Mackintosh M A, Hankey C R
Department of Nutrition & Diet Therapy, Ayrshire & Arran Primary Care NHS Trust, UK.
J Hum Nutr Diet. 2001 Apr;14(2):129-36. doi: 10.1046/j.1365-277x.2001.00276.x.
There are a plethora of nutrition screening tools (NSTs) in use in a variety of clinical settings that are either unvalidated and/ or not client specific. There is a need for an NST for all elderly patients attending community day hospitals. At present such a validated tool is unavailable.
To assess the reliability and reproducibility of a developed NST; and to identify elderly patients attending day hospitals who have, or are at risk of, poor nutritional status.
Three day hospitals were selected and 70 admissions were prospectively assessed by Nursing staff and independently by a State Registered Dietitian (SRD) The patients' nutritional status was anthropometrically assessed using the NST.
The level of agreement between the nurse and the dietitian for each of the levels of the NST and the overall score was either 'good agreement' or 'very good agreement' as defined by Cohen's Kappa. Spearman's Rank Correlation between objective markers of assessment and the Nurse or Dietitian score from the NST were all statistically significant (P = 0.42). As an identifier of risk, the NST has low levels of sensitivity, but high levels of specificity.
The Ayrshire NST is a reliable and valid tool which can be used by qualified Nursing staff to assist in screening elderly patients at high risk of poor nutritional status.
在各种临床环境中使用着大量营养筛查工具(NSTs),这些工具要么未经验证,要么并非针对特定患者。对于所有在社区日间医院就诊的老年患者而言,需要一种营养筛查工具。目前尚无经过验证的此类工具。
评估一种已开发的营养筛查工具的可靠性和可重复性;并识别在日间医院就诊的、存在营养状况不佳或有营养状况不佳风险的老年患者。
选取了三家日间医院,护理人员对70名入院患者进行了前瞻性评估,一名国家注册营养师(SRD)也独立进行了评估。使用该营养筛查工具对患者的营养状况进行了人体测量评估。
根据科恩kappa系数的定义,护士与营养师在营养筛查工具各等级及总分上的一致性水平为“良好一致”或“非常良好一致”。评估的客观指标与营养筛查工具中护士或营养师评分之间的斯皮尔曼等级相关性均具有统计学意义(P = 0.42)。作为风险识别工具,该营养筛查工具敏感性较低,但特异性较高。
艾尔郡营养筛查工具是一种可靠且有效的工具,合格的护理人员可使用该工具协助筛查存在营养状况不佳高风险的老年患者。