Criterion validity of the visual estimation method for determining patients' meal intake in a community hospital
Criterion validity of the visual estimation method for determining patients' meal intake in a community hospital
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DOI：
10.1016/j.clnu.2016.04.006
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发表时间：
2016-12-01
影响因子：
6.3
通讯作者：
Akamatsu, Rie
中科院分区：
文献类型：
--
作者：
Kawasaki, Yui;Sakai, Masashi;Akamatsu, Rie
背景和目标：视觉估计方法的准确性是未知的，即使它是常用的医院来衡量病人的饮食摄入量。我们的目的是比较根据评分员的工作类别和托盘划分的视觉估计的有效性的差异，并证明膳食特征和视觉估计的有效性之间的关联，在一个普通的临床设置在社区hospital.Methods：我们收集患者的饮食摄入数据，在普通的临床设置为每个托盘在3种方式：护理助理的视觉估计、营养师的视觉估计和研究人员的称重（参考方法）。营养师采用整盘和食物两部分估计膳食摄入量，然后将重量和视觉估计数据进行比较，以评估视觉估计方法的有效性。目标托盘的数量比使用称重法时多（护理助理的视觉估计[589 +/- 168千卡，24.3 +/- 7.0克/盘，p < 0.01]，营养师的整个盘[561 +/- 171千卡，23.0 +/- 6.9克/盘，p < 0.05]，食物项目[562 +/- 171千卡/盘，p < 0.05]和营养师的食物项目[23.4 +/- 7.3 gitray，p = 0.63]）。两种方法的能量（rho = 0.91-0.98，p < 0.01）和蛋白质摄入（rho = 0.88-0.96，p < 0.01）的斯皮尔曼相关性分别非常高。Bland-Altman图中两种膳食摄入量类别的一致性限度分别为121 kcal至147 kcal/托盘和-6.4 g至7.0 gitray（护理助理，整个部门），122千卡-106千卡/托盘和-6.7克至5.5吉雷（营养师，整个部门），以及-82千卡至66千卡/盘和-4.3克至3.9克/盘（营养师，食品部门）。根据护理助理的全托盘评估，高谷物摄入率与两种方法之间差异的几率降低显著相关（比值比[OR]：0.85; 95%置信区间[CI]：0.76 - 0.94）和营养师的整个托盘（OR：0.80; 95% CI：0.72-0.89）和食物项目评价（OR：0.64; 95% CI：0.56-0.73）。此外，切碎的饭菜也与两种方法之间的差异，为护理助理的整个托盘（OR：3.53，95%CI：1.66-7.51）和营养师的食物项目（OR：2.92; 95%CI：1.37-6.22）。视觉估计的护理助理和营养师与称重方法高度相关，虽然协议的限制是广泛的。护理人员及营养师在使用目测法评估膳食摄取量时，应注意低消耗及改良质构餐。(C)2016由Elsevier Ltd.出版
Background & aims: The accuracy of the visual estimation method is unknown, even though it is commonly used in hospitals to measure the dietary intake of patients. We aimed to compare the difference in the validity of visual estimation according to the raters' job categories and tray divisions, and to demonstrate associations between meal characteristics and validity of visual estimation in a usual clinical setting in a community hospital.Methods: We collected patients' dietary intake data in usual clinical settings for each tray in 3 ways: visual estimation by nursing assistants, visual estimation by dietitians, and weighing by researchers (reference method). Dietitians estimated the dietary intake using 2 divisions, namely, whole tray and food items.Thenwe compared the weights and visual estimation data to evaluate the validity of the visual estimation method.Results: Mean nutrient consumption of target trays was significantly different when using the visual estimation. of target trays than when using the weighed method (visual estimation by nursing assistants [589 +/- 168 kcal, 24.3 +/- 7.0 g/tray, p < 0.01], dietitians' whole trays [561 +/- 171 kcal, 23.0 +/- 6.9 g/tray, p < 0.05], food items [562 +/- 171 kcal/tray, p < 0.05], and dietitians' food items [23.4 +/- 7.3 gitray, p = 0.63]). Spearman's correlations for both methods were very high for energy (rho = 0.91-0.98, p < 0.01) and protein intakes (rho = 0.88-0.96, p < 0.01), respectively. The limits of agreement in the Bland-Altman plot for both dietary intake categories were 121 kcal to 147 kcal/tray and -6.4 g to 7.0 gitray (nursing assistants, whole division), 122 kcal-106 kcal/tray and -6.7 g to 5.5 gitray (dietitians, whole divisions), and -82 kcal to 66 kcal/tray and -4.3 g to 3.9 g/tray (dietitians, food items divisions). High intake rate of grains was significantly associated with decreased odds of a difference between two methods based on the nursing assistant's whole tray evaluation (odds ratio [OR]: 0.85; 95% confidence interval [CI]: 0.76 -0.94) and the dietitians' whole tray (OR: 0.80; 95% CI: 0.72-0.89) and food-items evaluations (OR: 0.64; 95% CI: 0.56-0.73), respectively. In addition, minced meals were also associated with a difference between two methods, for the nursing assistants' whole tray (OR: 3.53; 95% CI: 1.66-7.51) and dietitians' food items (OR: 2.92; 95% CI: 1.37-6.22).Conclusions: Visual estimation by nursing assistants and dietitians correlated highly with the weighing method although the limits of agreement were wide. Nursing assistants and dietitians should pay attention to low consumption and modified texture meals when evaluating dietary intake using the visual estimation method. (C) 2016 Published by Elsevier Ltd.