食慾評估量表(CNAQ)可有效判定台灣血液透析患者之食慾狀況

Validation of CNAQ for assessing the appetite status of maintenance hemodialysis patients in Taiwan

翁慧君(Hui, June Wong)

指導教授 ： 蔡仲弘

亞洲大學/健康學院/長期照護研究所/碩士(2008年)

摘要

食慾評估量表(Council on Nutrition Appetite Questionnaire, CNAQ)為美國長期照護機構營養策略組織(Council for Nutritional Strategies in Long-Term Care)為了避免居家及照護機構之住民可能因食慾不良導致體重減輕所研發的食慾評估工具，其使用簡便，功能良好，並已獲驗證。CNAQ共包含一般食慾狀況、進餐飽足感、饑餓情況、食物味道、食物味道與年輕時比較有否改變、吃東西是否有不舒服感、每天用餐次數、一般情緒狀況等八題。由於CNAQ量表的發展是以美國臨床資料為基礎，因文化的差異，要適用於國人時，必須加以驗證。本研究目的在於驗證CNAQ用於評估台灣血液透析患者食慾狀況的功能，並探討血液透析病人食慾的預測因子。以台灣中部某三血液透析中心108名病人為方便樣本，進行血液生化檢測、體位測量及問卷訪談，並以CNAQ評估其食慾。經CNAQ評為食慾不良者有58人(53.7%)，良好者50人(46.3%)。CNAQ之總分與主要營養生化指標血清白蛋白呈顯著相關(P<0.01)。其他重要營養指標如體重改變(P<0.01)、血清肌酸酐(P<0.01)、臂中圍指數(P<0.05)、小腿圍指數(P<0.05)、臀圍(P<0.01)、每週運動次數(P<0.01)、及慢性疾病數(P<0.05)亦均與CNAQ之總分呈顯著相關，且相關強度大多高於與血清白蛋白的相關。這些結果顯示以CNAQ評估食慾狀況比使用血清白蛋白更為可靠。CNAQ可有效評估台灣血液透析病人的食慾狀況。CNAQ功能良好，使用簡便，不需任何介入性指標，在短短數分鐘內即可獲得結果。使用此工具將有助於減少因食慾不良所造成的營養不良。

關鍵字

食慾評估量表 ； 血液透析病人 ； 食慾

並列摘要

CNAQ (Council on Nutrition Appetite Questionnaire) was developed by the Council for Nutritional Strategies in Long-Term Care of the United States. It is a tool for evaluating the appetite status of community-dwelling adults and nursing home residents. The tool has been shown to be useful because of its simplicity and efficiency. This study attempted to examine whether this tool can be applied to assess the appetite status of maintenance hemodialysis patients in Taiwan. One hundred and eight community-living patients from three hemodialysis centers were chosen as study samples. A structured-questionnaire elicited personal data and health conditions, in addition to answers to questions in the CNAQ during a routine dialysis session. Anthropometric measurements were also carried out. Biochemical indicators were obtained from their routine tests. CNAQ identified 58 of the 108 patients (53.7%) poor appetite and 50 (46.3 %) good appetite. Subjects' CNAQ scores were significantly correlated with serum albumin (P<0.01), an indicator of nutritional status. Most nutritional indicators including weight change (P<0.01), serum creatinine (P<0.01), calf circumference index (P<0.05), mid-arm circumference index (P<0.05), hip circumference (P<0.01), physical activity (P<0.01) and number of chronic diseases (P<0.05) showed stronger correlations with CNAQ scores than with serum albumin concentrations. These results suggest that CNAQ is a more reliable indicator of nutritional status than serum albumin for hemodialysis patients. The simplicity, efficiency and low cost of CNAQ make this tool a method of choice for assessing the appetite status of maintenance hemodialysis patients.

並列關鍵字

Council on Nutrition Appetite Questionnaire ； CNAQ ； hemodialysis patients ； appetite

參考文獻

陳淑子 (2006)。血液透析患者蛋白質熱量營養不良的監測評估與飲食處理。臺灣腎臟護理學會雜誌，5 (1),12-21。

Detsky, A. S., McLaughlin, J. R., Baker, J. P., Johnston, N., Whittaker, S., & Mendelson, R. A. (1987). What is subjective global assessment of nutritional status? Journal of Parenteral and Enteral Nutrition, 11 (1), 8-13.

Daugirdas, J. T., Blake, P. G., & Ing, T. S. (2001). Handbook of Dialysis, Philadelphia: Lippincott Williams and Wilkins.

Agodoa, L., Briggs, J., Mitch, W., McCleland, W., & Kopple, J. (1999). Nutrition in ESRD patients: rationale and plan for an initiative. Journal of Renal Nutrition, 9 (3), 116-118.

Allison, S. P. (2000). Malnutrition, disease, and outcome. Nutrition, 16, 590-593.