| Despite the importance of appetite as a key nutritional parameter and the common use of poor appetite as an indicator of nutritional risk, no theories about appetite exist. The study of appetite in frail seniors is particularly important because this subgroup has an increased risk for poor appetite. A comprehensive understanding of the meaning of appetite is needed before research in this area can be done well. This study explored the meaning of appetite from the perspectives of frail, community-living seniors for the purpose of generating a substantive theory on appetite.; Qualitative methods based on grounded theory were used. In-depth interviews were used because of the complex and potentially personal nature of appetite, and to gather rich and detailed narratives. Selective and theoretical sampling methods were used, and sampling continued until theoretical saturation of data. Interviews, conducted in the seniors' homes, were audio taped and transcribed verbatim. Open, axial, and selective coding processes were used. Memos were kept to help formulate thoughts and insights about emerging categories, and an ongoing process of reflexivity was used to monitor the interpretive process.; Theoretical saturation was achieved after interviewing 40 frail seniors. Seniors gave rich descriptions of their own appetite in ways that strongly paralleled their life story. Appetite is a metaphor for life emerged as the core category that encapsulated the central notion of appetite for food corresponding with appetite for life. Appetite emerged to be a multidimensional, complex phenomenon ingrained in life history and reflective of life experiences. Throughout the course of life, appetite develops in learning and maturity, and is reflective of critical life experiences. Further work should extend on this inquiry beyond frail, community-living seniors. Empirical work on assessment of appetite, and treatment and prevention of poor appetite, would also be important extensions of this study.; In conclusion, the seniors framed their conceptualizations on appetite within a lifespan perspective, and offered rich accounts of appetite beyond the traditional physiological perspective. Appetite emerged to reflect not only a physiologic part of life, but also several other important domains in life including the physical, moral, and spiritual. |
