Nutritional Screening in Community-Dwelling Older Adults: A Systematic Literature Review

社區老人之營養篩檢：一個系統性文獻回顧

Megan B Phillips ； Amanda L Foley ； Robert Barnard ； Elisabeth A Isenring ； Michelle D Miller

《Asia Pacific Journal of Clinical Nutrition》 19卷3期 (2010/09) Pp. 440-449

https://doi.org/10.6133/apjcn.2010.19.3.20

摘要

營養篩檢是用來快速確認那些可能有營養不良風險的個體的一個步驟，進而提供完整的營養評估及適當的營養介入。雖然很多營養篩檢工具已經被發展出來，於社區老人的使用卻很少被評估。這篇文章的目的，是由信效度的角度來決定最適當的營養篩檢工具，以確認社區老人的營養不良風險。從電子資料庫MEDLINE、PUBMED、CINAHL及Cochrane Library搜尋，曾使用在65歲以上的社區老人，以確認營養不良或營養不足的營養篩檢工具。有10種篩檢工具被應用在社區老人，並有信效度測試，包括：簡易的營養評估-短版（MNA-SF）、營養不良通用篩檢工具（MUST）、營養篩檢方案（NSI），包含評估清單及第一、二級篩檢、澳洲營養篩檢方案（ANSI）、社區老人：飲食及營養危險性評估（SCREEN I和SCREEN II）、短版營養評估問卷（SNAQ©）、簡化營養食慾問卷（SNAQ）及兩種未命名的工具。MNA-SF顯示為最適合使用在社區老人的營養篩檢工具，另外也有證據支持MUST和SCREEN II的使用適合性。更進一步的研究必須探究篩檢工具在營養篩檢結果及適合的營養介入的可接受性。

關鍵字

營養不良 ； 營養不足 ； 篩檢工具 ； 效度 ； 信度

並列摘要

Nutrition screening is a process used to quickly identify those who may be at risk of malnutrition so that a full nutrition assessment and appropriate nutrition intervention can be provided. While many nutrition screening tools have been developed, few have been evaluated for use in older adults in the community setting. The aim of this paper is to determine the most appropriate nutrition screening tool/s, in terms of validity and reliability, for identifying malnutrition risk in older adults living in the community. Electronic databases MEDLINE, PUBMED, CINAHL and the Cochrane Library were searched for nutrition screening tools to identify malnutrition or under-nutrition for adults greater than 65 years living in the community. Ten screening tools were found for use in community-dwelling older adults and subjected to validity and/or reliability testing: Mini Nutritional Assessment-Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutrition Screening Initiative (NSI), which includes the DETERMINE Checklist and Level I and II Screen, Australian Nutritional Screening Initiative (ANSI), Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN I and SCREEN II), Short Nutritional Assessment Questionnaire (SNAQ©), Simplified Nutritional Appetite Questionnaire (SNAQ), and two unnamed tools. MNA-SF appears to be the most appropriate nutrition screening tool for use in community-dwelling older adults although MUST and SCREEN II also have evidence to support their use. Further research into the acceptability of screening tools focusing on the outcomes of nutrition screening and appropriate nutrition intervention are required.

並列關鍵字

malnutrition ； under-nutrition ； screening tools ； validity ； reliability