Search

Objectives: Many existing malnutrition screening and diagnostic tools require body mass index (BMI) and quantification of weight change to detect malnutrition or risk thereof. This is often a challenge in South African public hospitals due to missing data, including patient records. This study investigated the extent to which hospitalised patients can gauge their current and usual body size from a validated BMI-based figure rating scale (FRS). It also ascertained whether a relationship exists between a change in clothing size and a change in perceived BMI, derived from the FRS. Methods: A total of 196 adult patients participated in a cross-sectional study, in three Eastern Cape public hospitals. Data were collected by consulting medical files, patients and taking anthropometric measurements. Validated FRSs were used to determine patients' accuracy of actual and usual BMI. Data were analysed with Statistica® and Microsoft Excel 2016. Results: Some 66% (n = 131) of participants were accurate in selecting an image representative of their BMI, which was statistically significant (r2 = 0.80; p < 0.001). Female participants were more likely to select the correct corresponding BMI image (p < 0.05; r2 = 0.77 for males; r2 = 0.82 for females). Altogether, 61% (n = 79) of participants with a known previous weight were accurate in selecting an accurate image representative of their usual BMI, also statistically significantly (r2 = 0.71; p < 0.001). Conclusion: An existing FRS may be a useful adjunctive aid in clinical practice to estimate certain anthropometric indices when not otherwise available. This may be especially relevant to nutritional screening practices conducted by frontline healthcare professionals, e.g. nurses and doctors not specifically trained in anthropometry. This in turn may improve malnutrition detection rates and facilitation of appropriate nutrition care pathways. [ABSTRACT FROM AUTHOR]

The objectives of this study were to assess the nutritional status and the most commonly reported nutrition-related factors contributing to nutritional risk in people living with HIV/AIDS (PLWHA) in Ghana and the specificity and sensitivity of the Rapid Nutrition Screening for HIV disease tool (RNS-H) in this population. A cross-sectional design was utilised. Patients were screened for nutritional status during a one-week period by clinic nurses using the RNS-H. Results were compared with a comprehensive nutritional assessment by a dietitian. The research was conducted in a public health clinic at the University of Ghana Hospital, Legon. Patients receiving care at the clinic were asked to participate. The nutritional screening and nutritional assessment both resulted in participants being assigned to one of three nutritional statuses: 'low risk', 'at risk' and 'high risk'. The association between the nutritional screening and nutritional assessment was measured. The results of the nutritional status assigned by the RNS-H and nutritional assessment were compared. A total of 51 patients participated. A high prevalence of nutritional risk based on the RNS-S (54.9%) was found with 33.3% of the sample being malnourished. The most common nutrition-related complications were food insecurity, poor appetite, weight loss and diarrhoea. The RNS-H was found to have a strong specificity and sensitivity in a sample of Ghanaian PLWHA. Because of the nutritional risk and complexity of HIV in Ghana, nutritional screening using the RNS-H and nutrition care by a dietitian should be a standard of care. [ABSTRACT FROM AUTHOR]

Information regarding nutritional risk among users of American adult day health centers (ADHCs), 60% of whom are racial minorities, is scant. This study examined nutritional risk and associated factors in a diverse sample ADHC users aged 50+ using secondary cross-sectional analysis of data collected between 2013 and 2017. Risk was assessed using the DETERMINE checklist, and results were stratified by race. The majority of the sample (N = 188) was at moderate (45.2%) or high (38.5%) nutritional risk, with statistically significant racial differences. Blacks were at greater risk than any other group: 65% had high nutritional risk; 76.5% ate <5 servings of fruits, vegetables, or milk daily; 21% ate <2 meals daily, 48.5% reported involuntary weight loss/gain, and 41.2% had tooth loss/mouth pain. Older adults in ADHCs are at elevated risk of malnutrition, disproportionately so amongst blacks. Both routine nutrition screening and population-specific approaches are needed to attenuate risk. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to determine and compare the nutritional status of the elderly in two long-term care facilities - one situated in a higher socio-economic area and one in a lower socio-economic area. Design: A cross-sectional study was undertaken. Setting: The study setting comprised two urban areas of Bloemfontein, Free State province, South Africa. Subjects: Sixty-two elderly residing in a long-term care facility from both the higher and lower socio-economic areas agreed to participate and met inclusion criteria (N = 124). Outcome measures: The nutritional status of participants was assessed using the Mini Nutritional Assessment (MNA®) questionnaire. Indicators of nutritional status that were assessed as part of the validated MNA® included anthropometry, a global assessment, dietary assessment and subjective assessment. A total score of 24 or more points was interpreted as being well-nourished. Results: Malnutrition was identified in 3.2% of participants from the long-term care facility situated in the higher socio-economic area and 11.3% from the lower socio-economic area. A significantly higher percentage of participants from the lower socio-economic area were found to be at risk of malnutrition than those from the higher socio-economic area (74.2% vs. 37.1%) [95% CI 19.8%; 51.4%]. Participants from the higher socio-economic area consumed significantly more fluid and protein rich foods than their counterparts. Conclusion: Elderly participants from the lower socio-economic area were more likely to have a poor nutritional status and be at risk of malnutrition. The findings highlight the need to focus on screening for malnutrition in order to promote health and prevent the possible development of nutrition-related co-morbidities in the elderly. [ABSTRACT FROM AUTHOR]

Malnutrition is a frequent finding in pediatric health care settings in the form of undernutrition or excess body weight. Its increasing prevalence and impact on overall health status, which is reflected in the adverse outcomes, renders imperative the application of commonly accepted and evidence-based practices and tools by health care providers. Nutrition risk screening on admission and nutrition status evaluation are key points during clinical management of hospitalized pediatric patients, in order to prevent health deterioration that can lead to serious complications and growth consequences. In addition, anthropometric data based on commonly accepted universal growth standards can give accurate results for nutrition status. Both nutrition risk screening and nutrition status assessment are techniques that should be routinely implemented, based on commonly accepted growth standards and methodology, and linked to clinical outcomes. The aim of the present review was to address the issue of hospital malnutrition in pediatric settings in terms of prevalence, outline nutrition status evaluation and nutrition screening process using different criteria and available tools, and present its relationship with outcome measures. Key teaching points • Malnutrition—underweight or excess body weight—is a frequent imbalance in pediatric settings that affects physical growth and results in undesirable clinical outcomes. • Anthropometry interpretation through growth charts and nutrition screening are cornerstones for the assessment of malnutrition.To date no commonly accepted anthropometric criteria or nutrition screening tools are used in hospitalized pediatric patients. • Commonly accepted nutrition status and screening processes based on the World Health Organization's growth standards can contribute to the overall hospital nutrition care of pediatric patients. [ABSTRACT FROM PUBLISHER]

Purpose: The objective of this study was to survey registered dietitians (RDs) at acute care hospitals across Canada to determine whether valid screening and assessment methods (i.e. those with formal evaluation of the psychometric and/or clinimetric properties of the tool) are used to identify protein-energy malnutrition following stroke.Methods: One hundred and twenty-five Canadian healthcare institutions admitting high volumes (≥100/year) of acute stroke patients were identified. RDs at these sites who provided services to patients recovering from acute stroke were contacted and invited to participate in an online survey.Results: Ninety-five RDs completed the survey. Sixty dietitians (63%) indicated that patients were screened routinely at their institution, which was conducted primarily by dietitians (n = 64, 67.3%). Ten respondents (10.5%) stated they used a screening tool with previously-established validity, while 32 (33.7%) indicated they used a validated assessment tool. Among dietitians using validated tools, 40% and 64% indicated that they used modified versions of the original screening and assessment tools. The most frequently cited tools used for both screening and assessment purposes were Subjective Global Assessment and Mini Nutritional Assessment.Conclusions: The results of this national survey suggest that screening and assessment of nutritional status following acute stroke is conducted using tools that have not been validated previously.Implications for RehabilitationAlthough the use of valid screening and assessment tools is considered part of evidence-based practice, and recommendations for their adoption are included in several national stroke-specific clinical practice guidelines, the results from an online survey suggest that they are not used in clinical practice by RDs in Canada caring for patients following stroke.There are associated risks with the use of screening and assessment tools, which have not been formally validated. The true nutritional status of patients may not be initially identified correctly, and the response to subsequent nutritional interventions may not be assessed accurately or reliably.While the results of this survey were stroke-specific, we suggest that the results are likely generalizable to dietitians working in other patient areas. [ABSTRACT FROM AUTHOR]

This is a prospective observational study of malnutrition and six-week clinical outcomes on a previously unstudied population of older hospital inpatients in rural Wales. One hundred and twenty-six of 152 patients older than 60 years identified on the wards surveyed were included. Patients unable to give informed consent and those too ill to participate were excluded. The main findings were that 55 (44%) were malnourished at the first assessment, that nutrition risk predicted mortality (P = 0.019), length of hospital stay (P = 0.026), and discharge destination (P = 0.005), that only 17 patients had received nutritional support, and that many of those who received support nevertheless had lost weight at the 6-week follow-up. This confirms previous research which suggests that, while malnutrition is associated with poorer clinical outcomes, nutrition support for older patients in hospital nevertheless is often insufficient. [ABSTRACT FROM AUTHOR]