Tsai Alan C, Shih Chi-Ling
Graduate Institute of Long-term Care, Asia University, Wufeng, Taichung, Taiwan.
J Clin Nurs. 2009 Jan;18(1):82-8. doi: 10.1111/j.1365-2702.2008.02319.x. Epub 2008 Jul 28.
To determine whether a modified version of the Mini-Nutritional Assessment without body mass index could effectively assess the nutritional risk status of stroke rehabilitation patients in Taiwan.
The Mini-Nutritional Assessment was developed on the basis of clinical data of Western populations. Although widely used, its application to assess stroke rehabilitation patients has been limited. Further, to get best results, population-specific modifications to address anthropometric and lifestyle differences have been suggested, especially for non-Caucasian populations.
The study assessed the nutritional status of stroke rehabilitation patients who enrolled in the Long-Term Care Service of Taipei. Strokes who were >40 years old, in the program for >1 month and cognitively able to answer the questions were recruited to participate in the study.
An on-site in-person interview with structured questionnaire elicited information on personal data, disease history and healthcare use and answers to the Mini-Mental State Examination, the Activities of Daily Living and the Mini-Nutritional Assessment. Patient's nutritional status was assessed with the Mini-Nutritional Assessment in three versions: the original, population-specific (MNA-TI) and population-specific, without body mass index (MNA-TII).
The original Mini-Nutritional Assessment rated 24% of patients malnourished and 57% at risk of malnutrition. Similar results, 14 and 64%, respectively, for MNA-TI; and 19 and 57%, respectively, for MNA-TII were observed.
Both the original and the modified versions of the Mini-Nutritional Assessment can effectively rate the nutritional risk status of stroke rehabilitation patients in Taiwan. Version MNA-TII that adopted population-specific anthropometric cut-values but without body mass index can effectively predict the nutritional status of stroke patients.
The modified scale (MNA-TII) can enhance the application of the tool and timely detection and intervention of undernutrition among stroke rehabilitation patients. It can also help to improve job efficiency of the primary care professionals.
确定不包含体重指数的改良版微型营养评定法能否有效评估台湾地区中风康复患者的营养风险状况。
微型营养评定法是基于西方人群的临床数据制定的。尽管应用广泛，但其在评估中风康复患者方面的应用一直有限。此外，为了获得最佳结果，有人建议针对特定人群进行修改，以解决人体测量和生活方式的差异，特别是对于非白种人群。
该研究评估了台北长期护理服务机构中中风康复患者的营养状况。招募年龄大于40岁、参与该项目超过1个月且认知上能够回答问题的中风患者参与研究。
通过现场面对面访谈和结构化问卷，收集个人数据、病史、医疗保健使用情况以及简易精神状态检查表、日常生活活动能力和微型营养评定法的答案。使用三种版本的微型营养评定法评估患者的营养状况：原版、特定人群版（MNA-TI）和特定人群版且不包含体重指数（MNA-TII）。
原版微型营养评定法将24%的患者评定为营养不良，57%的患者存在营养不良风险。MNA-TI的类似结果分别为14%和64%；MNA-TII的类似结果分别为19%和57%。
微型营养评定法的原版和改良版均可有效评估台湾地区中风康复患者的营养风险状况。采用特定人群人体测量临界值但不包含体重指数的MNA-TII版本能够有效预测中风患者的营养状况。
改良量表（MNA-TII）可增强该工具的应用，及时发现并干预中风康复患者的营养不良情况。它还有助于提高基层医疗专业人员的工作效率。
