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在营养与饮食学会糖尿病登记研究中,证据与诊断关联的记录可预测营养诊断的解决情况:营养护理流程结果的二次分析

Documentation of the evidence-diagnosis link predicts nutrition diagnosis resolution in the Academy of Nutrition and Dietetics' diabetes mellitus registry study: A secondary analysis of Nutrition Care Process outcomes.

作者信息

Colin Casey, Arikawa Andrea, Lewis Sherri, Cooper Melissa, Lamers-Johnson Erin, Wright Lauri, Papoutsakis Constantina

机构信息

Department of Nutrition & Dietetics, University of North Florida, Jacksonville, FL, United States.

James A. Haley Veterans' Hospital, Tampa, FL, United States.

出版信息

Front Nutr. 2023 Mar 9;10:1011958. doi: 10.3389/fnut.2023.1011958. eCollection 2023.

Abstract

OBJECTIVES

To describe nutrition care documentation patterns and investigate predictors of nutrition diagnosis resolution.

METHODS

This is a secondary data analysis of a 2-year pragmatic, quasi-experimental study conducted in outpatient clinics where nutrition care was provided to adults with diabetes Type 1 or 2 from May 2017 to June 2019 ( = 564 patients). The main outcome measures were frequency of standardized Nutrition Care Process (NCP) terms, NCP links, nutrition diagnosis resolution and predictors of nutrition diagnosis resolution. Predictors of diagnosis resolution were identified using a multivariable logistic regression model.

RESULTS

The most prevalent resolved diagnoses were excessive carbohydrate intake (32%), undesirable food choices (21%) and excessive energy intake (13%). The top etiology was food and nutrition related knowledge deficit (57%) and interventions were drawn mainly from the domain (64%). One hundred forty-six patient cases (26%) had at least one follow-up visit and 26% of those with a follow-up ( = 38) had a resolved diagnosis. The presence of the evidence-diagnosis NCP link in documentation predicted diagnosis resolution (OR = 2.80, 95% CI 1.30-6.02; = 0.008).

CONCLUSION

Most diagnoses were caused by patients' lack of knowledge and respective interventions focused on nutrition education. Odds of diagnosis resolution improved when the signs and symptoms of the diagnosis were documented during assessment (evidence-diagnosis NCP link). Training dietitians on NCP links may be important to resolve nutrition diagnoses. Presented findings are hypothesis generating.

摘要

目的

描述营养护理记录模式,并调查营养诊断解决的预测因素。

方法

这是一项对2年务实的准实验研究的二次数据分析,该研究在门诊诊所进行,2017年5月至2019年6月期间为1型或2型糖尿病成人提供营养护理(n = 564例患者)。主要结局指标为标准化营养护理流程(NCP)术语的使用频率、NCP链接、营养诊断解决情况以及营养诊断解决的预测因素。使用多变量逻辑回归模型确定诊断解决的预测因素。

结果

最常见的已解决诊断为碳水化合物摄入过多(32%)、不良食物选择(21%)和能量摄入过多(13%)。最主要的病因是食物和营养相关知识缺乏(57%),干预措施主要来自营养领域(64%)。146例患者病例(26%)至少进行了一次随访,其中26%进行随访的患者(n = 38)诊断得到解决。记录中存在证据 - 诊断NCP链接可预测诊断解决情况(OR = 2.80,95%CI 1.30 - 6.02;P = 0.008)。

结论

大多数诊断是由患者知识缺乏引起的,相应的干预措施集中在营养教育上。在评估期间记录诊断的体征和症状(证据 - 诊断NCP链接)时,诊断解决的几率会提高。对营养师进行NCP链接培训可能对解决营养诊断很重要。呈现的研究结果仅供提出假设。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d9/10034103/177d2d059a6a/fnut-10-1011958-g0001.jpg

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