简化营养食欲问卷韩文版在晚期癌症患者中的有效性和可靠性：一项多中心纵向研究。
Validity and Reliability of Korean Version of Simplified Nutritional Appetite Questionnaire in Patients with Advanced Cancer: A Multicenter, Longitudinal Study.
机构信息
Division of Medical Oncology and Hematology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Division of Hematology and Oncology, Department of Internal Medicine, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea.
出版信息
Cancer Res Treat. 2019 Oct;51(4):1612-1619. doi: 10.4143/crt.2018.505. Epub 2019 Apr 12.
PURPOSE
Malnutrition and a loss of muscle mass are frequent in cancer patients and have a negative effect on clinical outcome. Nutrition risk screening aims to increase awareness and allow early recognition and treatment of cancer cachexia. Therefore, screenings should be brief, inexpensive, highly sensitive, and have good specificity. Simplified Nutritional Appetite Questionnaire (SNAQ) is a simple screening tool including four questions, and validated to predict weight loss within 6 months in community-dwelling adults and nursing home residents. Our study aimed to translate the SNAQ into Korean, and to assess the validity and reliability of the translated screening tool in advanced cancer patients.
MATERIALS AND METHODS
The SNAQ was translated into Korean according to linguistic validation. The internal consistency of the SNAQ was evaluated by Cronbach's alpha coefficient. Test-retest reliability was evaluated using the intraclass correlation coefficient. Concurrent validity was evaluated by measuring the Pearson's correlation coefficient between the SNAQ and Mini-Nutritional Assessment (MNA) and Patient-Generated Subjective Global Assessment (PG-SGA).
RESULTS
In the 194 patients included in full analysis set, cancer stage was predominantly metastatic (98.5%), the mean age was 60 years (range, 23 to 81 years), and the mean body mass index was 24 kg/m2 (range, 15.6 to 39.6 kg/m2). According to MNA score ≤ 11, 57 patients (29.4%) were malnourished. The mean score (±standard deviation) of the Korean version of the SNAQ was 13.8±2.5 with a range of 6-19. Cronbach's alpha coefficient was 0.737, and intraclass correlation coefficient was 0.869. The SNAQ was moderately correlated with MNA (r=0.404, p < 0.001) and PG-SGA (r=-0.530, p < 0.001). A significant weight loss of > 5% of the original bodyweightwithin 6 months occurred in 46 of the 186 patients (24.7%). SNAQ score ≤ 14 predicted > 5% weight loss with a sensitivity of 56.5% and a specificity of 44.3%.
CONCLUSION
The Korean version of the SNAQ had high validity and reliability. SNAQ is useful for the screening tool for advanced cancer patients. The SNAQ had a limitation to predict impending weight loss in advanced cancer patients.
目的
营养不良和肌肉质量下降在癌症患者中很常见，对临床结局有负面影响。营养风险筛查旨在提高认识，早期识别和治疗癌症恶病质。因此，筛查应简单、廉价、高度敏感且特异性好。简化营养食欲问卷（SNAQ）是一种包含四个问题的简单筛查工具，已在社区居住的成年人和养老院居民中得到验证，可预测 6 个月内的体重减轻。我们的研究旨在将 SNAQ 翻译成韩语，并评估其在晚期癌症患者中的有效性和可靠性。
材料和方法
根据语言验证将 SNAQ 翻译成韩语。通过 Cronbach 的 alpha 系数评估 SNAQ 的内部一致性。使用组内相关系数评估测试-重测可靠性。通过测量 SNAQ 与迷你营养评估（MNA）和患者生成的主观整体评估（PG-SGA）之间的 Pearson 相关系数来评估同时效度。
结果
在纳入全分析集的 194 名患者中，癌症分期主要为转移性（98.5%），平均年龄为 60 岁（范围 23 至 81 岁），平均体重指数为 24kg/m2（范围 15.6 至 39.6kg/m2）。根据 MNA 评分≤11，57 名患者（29.4%）存在营养不良。韩国版 SNAQ 的平均评分（±标准差）为 13.8±2.5，范围为 6-19。Cronbach 的 alpha 系数为 0.737，组内相关系数为 0.869。SNAQ 与 MNA（r=0.404，p<0.001）和 PG-SGA（r=-0.530，p<0.001）中度相关。186 名患者中有 46 名（24.7%）在 6 个月内体重减轻超过原始体重的 5%。SNAQ 评分≤14 预测体重减轻>5%的灵敏度为 56.5%，特异性为 44.3%。
结论
韩国版 SNAQ 具有较高的有效性和可靠性。SNAQ 是一种用于晚期癌症患者的筛查工具。SNAQ 预测晚期癌症患者即将发生体重减轻的能力有限。
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