Kubrak Cathy, Jensen Louise
Faculty of Nursing, University of Alberta, 3rd Floor Clinical Sciences Bldg., Edmonton, Alta., Canada.
Int J Nurs Stud. 2007 Aug;44(6):1036-54. doi: 10.1016/j.ijnurstu.2006.07.015. Epub 2006 Sep 22.
This narrative review assesses the current prevalence of malnutrition, the methods for detection of malnutrition, the factors associated with malnutrition, and the effects of malnutrition in the acute care patients.
A narrative review methodology was employed.
CINAHL, Pub Med, and MEDLINE electronic databases were searched from 1996 to 2005, for English language articles. Search terms of malnutrition, acute care patients, nutrition assessment, and nutrition screening were used.
The titles and abstracts of 857 articles were examined. Full text of the articles were obtained only when abstracts described undernutrition, malnutrition, protein-energy malnutrition, nutrition assessment, nutrition screening, factors contributing to malnutrition, or resultant outcomes of malnutrition in adult acute care patients. Additionally, a hand search through reference lists of retrieved articles was done. The articles reviewed included empirical reports (110), reviews (25), commentaries (4), and reports from professional associations (10).
Currently, malnutrition ranges from 13-78% among acute care patients. Different methods of detecting malnutrition make it difficult to determine the prevalence among acute care patients. Additionally, many nutrition-screening tools used to detect malnutrition have not undergone rigorous testing for validity, reliability, sensitivity, and specificity. Numerous personal and organizational factors affect the nutritional status of acute care patients. Diminished nutritional status contributes to increased use of hospital resources and increased hospital costs.
Malnutrition continues to be a significant problem among acute care patients. The Subjective Global Assessment tool has the most diagnostic value for acute care patients. Simple measures, like documenting height and weight on admission, and assessing patient's nutritional intake, weight status, and medications that alter nutritional intake could assist in early detection of malnutrition in the acute care patient.
本叙述性综述评估了急性护理患者中营养不良的当前患病率、营养不良的检测方法、与营养不良相关的因素以及营养不良的影响。
采用叙述性综述方法。
检索了1996年至2005年CINAHL、PubMed和MEDLINE电子数据库中的英文文章。使用了营养不良、急性护理患者、营养评估和营养筛查等检索词。
检查了857篇文章的标题和摘要。仅当摘要描述了成年急性护理患者的营养不良、蛋白质 - 能量营养不良、营养评估、营养筛查、导致营养不良的因素或营养不良的最终结果时，才获取文章全文。此外，还对检索到的文章的参考文献列表进行了手工检索。所综述的文章包括实证报告（110篇）、综述（25篇）、评论（4篇）和专业协会的报告（10篇）。
目前，急性护理患者中营养不良的患病率在13%至78%之间。不同的营养不良检测方法使得难以确定急性护理患者中的患病率。此外，许多用于检测营养不良的营养筛查工具尚未经过有效性、可靠性、敏感性和特异性的严格测试。众多个人和组织因素影响急性护理患者的营养状况。营养状况下降导致医院资源使用增加和医院成本上升。
营养不良仍然是急性护理患者中的一个重要问题。主观全面评定工具对急性护理患者具有最大的诊断价值。一些简单的措施，如在入院时记录身高和体重，评估患者的营养摄入、体重状况以及改变营养摄入的药物，有助于早期发现急性护理患者中的营养不良。
