Nutr. 2013;32:737–745.
30. Rogozinski A, Zisberg A. Associations between depressive symptoms, appetite and food ıntake among hospitalized older adults. Innov Aging. 2020;4:919–919.
31. Sieske L, Janssen G, Babel N, Westhoff TH, Wirth R, Pourhassan M. Inflammation, appetite and food intake in older hospitalized patients. Nutrients. 2019;11:1986.
32. Sahin B, Demir C, Celik Y, Teke AK. Factors affecting satisfaction level with the food services in a military hospital. J. Med Syst. 2006;30:381–387.
33. Wright ORL, Connelly LB, Capra S. Consumer evaluation of hospital foodservice quality: an empirical investigation. Int J Health Care Qual Assur. 2006;19:181–194.
34. Abdelhafez A, Al Qurashi L, Al Ziyadi R, Kuwair A, Shobki M, Mograbi H. Analysis of factors affecting the satisfaction levels of patients toward food services at general hospitals in Makkah, Saudi Arabia. Am J Med Med Sci. 2012;2:123–130.
35. Miyagi M, Miyatani M, Nakao T. Relation between choice-induced preference change and depression. PLoS One. 2017;12:e0180041.
36. Kohli P, Soler ZM, Nguyen SA, Muus JS, Schlosser RJ. The Association Between Olfaction and Depression: A Systematic Review. Chem Senses. 2016;41:479–486. doi: 10.1093/chemse/bjw061.
37. Schablitzky S, Pause BM. Sadness might isolate you in a non-smelling world: olfactory perception and depression. Front. Psychol. 2014;5:1-20. doi: 10.3389/fpsyg.2014.00045.
38. Aucoin M, LaChance L, Naidoo U, et al. Diet and anxiety: A scoping review. Nutrients. 2021;13(12):4418. doi: 10.3390/nu13124418
39. Balcı M. Koronavirüs Hastalığı Nedeniyle Hastanede Yatarak Tedavi Gören Hastalar İle Diğer Nedenlerle Yatan Hastaların Hastane Anksiyete ve Depresyon Düzeylerinin Karşılaştırılması. [Medical Thesis]. İstanbul, Türkiye: Aile Hekimliği Ana Bilim Dalı, Konya Şehir Hastanesi; 2021.
40. Kaner G, Soylu M, Yüksel N, Inanç N, Ongan D, Başmısırlı E. Evaluation of nutritional status of patients with depression. Biomed Res Int. 2015;2015:1–9.
41. Jieqiong H, Yunxin J, Ni D, Chen L, Ying C. The correlation of body mass index with clinical factors in patients with first-episode depression. Front Psychiatry. 2022;13:938152. doi:10.3389/fpsyt.2022.938152
42. Doğan G, Yabancı Ayhan N, Varlı M. Association between nutritional status and depression in hospitalized elderly patients. Aging Med Healthc. 2022;13:118–124.
43. Paquet C, St-Arnaud-McKenzie D, Kergoat MJ, Ferland G, Dubé L. Direct and indirect effects of everyday emotions on food intake of elderly patients in institutions. J Gerontol A Biol Sci Med Sci. 2003;58:153-158. doi:10.1093/gerona/58.2.m153
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Details

Primary Language	English
Subjects	Nutrition and Dietetics (Other)
Journal Section	Articles
Authors	Meryem Elif Öztürk 0000-0002-2176-374X Nurcan Yabancı Ayhan 0000-0003-1233-246X
Early Pub Date	April 29, 2025
Publication Date	April 29, 2025
Submission Date	September 14, 2024
Acceptance Date	April 11, 2025
Published in Issue	Year 2025 Issue: 25

Cite

JAMA	Öztürk ME, Yabancı Ayhan N. The Relationship between Depression/Anxiety and Food Service Satisfaction in Hospitalized Patients. IGUSABDER. 2025;:343–357.

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