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使用电子版营养不良通用筛查工具(MUST)对医院门诊患者进行“自我筛查”营养不良:同时评估其有效性、偏好和易用性。

'Self-screening' for malnutrition with an electronic version of the Malnutrition Universal Screening Tool ('MUST') in hospital outpatients: concurrent validity, preference and ease of use.

机构信息

1Faculty of Medicine,University of Southampton,Mailpoint 113,Southampton General Hospital,Tremona Road,Southampton SO16 6YD,UK.

2Department of Nutrition and Dietetics,Southampton General Hospital,University Hospital Southampton NHS Foundation Trust,Tremona Road,Southampton SO16 6YD,UK.

出版信息

Br J Nutr. 2018 Sep;120(5):528-536. doi: 10.1017/S000711451800185X. Epub 2018 Jul 30.

Abstract

Self-screening using an electronic version of the Malnutrition Universal Screening Tool ('MUST') has been developed but its implementation requires investigation. A total of 100 outpatients (mean age 50 (sd 16) years; 57 % male) self-screened with an electronic version of 'MUST' and were then screened by a healthcare professional (HCP) to assess concurrent validity. Ease of use, time to self-screen and prevalence of malnutrition were also assessed. A further twenty outpatients (mean age 54 (sd 15) years; 55 % male) examined preference between self- screening with paper and electronic versions of 'MUST'. For the three-category classification of 'MUST' (low, medium and high risk), agreement between electronic self-screening and HCP screening was 94 % (κ=0·74, se 0·092; P<0·001). For the two-category classification (low risk; medium+high risk) agreement was 96 % (κ=0·82, se 0·085; P<0·001), comparable with the previously reported paper-based self-screening. In all, 15 % of patients categorised themselves 'at risk' of malnutrition (5 % medium, 10 % high). Electronic self-screening took 3 min (sd 1·2 min), 40 % faster than previously reported for the paper-based version. Patients found the tool easy or very easy to understand (99 %) and complete (98 %). Patients that assessed both tools found the electronic tool easier to complete (65 %) and preferred it (55 %) to the paper version. Electronic self-screening using 'MUST' in a heterogeneous group of hospital outpatients is acceptable, user-friendly and has 'substantial to almost-perfect' agreement with HCP screening. The electronic format appears to be as agreeable and often the preferred format when compared with the validated paper-based 'MUST' self-screening tool.

摘要

使用电子版营养不良通用筛查工具(“MUST”)进行自我筛查已经开发出来,但需要对其实施情况进行调查。共有 100 名门诊患者(平均年龄 50(16)岁;57%为男性)使用电子版“MUST”进行自我筛查,然后由医疗保健专业人员(HCP)进行筛查,以评估其同时效度。还评估了易用性、自我筛查时间和营养不良的患病率。另外 20 名门诊患者(平均年龄 54(15)岁;55%为男性)检查了他们对纸质和电子版“MUST”自我筛查的偏好。对于“MUST”的三分类(低、中、高风险),电子自我筛查和 HCP 筛查之间的一致性为 94%(κ=0.74,se 0.092;P<0.001)。对于二分类(低风险;中+高风险),一致性为 96%(κ=0.82,se 0.085;P<0.001),与之前报告的纸质自我筛查相当。总的来说,15%的患者自我评估为营养不良“风险”(5%为中度,10%为高度)。电子自我筛查耗时 3 分钟(标准差 1.2 分钟),比之前报告的纸质版本快 40%。患者认为该工具易于或非常易于理解(99%)和完成(98%)。评估了两种工具的患者发现电子工具更容易完成(65%),并更喜欢它(55%)而不是纸质版本。在一组异质的医院门诊患者中,使用“MUST”进行电子自我筛查是可以接受的,用户友好的,并且与 HCP 筛查具有“实质性到几乎完美”的一致性。与经过验证的纸质“MUST”自我筛查工具相比,电子格式似乎更合意,而且通常是首选格式。

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