OBJECTIVE: To know the objective and subjective reasons, material and symbolic, which act as the foundation of the attitude of hospital institutions towards meals, considered as a social construction, a product of the conceptions and practices of professionals who determine and reproduce them directly or indirectly. METHOD: A qualitative survey was carried out involving 32 intensity, half-structured interviews, applied to individuals participating in the process of producing hospital diets cooks, maids, nutritionists, doctors (medical), nurses and their auxiliaries and clinical and administrative directors and field observation in two kinds of hospital, private and public. RESULTS: The analysis of the content of the interviews and of the field observation data was organized into two categories: nutritional aspects separate from those of the food in which a valorization of the nutritional aspect was noted, principally in nutritional support actions, in detriment of the sensory and symbolic aspects of the hospital food; and the hospital diet in which a lack of technical information about available hospital diets was observed; the actual hospitalization, as referring to the conditions of control and discipline and the limited autonomy and right to speak of the patients, were reflected in their social representation. The importance given to hospital diets is limited and the attention given to nutrition embryonic. CONCLUSION: Attempts must be made to change the hospital food culture in order to install the idea of hospital nutritional assistance in which the hospital diet and attention to nutrition become an important part of the patient's treatment, collaborating with the quality of the hospitalization experience.
institutional feeding; malnutrition; diet; nutritional status; food service hospitalar
