• Title/Summary/Keyword: Nutritional assessment

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Evaluation of the efficacy of nutritional screening tools to predict malnutrition in the elderly at a geriatric care hospital

  • Baek, Myoung-Ha;Heo, Young-Ran
    • Nutrition Research and Practice
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    • v.9 no.6
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    • pp.637-643
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    • 2015
  • BACKGROUND/OBJECTIVES: Malnutrition in the elderly is a serious problem, prevalent in both hospitals and care homes. Due to the absence of a gold standard for malnutrition, herein we evaluate the efficacy of five nutritional screening tools developed or used for the elderly. SUBJECTS/METHODS: Elected medical records of 141 elderly patients (86 men and 55 women, aged $73.5{\pm}5.2years$) hospitalized at a geriatric care hospital were analyzed. Nutritional screening was performed using the following tools: Mini Nutrition Assessment (MNA), Mini Nutrition Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated as a reference tool. Each patient evaluated as malnourished to any degree or at risk of malnutrition according to at least four out of five of the aforementioned tools was categorized as malnourished in the combined index classification. RESULTS: According to the combined index, 44.0% of the patients were at risk of malnutrition to some degree. While the nutritional risk and/or malnutrition varied greatly depending on the tool applied, ranging from 36.2% (MUST) to 72.3% (MNA-SF). MUST showed good validity (sensitivity 80.6%, specificity 98.7%) and almost perfect agreement (k = 0.81) with the combined index. In contrast, MNA-SF showed poor validity (sensitivity 100%, specificity 49.4%) and only moderate agreement (k = 0.46) with the combined index. CONCLUSIONS: MNA-SF was found to overestimate the nutritional risk in the elderly. MUST appeared to be the most valid and useful screening tool to predict malnutrition in the elderly at a geriatric care hospital.

The effect of a nutritional education program on the nutritional status of elderly patients in a long-term care hospital in Jeollanamdo province: health behavior, dietary behavior, nutrition risk level and nutrient intake

  • Kim, Bok-Hee;Kim, Mi-Ju;Lee, Yoon-Na
    • Nutrition Research and Practice
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    • v.6 no.1
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    • pp.35-44
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    • 2012
  • This study was conducted to assess improvements in nutritional status following the application of nutrition education to elderly patients in a long-term care hospital. The study was carried out from January to May 2009, during which a preliminary survey, a pretest, the application of nutrition education, and a post-test were applied in stages. The number of subjects at pretest was 81, and the number of participants included in the final analysis was 61 (18 men, 43 women), all of whom participated in both the nutrition education program and the post-test. The survey consisted of general demographic items, health behaviors, dietary behaviors, the Nutrition Screening Initiative checklist, and nutrient intake assessment (24 hour recall method). The nutrition education program lasted for four weeks. It included a basic education program, provided once a week, and mini-education program, which was offered daily during lunch times. The survey was conducted before and after the education program using the same assessment method, although some items were included only at pretest. When analyzing the changes in elderly patients after the nutritional education program, we found that, among subjective dietary behaviors, self-rated perceptions of health (P<0.001) and of depression (P<0.001) improved significantly and that dietary behavior scores also improved significantly (P<0.001), while nutritional risk levels decreased. In terms of nutrient intake, subjects' intake of energy, protein, fat, carbohydrate, calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C all increased significantly (P<0.001). These results indicated that nutritional education is effective in improving the nutritional status of elderly patients. We hope that the results of this study can be used as preliminary data for establishing guidelines for nutrition management tailored to elderly patients in long-term care hospitals.

Nutritional evaluation of infants and young children - About Definition, Method, necessity, Importance and Korean Medical Approach - (영유아의 영양평가)

  • DaHee Jeong
    • Journal of Convergence Korean Medicine
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    • v.3 no.1
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    • pp.15-27
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    • 2022
  • Objectives: This study was conducted to review the overall concept of nutritional evaluation of infants and young children. Methods: Literature search was done to study definition, method and importance of nutritional evaluation of infants and young children. Pubmed and Google scholarship were used in the research. Search words were 'Nutritional evaluation', 'infants' and 'young children'. Results: Nutrition evaluation is mainly used by physical measurement, clinical evaluation, dietary intake survey, and biochemical test depending on the age and disease. The treatment method for 治未病, which is a concept of korean medicine, and 健兒法 for treating the concept of weak children are considered to have very high applicability in solving various problems found through nutrition evaluation in korean medical approach. Conclusion: Infants and children are the fastest growing period of their lives, showing rapid growth in physical, and emotional development along with rapid brain growth. Therefore, inadequate nutrition during this period affects mental and physical growth and development not only during that period but also throughout life. Nutrition evaluation is divided into regular evaluation that includes children in all growing seasons and screening evaluation for problem solving, and follow-up nutritional evaluation that evaluates nutritional status in the long run. For each nutritional evaluation, evaluation is conducted by physical measurement, clinical evaluation, dietary intake survey, and biochemical test. By comprehensively interpreting them, nutritional status is determined. This study provides basic data on the proper nutrition evaluation method to identify and correct nutritional problems such as growth level, nutritional deficiency, and nutritional excess early.

Assessment of Nutritional Status before TPN Support of Hospitalized Patients (입원환자의 TPN 투여전 영양상태 평가)

  • Park, Hyoung-Sook;Lee, Soo-Kyeong;Ha, Mi-Jeong
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.9 no.2
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    • pp.69-77
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    • 2002
  • The purpose of this study was to assessment of hospitalized patients. Nutritional assessment was performed on 353 hospitalized patients before TPN support by ideal body weight. albumin, total lymphocyte count, cholesterol. The data analysis were performed on frequency, percentage, means and standard deviation. The major findings as follows: 1. Everage NPO duration was $6.77\pm5.39$day and $\geq5$days 48.9%, >5days 51.1%. NPO duration of 1M, NL, GS, Others prolonged. 2. %IBW was everge $94.86\pm17.21%$ 43.1% normal. 37.8% low weight. There were low weight IM 44.8%. TS 47.8%, Others 44.0%. 3. Albumin was everage $2.93\pm0.51$g/dl. moderate malnutrition 45.4%, mild malnutrition 30.9%. All session were malnutrition status. 4. Total lymphocyte count was ever age $960.41\pm721.32cell/mm^2$. severe malnutrition 43.9%. moderate malnutrition 29.0%, mild malnutrition 24.4%, normal 2.7%. All session were malnutrition status. 5. Cholesterol was everage $123.02\pm45.67$mg/dl 58.4% low level. 41.2% normal. 0.4% high level. 1M, GS and TS were low level. NL, NS, DR, Others were normal. It was very poor nutritional status before TPN support of patients. The malnutrition decrease immunity, slowly cure injury, cause abnormality organs, increase the complication and obstruct the recovery. Therefore, Evaluating and correcting are very important.

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Reliability of Nutritional Screening Using DETERMINE Checklist for Elderly in Korean Rural Areas by Season (우리나라 농촌지역 노인들의 영양점검표(DETERMINE)를 통한 계절별 영양상태 판정의 신뢰도 분석 연구)

  • Moon, Hyun-Kyung;Kong, Jung-Eun
    • Korean Journal of Community Nutrition
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    • v.14 no.3
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    • pp.340-353
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    • 2009
  • It is very important to screen the elderly for nutritional risk, because nutritional status is a critical factor to maintain their health. Some nutrition checklists used in Korea for the elderly are from other countries. Reliability of those checklist in Korea is not studied enough. This survey was done for the elderly over 65-years-old who live in Hong-cheon, An-dong, Dam-yang and Yeon-gi in Korea (subject; summer: 146, winter: 145) to study the reliability of DETERMINE checklist which is adopted widely in Korea. Using the score of DETERMINE checklist, the elderly were divided as high, middle and low risk groups. For nutritional assessment for those elderly, dietary assessment using 24 recall, anthropometry, biochemical assessment and health condition were used. Results for the checklist showed that percentage below EAR for energy intake and protein intake in winter were higher in the high risk group than other groups. The intakes of phosphorus and iron and most vitamins were below the DRI. The percentage of subjects with intake below DRI was highest in the high risk group. Sensitivity, specificity, and positive predictive values using the DETERMINE were calculated using 6 point as a cut-off point. Subjects were divided into two groups by MAR (MAR < 0.75:undernutrition, MAR < 0.75 : normal). Sensitivity recorded 49.4% and 34.3%, specificity did 61.9% and 65.4 and Positive predictive value did 62.1% and 46.0% each for summer and winter. Results of screening using DETERMINE Checklist were not matched with dietary assessment but not with anthropometric and biochemical measurement. In conclusion DETERMINE 'Checklist' is shown be a good screening tool for finding out risk groups for dietary intake in the elderly, It needs to verify reliability and validity through large-scale survey.

Nutritional Status of Cancer Patients upon Admission (입원한 암환자의 영양상태 조사 연구)

  • 김은경;양영희;최스미
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.271-280
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    • 1999
  • The purpose of this study was to assess the nutritional status of cancer patients and non-cancer patients who were admitted to an internal medical department and to determine the degree of malnutrition among these patients. The study was performed from May to July l996 with 151 subjects recruited from the general medical department at D University Hospital. For nutritional assessment the anthropometric and biochemical assessment were performed. Biochemical measurements included serum hemoglobin, albumin, and lymphocytes. For anthropometric assessment, patient's body weight, skinfold thickness in four areas, body mass index, and percent of body fat were measured. The results were as follows : 1) Of the 151 patients who were studied, 47 patients had cancer while 104 patients had non cancer related disease. The mean age of the cancer patients was 57 and 52 for non cancer patients. The percentage of patients who had lost body weight during the last 6 months was 29.8% in cancer patients and 15.4% in non cancer patients. This percentage difference between the 2 groups was statistically significant. However, there was no statistical significance between the 2 groups in gastrointestinal symptoms which lasted more than 2 weeks. 2) There was a statistically significant difference in nutritional status(lympocyte : P=.002 ; skinfold thickness in four areas : p<0.05) between the cancer and the non-cancer patients. The percentage of the patients who had the possibility of malnutrition was 65.5% in cancer patients and 6% in non-cancer patients. 3) There was a correlation between the weight loss during the last 6 months before admission and body mass index and skinfold thickness.

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The Design, Implementation, and Evaluation of Social Marketing Campaigns in Nutrition

  • Keenan, Debra-Palmer;Patricia M. Heacock
    • Journal of Community Nutrition
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    • v.5 no.4
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    • pp.218-229
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    • 2003
  • Over the past two decades in the United States, social marketing has become an increasingly popular means of delivering nutrition education for the purpose of eliciting a specific behavior change. This manuscript defines social marketing via traditional marketing concepts and jargon, as well as through a communications strategy that can be used to guide message and campaign development. Research and evaluation strategies necessary to support the development and assessment of campaign promotions, is discussed. Four campaigns implemented in the United States, and one campaign implemented in Indonesia, are discussed in terms of the strategies presented. These campaigns illustrate how this educational technique and an array of assessment approaches have been applied to varied nutritional issues across diverse target audiences and settings. Practical recommendations, as well as discussion of issues regarding the advantages and disadvantages of using social marketing as an educational strategy, campaign sustainability, and philosophical considerations regarding the use of this educational approach, are addressed.