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Measurement of perceived health problems as a means of detecting elderly people at risk of malnutrition
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
2003 (English)In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 7, no 4, 257-262 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

As nutritional preventative measures are more effective in elderly people assessed as non protein-energy malnourished (non-PEM) than such interventions are in those who are malnourished, early detection of those at risk of malnutrition is important.

OBJECTIVE:

This study tests the hypothesis that health problems measured by the Nottingham Health Profile (NHP) can predict residents at risk of malnutrition.

DESIGN:

Nutritional status was assessed in 261 residents newly admitted to municipal care using a combination of anthropometry and serum protein measurements. From this sample, 20 non-PEM residents, simultaneously assessed as moderately malnourished according to a subjective method, were consecutively included. Using a paired matched design, 20 other non-PEM residents, who were simultaneously subjectively assessed as well nourished, completed the pairs.

RESULTS:

Univariate logistic regression analyses showed that the dimensions of emotional reactions, energy, pain, physical mobility and sleep had significant power to predict residents at risk of malnutrition. In the multiple logistic regression analysis, energy had the highest explanatory power.

CONCLUSION:

Non-PEM residents, assessed as moderately malnourished according to the Subjective Global Assessment, perceived significantly greater health problems than non-PEM residents subjectively assessed as well nourished. Measurement of health problems adds important information to that used in early detection of residents at risk of malnutrition.

Place, publisher, year, edition, pages
2003. Vol. 7, no 4, 257-262 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-26840PubMedID: 12917751Local ID: 11458OAI: oai:DiVA.org:liu-26840DiVA: diva2:247390
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Malnutrition in elderly people in need of municipal care
Open this publication in new window or tab >>Malnutrition in elderly people in need of municipal care
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to describe nutritional status in elderly people at the time of entering municipal care, to evaluate nutritional assessment techniques and to investigate the effect of a nutritional care plan. Furthermore the aim was to investigate the staffs' attitudes towards nutritional nursing care. A total of 261 residents, mean age 84 years (range 65-103 years), admitted to a community resident home in a municipality in the south of Sweden were included. At the same municipalities, 151 nursing staff responded to an attitude scale on two occasions with one year between.

During the first or second week after admission nutritional status was assessed using a combination of anthropometry and serum protein measurements as the criterion to define protein- energy malnutrition (PEM). This combination constituted the standard criterion when validity of the Subjective Global Assessment (SGA) and the Mini Nutritional Assessment (MNA) were evaluated. In 40 residents assessed as non-PEM on admission health problems were measured by the Nottingham Health Profile (NHP). To investigate the effect of a nutritional programme energy intake, anthropometry, serum protein measurements and functional capacity were assessed continuously during a five months period in 11 residents assessed as being PEM on admission. The nutritional programme consisted of meals based on individual energy requirements. An attitude scale was developed and used in order to measure whether the attitudes of nursing staff towards important issues within eating and nutrition changed after implementation of an educational programme.

On admission, 33% of 261 elderly people were assessed as being PEM. The frequency of pressure sores or leg ulcers, psychological stress or acute disease in the previous 3 months, reduced fluid intake, deteriorated appetite, reduced mobility, need of help during meals and gastrointestinal symptoms were significant higher in residents assessed as PEM compared with residents assessed as non-PEM. Both SGA and MNA proved to be useful in detecting residents objectively assessed as PEM. NHP, measuring health problems, showed power to predict residents at risk of malnutrition. Anthropometric measurements, serum protein concentration and functional capacity increased significantly in 11 residents assessed as PEM after 3 months on the individualised care programme. Nutritional education and implementation of a nutritional programme did not change the attitudes of nursing staff towards important nutritional issues.

In conclusion, at the time of entering municipal care a high frequency of residents assessed as PEM or at risk of PEM was found. The SGA and MNA were shown to be useful tools in detecting resident in need of nutritional attention. For early detection of residents at risk of malnutrition, measurement of health problems added important information. An individualised nutritional care programme was one useful approach to the improvement of nutritional status and functional capacity in residents assessed as PEM on admission. On the whole, nursing staff responded with positive attitudes towards nutritional nursing care. Nutritional education and implementation of a nutritional programme did not significantly change their attitudes.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2002. 63 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 755
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27471 (URN)12124 (Local ID)91-7373-197-8 (ISBN)12124 (Archive number)12124 (OAI)
Public defence
2002-11-22, Berzeliussalen, Hälsouniversitetet, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-09-18Bibliographically approved

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Christensson, LennartUnossoon, MitraEk, Anna-Christina

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