Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan.
Natural Science Division, Faculty of Core Research, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan.
Clin Nutr. 2019 Feb;38(1):240-245. doi: 10.1016/j.clnu.2018.01.026. Epub 2018 Feb 15.
BACKGROUND & AIMS: Despite a clinical need, only a few studies have provided information concerning visual estimation training for raters to improve the validity of their evaluations. This study aims to describe the differences in the characteristics of raters who evaluated patients' dietary intake in hospitals using the visual estimation method based on their training experiences.
We collected data from three hospitals in Tokyo from August to September 2016. The participants were 199 nursing staff members, and they completed a self-administered questionnaire on demographic data; working career; training in the visual estimation method; knowledge, attitude, and practice associated with nutritional care; and self-evaluation of method validity of and skills of visual estimation. We classified participants into two groups, experienced and inexperienced, based on whether they had received training. Square test, Mann-Whitney U test, and univariable and multivariable logistic regression analysis were used to describe the differences between these two groups in terms of their characteristics; knowledge, attitude, and practice associated with nutritional care; and self-evaluation of method validity and tips used in the visual estimation method.
Of the 158 staff members (79.4%) (118 nurses and 40 nursing assistants) who agreed to participate in the analysis, thirty-three participants (20.9%) were trained in the visual estimation method. Participants who had received training had better knowledge (2.70 ± 0.81, score range was 1-5) than those who had not received any training (2.34 ± 0.74, p = 0.03). Score of self-evaluation of method validity of the visual estimation method was higher in the experienced group (3.78 ± 0.61, score range was 1-5) than the inexperienced group (3.40 ± 0.66, p < 0.01). Mean total scores of using tips in the visual estimation method in the experienced and inexperienced groups were 19.6 ± 1.76 and 17.9 ± 2.28, respectively (score range was 6-24), differing significantly between the two groups (p < 0.01). Multivariable logistic regression revealed that participants who had been trained had adequate knowledge (OR: 2.78, 95% CI: 1.05-7.35) and frequently used tips in visual estimation (OR: 1.85, 95% CI: 1.26-2.73).
Trained participants had more required knowledge and they used visual estimation tips more frequently than participants who had not been trained in the visual estimation method. This study provides new evidence for the importance of training clinical staff members to use the visual estimation method appropriately and makes suggestions to improve the validity of the visual estimation method.
尽管存在临床需求,但只有少数研究提供了有关评估者视觉估计训练的信息,以提高其评估的有效性。本研究旨在描述在医院中使用视觉估计方法评估患者饮食摄入的评估者的特征差异,这些评估者基于其培训经验。
我们于 2016 年 8 月至 9 月从东京的 3 家医院收集数据。参与者为 199 名护理人员,他们完成了一份关于人口统计学数据、工作生涯、视觉估计方法培训、与营养护理相关的知识、态度和实践以及视觉估计方法有效性和技巧自我评估的自我管理问卷。我们根据是否接受过培训将参与者分为经验丰富组和无经验组。采用卡方检验、Mann-Whitney U 检验、单变量和多变量逻辑回归分析描述两组之间在与营养护理相关的知识、态度和实践以及视觉估计方法有效性和技巧自我评估方面的差异。
在同意参与分析的 158 名工作人员(79.4%)(118 名护士和 40 名护理助理)中,有 33 名参与者(20.9%)接受过视觉估计方法培训。接受过培训的参与者的知识得分(2.70±0.81,评分范围为 1-5)高于未接受任何培训的参与者(2.34±0.74,p=0.03)。经验丰富组视觉估计方法有效性自我评估得分(3.78±0.61,评分范围为 1-5)高于无经验组(3.40±0.66,p<0.01)。经验丰富组和无经验组在视觉估计方法中使用技巧的总平均分分别为 19.6±1.76 和 17.9±2.28(评分范围为 6-24),两组之间差异有统计学意义(p<0.01)。多变量逻辑回归显示,接受过培训的参与者具有足够的知识(OR:2.78,95%CI:1.05-7.35)和经常使用视觉估计技巧(OR:1.85,95%CI:1.26-2.73)。
接受过培训的参与者比未接受过视觉估计方法培训的参与者具有更多的必要知识,并且更频繁地使用视觉估计技巧。本研究为培训临床工作人员正确使用视觉估计方法的重要性提供了新的证据,并提出了提高视觉估计方法有效性的建议。