McCall R, Cotton E
Nutrition and Dietetic Department, Central Sheffield University Hospitals NHS Trust, Royal Hallamshire Hospital, UK.
J Hum Nutr Diet. 2001 Apr;14(2):137-48. doi: 10.1046/j.1365-277x.2001.00277.x.
Elderly people are at great risk of poor nutritional status. Identifying those at nutritional risk is complex owing to its multifactorial nature and highlights the need for an easily administered nutritional screening tool.
To test the robustness of a tool used to identify those patients who require further dietetic assessment.
The tool was tested on an 'acute elderly' ward to assess its statistical robustness, i.e. test-retest reliability, inter-rater reliability, internal consistency and factor structure, concurrent and construct validity. The research was carried out by a dietitian and two nurses on an overall sample of 185 consecutive admissions.
Test-retest results reflect that the tool is capable of yielding consistent assessments over time. Inter-rater reliability results revealed that when comparisons of agreement between nurses and dietitians were examined there was consistent disagreement. Internal consistency was found to be low but the rotated factor analysis suggested a relationship between the items in the tool. Concurrent validity was exhibited with body mass index, albumin and American Nutrition Risk Index only. Construct validity was not sufficiently exhibited with any of the measures used.
The tool has not demonstrated reliability as determined by the statistical measures and hence validity at this stage. Issues which need to be addressed to allow this tool to be used appropriately are discussed.
老年人营养状况不佳的风险很大。由于其多因素性质，识别有营养风险的人很复杂，这凸显了对一种易于实施的营养筛查工具的需求。
测试一种用于识别那些需要进一步饮食评估的患者的工具的稳健性。
该工具在一个“急性老年病”病房进行测试，以评估其统计稳健性，即重测信度、评分者间信度、内部一致性和因子结构、同时效度和结构效度。这项研究由一名营养师和两名护士对185例连续入院患者的总体样本进行。
重测结果表明该工具能够随着时间推移得出一致的评估。评分者间信度结果显示，在检查护士和营养师之间的一致性比较时，存在持续的不一致。发现内部一致性较低，但旋转因子分析表明该工具中的项目之间存在关联。仅与体重指数、白蛋白和美国营养风险指数表现出同时效度。使用的任何测量方法均未充分显示出结构效度。
该工具尚未通过统计方法确定其可靠性，因此现阶段也未显示出有效性。讨论了为使该工具能够适当使用而需要解决的问题。
