Dietary Behavior Challenges Among Hospitalized Older Adults with Oral Frailty: A Qualitative Study

Background Oral frailty profoundly compromises the nutritional status and overall well-being of older adults. Although dietary modifications are essential for managing this condition, many older patients struggle to maintain healthy eating behaviors. Therefore, this study aimed to explore the multifaceted barriers to dietary behavior change from the lived perspectives of older adults with oral frailty, guided by the Theory of Planned Behavior. Methods A descriptive qualitative study design was adopted. Sixteen older adults with oral frailty were recruited using maximum variation purposive sampling to ensure diversity of experiences. Data were collected over a three-month period through fully audio-recorded, semi-structured, in-depth interviews. All interviews were transcribed verbatim and analyzed using directed content analysis guided by the Theory of Planned Behavior. Results Three themes and nine subthemes were identified: Behavioral attitudes were characterized by limited awareness and understanding of oral frailty, along with a passive, age-related mindset of compromise. Subjective norms were marked by limited family involvement, a lack of dietary guidance for oral health, and insufficient institutional dietary support. Perceived behavioral control was constrained by diminished chewing function that restricted food choices, reduced taste perception that weakened motivation for change, the influence of traditional dietary patterns, and conflicts between dietary requirements of comorbidities and oral function. Conclusion Dietary behavior changes in older inpatients with frailty are influenced by three factors: behavioral attitudes, subjective norms, and perceived behavioral control. Healthcare providers should enhance dynamic assessments of dietary behaviors in frail patients, assist them in maintaining healthy eating habits by addressing specific underlying causes, and thereby improve their health outcomes.