Amano Nobuko, Nakamura Tomiyo
Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, 6-2-23 Morikitacho, Higashinadaku, Kobe 658-0001, Japan.
Department of Food Sciences and Human Nutrition, Faculty of Agriculture, Ryukoku University, 1-5 Yokotani Seta-Oe cho, Otsu, Shiga 520-2194, Japan.
Clin Nutr ESPEN. 2018 Feb;23:122-128. doi: 10.1016/j.clnesp.2017.11.003. Epub 2017 Dec 6.
BACKGROUND & AIMS: The visual estimation method is commonly used in hospitals and other care facilities to evaluate food intake through estimation of plate waste. In Japan, no previous studies have investigated the validity and reliability of this method under the routine conditions of a hospital setting. The present study aimed to evaluate the validity and reliability of the visual estimation method, in long-term inpatients with different levels of eating disability caused by Alzheimer's disease. The patients were provided different therapeutic diets presented in various food types.
This study was performed between February and April 2013, and 82 patients with Alzheimer's disease were included. Plate waste was evaluated for the 3 main daily meals, for a total of 21 days, 7 consecutive days during each of the 3 months, originating a total of 4851 meals, from which 3984 were included. Plate waste was measured by the nurses through the visual estimation method, and by the hospital's registered dietitians through the actual measurement method. The actual measurement method was first validated to serve as a reference, and the level of agreement between both methods was then determined. The month, time of day, type of food provided, and patients' physical characteristics were considered for analysis.
For the 3984 meals included in the analysis, the level of agreement between the measurement methods was 78.4%. Disagreement of measurements consisted of 3.8% of underestimation and 17.8% of overestimation. Cronbach's α (0.60, P < 0.001) indicated that the reliability of the visual estimation method was within the acceptable range.
The visual estimation method was found to be a valid and reliable method for estimating food intake in patients with different levels of eating impairment. The successful implementation and use of the method depends upon adequate training and motivation of the nurses and care staff involved.
视觉估计法常用于医院及其他护理机构，通过估计餐盘剩余食物来评估食物摄入量。在日本，此前尚无研究在医院常规环境下调查该方法的有效性和可靠性。本研究旨在评估视觉估计法在因阿尔茨海默病导致不同程度进食障碍的长期住院患者中的有效性和可靠性。为患者提供了不同类型食物组成的不同治疗饮食。
本研究于2013年2月至4月进行，纳入了82例阿尔茨海默病患者。对每日三餐的餐盘剩余食物进行评估，共21天，在3个月中的每个月连续评估7天，共计4851餐，其中纳入分析3984餐。护士通过视觉估计法测量餐盘剩余食物，医院注册营养师通过实际测量法测量。实际测量法首先经过验证作为参考，然后确定两种方法之间的一致性水平。分析时考虑了月份、一天中的时间、提供的食物类型以及患者的身体特征。
在纳入分析的3984餐中，测量方法之间的一致性水平为78.4%。测量结果的不一致包括3.8%的低估和17.8%的高估。克朗巴哈系数α（0.60，P < 0.001）表明视觉估计法的可靠性在可接受范围内。
视觉估计法被发现是一种评估不同程度进食障碍患者食物摄入量的有效且可靠的方法。该方法的成功实施和应用取决于所涉及护士和护理人员的充分培训和积极性。
