Kontakt 2019, 21(4):337-343 | DOI: 10.32725/kont.2019.040
Malnutrition in older people in clinical nursing diagnosisNursing - Original article
- Constantine the Philosopher University in Nitra, Faculty of Social Sciences and Health Care, Department of Nursing, Nitra, Slovak Republic
The aim of this study was to validate the actual nursing diagnosis of imbalanced nutrition: less than body requirements in older patients. It is a retrospective and comparative study. To validate the nursing diagnosis, we used the Fehring's models: the Diagnostic Content Validity Model and the Patient-Focused Clinical Diagnostic Validity Model. They were used to find out the significance of the defining characteristics of the nursing diagnosis of imbalanced nutrition: less than body requirements. After data collection, we calculated a weighted score (WS) for each defining characteristic. There were two samples in the study. The first sample (n1) consisted of 101 nurses - experts according to the modified Fehring's criteria. The second sample (n2) consisted of 50 hospitalized older patients who had fewer than 17 points (a score indicative of malnutrition) in the first and second parts of the standardised nutrition assessment tool - the MNA (Mini Nutritional Assessment). Out of 22 items, the nurses rated one item as major: food intake less than recommended daily allowance (0.87). In the sample of patients, they rated six items out of 17 as major. They are: insufficient interest in food (0.83), food aversion (0.82), alteration in taste sensation (0.78), decreased body weight (0.77), weight loss with adequate food intake (0.77), and food intake less than recommended daily allowance (0.76). As a result of this study, we suggest considering the inclusion of measurement tools that focus on early detection of malnutrition in all hospitalised older people with lower food intake.
Keywords: Defining characteristic; Malnutrition; Nursing diagnosis; Older person; Validation
Received: January 24, 2019; Accepted: July 15, 2019; Prepublished online: October 5, 2019; Published: December 13, 2019 Show citation
References
- Ahmed T, Haboubi N (2010). Assessment and management of nutrition in older people and its importance to health. Clin Interv Aging 9(5): 207-216. DOI: 10.2147/CIA.S9664.
Go to original source...
Go to PubMed...
- Almeida MA, Aliti GB, Franzen E, Thomé EG, Unicovsky MR, Rabelo-Silva ER, et al. (2008). Prevalent nursing diagnoses and interventions in the hospitalized elder care. Rew Latino-Am Enfermagem 16(4): 707-711. DOI: 10.1590/S010411692008000400009.
Go to original source...
- Alzahrani SH, El Sayed IA, Alshamrani SM (2016). Prevalence and factors associated with geriatric malnutrition in an outpatient clinic of a teaching hospital in Jeddah, Saudi Arabia. Ann Saudi Med 36(5): 346-351. DOI: 10.5144/0256-4947.2016.346.
Go to original source...
Go to PubMed...
- Bauer JM, Sieber CC (2007). Significance and diagnosis of malnutrition in the elderly. Z Arztl Fortbild Qualitatssich 101(9): 605-609.
Go to original source...
- Carpenito-Moyet LJ (2004). Nursing Diagnosis: Aplication to Clinical Practice. Philadelphia U.S.A.: Lippincott Company.
- Charvát J, Kvapil M (2006). Praktikum umělé výživy. Praha: UK.
- Dias de Araújo D, Rodrigues de Carvalho RL, Machado Chianca TC (2014). Nursing Diagnoses identified in the medical records of hospitalized elderly. Invest Educ Enferm 32(2): 225-235. DOI: 10.17533/udea.iee.v32n2a05.
Go to original source...
Go to PubMed...
- Doherty TJ (2003). Invited review: Aging and sarcopenia. J Appl Physiol (1985) 95(4):1717-27. DOI: 10.1152/japplphysiol.00347.2003.
Go to original source...
Go to PubMed...
- Fehring RJ (1986). Validating diagnostic labels: standardized methodology. In: Hurley ME (Ed.). Classification of nursing diagnoses: Proceedings of the sixth Conference. Mosby: St. Louis, pp. 183-190.
- Guyonnet S, Rolland Y (2015). Screening for Malnutrition in Older People. Clin Geriatr Med 31(3): 429-437. DOI: 10.1016/j.cger.2015.04.009.
Go to original source...
Go to PubMed...
- Ham RJ (1994). The signs and symptoms of poor nutritional status. Primary Care 21(1): 33-54.
Go to original source...
- Herdman TH, Kamitsuru S (2014). Nursing diagnoses. Definitions and classification 2015-2017. Oxford: Wiley Blackwell.
- Hickson M (2006). Malnutrition and ageing. Postgrad Med J 82(963): 2-8. DOI: 10.1136/pgmj.2005.037564.
Go to original source...
Go to PubMed...
- Jones TE, Stephenson KW, King JG, Knight KR, Marshall TL, Scott WB J (2009). Sarcopenia - mechanisms and treatments. Geriatr Phys Ther 32(3): 83-89.
Go to original source...
- Kayashita A, Yamato H, Yoshida I, Matsuzaki K, Niki H, Nagae H, Miyamoto K (2013). Evaluation of 14 questions detecting malnutrition in newly hospitalized patients. J Med Invest 60(1-2): 138-145. DOI: 10.2152/jmi.60.138.
Go to original source...
Go to PubMed...
- Kinney JM, Allison SP (2002). Nutrition and ageing. Curr Opin Clin Nutr Metab Care 5(1): 1-3.
Go to original source...
Go to PubMed...
- Klevetová D, Topinková E (2003). Hodnocení malnutrice u seniorů v domáci péči. Sestra 13(4): 24-25.
- Kyle UG, Pirlich M, Schuetz T, Luebke HJ, Lochs H, Pichard C (2003). Prevalence of malnutrition in 1760 patients at hospital admission: a controlled population study of body composition. Clin Nutr 22(5): 473-481. DOI: 10.1016/SO261-5614(03)00049-9.
Go to original source...
Go to PubMed...
- Malafarina V, Uriz-Otano F, Gil-Guerrero L, Iniesta R (2013). The anorexia of ageing: Physiopathology, prevalence, associated comorbidity and mortality. A systematic review. Maturitas 74(4): 293-302. DOI: 10.1016/j.maturitas.2013.01.016.
Go to original source...
Go to PubMed...
- Martinický D (2008). Možnosti riešenia malnutrície u geriatrického pacienta. Kompendium medicíny, VII. slovenský geriatrický kongres a 34. Gressnerove dni, no. 15, pp. 12-17.
- Meijers JM, van Bokhorst-de van der Schueren MA, Schols JM, Soeters PB, Halfens RJ (2010). Defining malnutrition: mission or mission impossible? Nutrition 26(4): 432-440. DOI: 10.1016/j.nut.2009.06.012.
Go to original source...
Go to PubMed...
- Mikula J, Hluchová L (2005). Parenterálna a enterálna výživa. Via practica 2(5): 253-255.
- Mink M, Evans A, Moore CG, Calderon KS, Deger S (2010). Nutritional imbalance endorsed by televised food advertisements. J Am Diet Assoc 110(6): 904-910. DOI: 10.1016/j.jada.2010.03.020.
Go to original source...
Go to PubMed...
- Nakanishi N, Hino Y, Ida O, Fukuda H, Shinsho F, Tatara K (1999). Associations between self-assessed masticatory disability and health of community-residing elderly people. Community Dent Oral Epidemiol 27(5): 366-371. DOI: 10.1111/j.1600-0528.1999.tb02033.x.
Go to original source...
Go to PubMed...
- Rentero Redondo L, Iniesta Navalón C, Gascón Cánovas JJ, Tomás Jimenez C, Sánchez Álvarez C (2015). Malnutritionin the elderly patient to hospital admission, an old problem unsolved. Nutr Hosp 32(5): 2169-2177. DOI: 0.3305/nh.2015.32.5.9712.
Go to PubMed...
- Sobotka L, Allison SP, Fűrst R, Meier M, Pertkiewicz L (2004). Basics in clinical nutrition. Prague: Galen.
- Soenen S, Chapman IM (2013). Body weight, anorexia, and undernutrition in older people. J Am Med Dir Assoc 14(9): 642-648. DOI: 10.1016/j.jamda.2013.02.004.
Go to original source...
Go to PubMed...
- Stratton RJ, King CL, Stroud MA, Jackson AA, Elia M (2006). "Malnutrition Universal Screening Tool" predicts mortality and length of hospital stay in acutely ill elderly. Br J Nutr 95(2): 325-330. DOI: 10.1079/BJN20051622.
Go to original source...
Go to PubMed...
- Sullivan DH, Sun S, Walls RC (1999). Protein-Energy Undernutrition Among Elderly Hospitalized Patients. A Prospective Study. JAMA 281(21): 2013-2009. DOI: 10.1001/jama.281.21.2013.
Go to original source...
Go to PubMed...
- Svačina Š, et al. (2010). Poruchy metabolizmu a výživy. Praha: Galén.
- Tannen A, Lohrmann C (2013). Malnutrition in Austrian hospital patients. Prevalence, risk factors, nursing interventions, and quality indicators: a descriptive multicentre study. J Adv Nurs 69(8): 1840-1849. DOI: 10.1111/jan.12051.
Go to original source...
Go to PubMed...
- Teixeira IX, Lopes MV, Martins LC, Diniz CM, de Menezes AP, Alves NP (2016). Validation of clinical indicators of imbalanced nutrition: less than body requirements in early childhood. J Pediatr Nurs 31(2): 179-186. DOI: 10.1016/j.pedn.2015.02.011.
Go to original source...
Go to PubMed...
- Thompson LV (2009). Age-related muscle dysfunction. Exp Gerontol 44(1-2): 106-111. DOI: 10.1016/j.exger.2008.05.003.
Go to original source...
Go to PubMed...
- van Der Pols-Vijlbrief R, Wijnhoven Ha, Schaap La, Terwee Cb, Visser M (2014). Determinants of protein-energy malnutrition in community-dwelling older adults: a systematic review of observational studies. Ageing Res Rev Nov 18: 112-131. DOI: 10.1016/j.arr.2014.09.001.
Go to original source...
Go to PubMed...
- Vanderwee K, Clays E, Bocquaert I, Gobert M, Folens B, Defloor T (2010). Malnutrition and associated factors in elderly hospital patients: a Belgian cross-sectional, multi-centre study. Clin Nutr 29(4): 469-476. DOI: 0.1016/j.clnu.2009.12.013.
Go to original source...
Go to PubMed...
- Wilhelm Z (2001). Výživa v onkológii. Brno: IDVPZ.
- Zadák Z (2004). Metabolizmus a výživa v starobe. In: Kalvach Z, Zadák Z, Jirák R, Zavázalová H, Sucharda P, et al. (Eds). Geriatria a gerontológia. Praha: Grada Publishing, pp. 298-331.
- Zeleníková R, Žiaková K (2010). Validizačné štúdie ošetrovateľských diagnóz. Ošetřovatelství a porodní asistence 1(1): 1-9.
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.