Department of Healthcare Administration, Asia University, Taichung, Taiwan.
J Clin Nurs. 2013 Oct;22(19-20):2830-7. doi: 10.1111/jocn.12037. Epub 2013 Jun 14.
To improve the short-form Mini-Nutritional Assessment (MNA) to ameliorate under-rating the risk of malnutrition in patients on haemodialysis.
The full MNA was found to be appropriate for rating the risk of malnutrition in persons undergoing haemodialysis but the short-form under-rated the risk.
A cross-sectional study with purposive sampling.
The study recruited 152 adult ambulatory patients on maintenance haemodialysis from one dialysis centre in Taiwan. Each subject was rated with the Subjective Global Assessment (SGA), the original and selected alternative short-forms (by replacing better performing nonshort-form items for lesser performing short-form items) of a Taiwanese-specific MNA (T1). Serum albumin and creatinine concentrations and the SGA were also used as referents. Results were evaluated with Pearson's correlation analysis, binary classification test and receiver operating characteristic (ROC) curves.
The full MNA showed good consistency with the SGA, but the original short-form rated fewer patients at risk of malnutrition compared with the full MNA. Exchanging item O (self-rated nutritional status) with item E (neuropsychological problems) produced the best results and restored the predictive ability of the short-form. Replacing item P for E produced the next best results.
Results suggest that the predictive ability of the short-form can be greatly restored by rearranging the component items of the short-form without affecting the performance of the full MNA. The study is probably the first example of a disease-specific version of the MNA.
The revision makes short-form MNA suitable for rating the risk of malnutrition in patients on haemodialysis in clinical practice.
改良简易微型营养评估（MNA）量表，以改善血液透析患者营养不良风险评估不足的问题。
完整的 MNA 量表被发现适用于评估接受血液透析患者的营养不良风险，但简易量表低估了这种风险。
一项采用目的抽样的横断面研究。
本研究从台湾的一家透析中心招募了 152 名接受维持性血液透析的成年门诊患者。每位患者均接受主观全面评估（SGA）、原始和选定的替代简易形式（用表现更好的非简易形式项目替换表现较差的简易形式项目）的台湾特定 MNA（T1）评估。还使用血清白蛋白和肌酐浓度以及 SGA 作为参考。使用 Pearson 相关分析、二分类检验和接收者操作特征（ROC）曲线对结果进行评估。
完整的 MNA 与 SGA 具有良好的一致性，但原始简易量表评估的营养不良风险患者人数少于完整 MNA。用项目 O（自我评估的营养状况）替换项目 E（神经心理问题）可获得最佳结果，并恢复了简易量表的预测能力。用项目 P 替换项目 E 可获得其次的最佳结果。
结果表明，通过重新排列简易量表的组成项目，而不影响完整 MNA 的性能，可以大大恢复简易量表的预测能力。本研究可能是 MNA 疾病特异性版本的首例示例。
该修订使简易 MNA 适合在临床实践中评估血液透析患者的营养不良风险。
