- 期刊
Simplified Malnutrition Tool for Thai Patients
應用於泰國病人的簡易營養不良篩檢工具
摘要
營養不良在醫院裡經常沒被發現。目前，沒有滿意的營養篩檢工具以確認營養的風險。大部分診斷營養不良的工具是依據體重及身高當標準，但是很多病人沒有體重記錄，且某些工具是費時的。本文敘述發展一個完整的營養篩檢表單（營養警訊單，NAF）且測試其效度。NAF是修訂自主觀整體評估（SGA）原始版加入兩項標準生化值測量。評量症狀的嚴重性及生化值的改變。NAF的效度測試是由有經驗的臨床營養學者（醫師）評估210名在Ramathibodi醫院住院的泰國病人。交叉驗證是由營養師及護士執行於另90名病人。多數時候，護士可以在5分鐘內完成病人的營養篩檢。四分之一的病人在入院時無法秤體重。由於它們的高敏感度、特異度及準確性，5分和11分被當作不同營養不良程度的切點，6至10分被定義為中度營養不良。營養師及護士之間的診斷一致性，在「正常至輕度營養不良」、「中度營養不良」及「重度營養不良」分別為85%、70%及72%。應用於住院的泰國病人的營養不良篩檢，NAF優點是易使用、簡要、不需要營養專長，且不論是否有體重資料都可以使用。
並列摘要
Malnutrition in hospitals often goes unrecognized. At present, no nutrition screening tool provides satisfactory results in identifying nutritional risk. Most tools depend on weight and height as criteria for diagnosing malnutrition. Weight is not recorded in many patients and some tools are time-consuming. An inclusive nutrition screening form (Nutrition Alert Form, NAF) was developed and validated. NAF was modified from the original version of Subjective Global Assessment (SGA) by adding in two standard laboratory tests. The severity of the symptom and laboratory changes were scored. NAF was validated in 210 hospitalized Thai patients at Ramathibodi hospital by an experienced clinical nutritionist (physician) at Ramathibodi hospital. Cross validation was carried out between the dietitian and nurse in another 90 patients. Most of the time nurses could complete the nutrition screening in a patient within 5 minutes. One out of four patients could not be weighed on admission. The scores of 5 and 11 were selected as the cut-off scores of different malnutrition levels due to their high sensitivity, specificity and accuracy and scores of 6 to 10 were defined as moderate malnutrition. The diagnostic agreement between the dietitian and nurse for ”normal to mild malnutrition”, ”moderate malnutrition”, and ”severe malnutrition” were 85%, 70% and 72%, respectively. NAF for screening of malnutrition in hospitalized Thai patients is easy to use, concise, does not require nutrition expertise and can be used whether or not body weight is taken.
參考文獻
延伸閱讀
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