Evidence based practice, choose your study data option.

PAGE 2-TOPIC AND STUDY PAGE Please choose one of the topics and identify one study under that topic. Read the

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study and answer one of the following questions, according to the topic chosen, in a 300-word summary. References to the article are located in the 1st line under the study data section. Evaluating nutritional status Study 1 Formative evaluation of the feedback component of Children’s and Adolescents’ Nutrition Assessment and Advice on the Web (CANAA-W) among parents of schoolchildren Study data Vereecken, C., Covents, M., Maes, L. & Moyson, T. (2013). Public Health Nutrition, 16(1), 15-26. The purpose of this study was to evaluate an online nutrition tailoring instrument, The Children’s and Adolescents’ Nutrition Assessment and Advice on the Web (CANAA-W) among parents of schoolchildren. Parents (n = 46) of pre-primary and primary-school children recorded their child’s food intake over a 3-day period with CANAA-W and completed the evaluation questionnaire online. A subsample participated in focus group discussions. The findings of the study suggested that parents were enthusiastic about the CANAA-W and a majority (81%) found the advice comprehensible, logical, and useful. They also indicated that the advice was helpful to improve their children’s eating habits, and they intend to use it. Conclusions The authors concluded that the CANAA-W is a feasible modality for assessing nutritional status in children and adolescents, and may be used to provide guidance for parents. Further studies evaluating the outcomes of using the CANAA-W are needed. Study 2 Validation of the Diet Quality Index for adolescents by comparison with biomarkers, nutrient and food intakes: the HELENA study Study data Vyncke, K., Cruz, F. E., Fajo-Pascual, M., Cuenca-Garcia, M., De Keyzer, W., Gonzalez-Gross, M., et al., (2012). British Journal of Nutrition, 1-12. https://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8729138 The purpose of this study was to determine whether the Diet Quality Index for Adolescents (DQI-A) is a good surrogate measure for adherence to food-based dietary guidelines. Participants (n = 1,804) were recruited in the Health Lifestyle in Europe by Nutrition in Adolescence study. Dietary intake was assessed by two nonconsecutive 24-hour recalls, and a DQI- score was calculated considering the dietary quality, diversity, and equilibrium. Associations between the DQI-A score, food and nutrient intake, and serum biomarkers were investigated. There was a positive association between the DQI-A score and intake of nutrient-dense food items, but not total fat intake. The DQI-A score also had a positive association with some serum biomarkers, including 25-hydorxyvitamin D, holotranscobalamin, and n-3 fatty acid. Conclusions The authors concluded that the data supported good validity of the DQI-A by confirming expected associations with food and nutrient intake and some serum biomarkers. Further research evaluating the application of this tool in clinical practice is needed to determine clinically meaningful outcomes. Identifying those at risk for malnutrition STUDY 1 Beyond malnutrition screening: Appropriate methods to guide nutrition care for aged care residents Study data Isenring, E. A., Banks, M., Ferguson, M., & Bauer, J. D. (2012). Journal of the Academy of Nutrition and Dietetics, 112(3), 376-381. The purpose of this study was to determine the concurrent validity of several malnutrition screening tools and anthropometric parameters against validated nutrition assessment tools in aged care residents. In this observational study, 127 long-term residents over 50 years of age underwent a nutritional assessment using screening tools and anthropometric measurements to evaluate risk of malnutrition. The nutrition screening tools evaluated included the Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), Mini Nutritional Assessment-Short Form (MNA-SF), and the Simplified Nutritional Assessment Questionnaire. Nutritional status was assessed by Subjective Global Assessment (SGA), Mini Nutritional Assessment (MNA), body mass index (BMI), corrected arm muscle area, and calf circumference. Residents were rated as either well-nourished or malnourished according to each nutrition assessment tool. Conclusions The authors concluded that the MST, MUST, MNA-SF, and anthropometric screens corrected arm muscle area and calf circumference have acceptable concurrent validity compared with validated nutrition assessment tools and can be used to triage nutrition care in the long-term care setting. STUDY 2 Population-specific short-form mini nutritional assessment with body mass index or calf circumference can predict risk of malnutrition in community-living or institutionalized elderly people in Taiwan Study data Tsai, A. C., Chang, T. L., Wang, Y. C., & Liao, C. Y. (2010). Journal of the American Dietetic Association, 110(9), 1328-1334. The purpose of this study was to determine whether the cut points for body mass index (BMI) based on the population or calf circumference as an alternative would improve the predictive ability of the shortform Mini Nutritional Assessment (MNA). The study used a convenience sample of 301 community-living, 109 care center-living, and 68 nursing home-living people, 65 years or older. The researchers evaluated the short-form MNA in three versions: the original, a Taiwan version that used population-specific BMI cut points, and a Taiwan version that substituted calf circumference for BMI. The results were compared with the long-form MNA as a reference. The results showed that using population-specific BMI cut points improved the predictive ability of the short-form MNA, whereas replacement of BMI with calf circumference further improved the predictive ability of the scale. Conclusions The authors concluded that using BMI cut points of the target population improves the predictive ability of the Mini Nutritional Assessment, and that calf circumference can be an acceptable alternative to BMI. Because measuring calf circumference is easier and less time-consuming than measuring BMI, the modified tool can make periodic nutritional screening an easier job and routine nutritional screening a more realistic goal in geriatric care. STUDY 3 Comparison of the prevalence of malnutrition diagnosis in head and neck, gastrointestinal and lung cancer patients by three classification methods Study data Platek, M. E., Popp, J. V., Possinger, C. S., DeNysschen, C. A., Horvath, P., & Brown, J. K. (2011). Cancer Nursing, 34(5), 410-416. The purpose of this study was to compare the prevalence of malnutrition diagnosis by three classification methods using data from medical records of comprehensive cancer center. The records of 227 patients hospitalized with head and neck, gastrointestinal, or lung cancer were reviewed for malnutrition using three methods of evaluating malnutrition: diagnosed malnutrition ICD-9 codes, in-hospital nutritional assessment conducted by registered dietitians, and body mass index (BMI). The prevalence of malnutrition ranged from 8.8% based on BMI to 26% of all cases based on dietitian assessment. Conclusions The authors concluded that implementing a validated tool that can be used by various healthcare practitioners, including nurses, should be considered in order to meet the Joint Commission requirement of a nutritional screening of patients within 24 hours of admission. Malnutrition associated with specific health conditions STUDY 1 Malnutrition in a sample of community-dwelling people with Parkinson’s disease Study data Sheard, J. M., Ash, S., Mellick, G. D., Silburn, P. A., & Kerr, G. K. (2013). PLOS One, 8(1), e53290. The purpose of this study was to provide an estimate of the extent of malnutrition in community-dwelling people who have Parkinson’s disease. The Subjective Global Assessment (SGA) and Patient Generated Subjective Global Assessment (PG-SGA) were used to assess nutritional status in 125 participants who have Parkinson’s disease. In addition, body weight, standing or knee height, mid-arm circumference, and waist circumference were measured. There were 19 (15.2%) who were moderately malnourished. The symptoms most influencing intake were loss of appetite, constipation, early satiety, and problems swallowing. Conclusions The authors concluded that malnutrition remains under-recognized and undertreated in people who have Parkinson’s disease, and that regular screening of nutritional status is needed, with a focus on identifying problems that affect intake so that appropriate interventions can be implemented. STUDY 2 Nutritional risk index as a predictor of postoperative wound complications after gastrectomy Study data Oh, C. A., Kim, D. H., Oh, S. J., Choi, M. g., Noh, J. H., Sohn, T. S., Bae, J. M., & Kim, S. (2012). World Journal of Gastroenterology, 18(7), 673-678. The purpose of this study was to determine the association between the nutritional risk index score and postoperative wound complications in patients undergoing gastrectomy. Patients undergoing curative gastrectomy (N = 669) were included in this retrospective study. Medical records of the patients were analyzed to determine the nutritional risk index score on the fifth postoperative day and the rate of postoperative wound complications. The nutritional risk index score showed a malnutrition rate of 84.6% among postoperative patients. However, postoperative wound complications only occurred in 9.86% of the sample. Of the patients with wound complications, 94% were malnourished. Conclusions The authors concluded that malnutrition immediately after surgery may play a significant role in the development of wound complications in patients undergoing gastrectomy. Interventions designed to address malnutrition in this population are needed to determine whether they can decrease wound complications postoperatively. STUDY 3 Risk of malnutrition is associated with mental health symptoms in community living elderly men and women: The Tromso Study Study data Kvamme, J., Gronli, O., Florholmen, J., & Jacobsen, B. K. (2011). BMC Psychiatry, 11, 112. The purpose of this study was to evaluate the relationship between malnutrition and mental health in community-living elderly individuals. A cross-sectional survey with 1,558 men and 1,553 women aged 65 to 87 years was conducted to assess nutritional status using the Malnutrition Universal Screening Tool (MUST) and mental health using the Symptoms Check List 10. The risk of malnutrition was found in 5.6% of men and 8.6% of women. Significant mental health symptoms were reported by 3.9% of men and 9.1% of women. There was a positive association between the risk of malnutrition and both significant and subthreshold mental health symptoms in men and women. Conclusions The authors concluded that impaired mental health was strongly associated with the risk of malnutrition in community-living elderly men and women. Interventions to address malnutrition should also incorporate methods of addressing mental health, particularly anxiety and depression. Outcomes associated with nutritional status STUDY 1 Role of nutritional status in predicting quality of life outcomes in cancer – a systematic review of the literature Study data Lis, C. G., Gupta, D., Lammersfeld, C. A., Markman, M., & Vashi, P. G. (2012). Nutrition Journal, 11, 27. The purpose of this systematic review was to determine the role of nutritional status in predicting quality of life in cancer patients. Major databases were used to identify publications of research studies that used nutritional status as one of the predictor variables and quality of life as one of the outcome measures. Of the 26 included studies, 24 concluded that better nutritional status was associated with a better quality of life. One study supported this association only in high-risk patients, and one study did not support an association between nutritional status and quality of life. Conclusions The authors concluded that nutritional status is a strong predictor of quality of life in cancer patients and recommended that more providers implement the American Society of Parenteral and Enteral Nutrition (ASPEN) guidelines for oncology patients, including nutritional screening, nutrition assessment, and intervention as appropriate. STUDY 2 Study data Koretz, R. L., Avenell, A., & Lipman, T. O. (2012). Cochrane Database of Systematic Reviews, 2012, Articles 5, CD008344 The purpose of this systematic review was to assess the beneficial and harmful effects of parenteral, enteral, and oral nutritional supplements on the mortality and morbidity of patients who have underlying liver disease. Randomized clinical trials comparing groups of patients with any underlying liver disease who did or did not receive parenteral, enteral, or oral nutritional supplements were identified through large databases. Of the 37 trials identified, only one was at low risk of bias. Most of the findings did not find any significant differences. There were several trials suggesting improved serum nutritional biomarkers, lower rates of infection, and fewer complications with parenteral or enteral nutrition. However, the one trial of low risk for bias found an increased risk of death in patients receiving supplements. Conclusions The authors concluded that the data on providing parenteral, enteral, or oral nutritional supplements to patients with liver disease do not provide compelling evidence to justify routine use. Data from welldesigned randomized controlled trials with an untreated control group are needed in order to determine recommendations. Interventions to improve nutritional status STUDY 1 Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults Study data Desroches, S., Lapointe, A., Ratté, S., Gravel, K., Légaré, F., Turcotte, S. (2013). Cochrane Database of Systematic Reviews, 2013, Issue 2. Art. No.: CD008722. The purpose of this review was to assess the effects of interventions for enhancing adherence to dietary advice for preventing and managing chronic diseases in adults. Randomized controlled trials that evaluated interventions enhancing adherence to dietary advice for preventing and managing chronic diseases in adults were included if the primary outcome was the patient’s adherence to dietary advice. Of the studies identified, 38 were included involving 9,445 participants. Among studies that measured diet adherence outcomes between an intervention group and a control/usual care group, 32 out of 123 diet adherence outcomes favored the intervention group. Four favored the control group, whereas 62 had no significant difference between groups. Interventions shown to improve at least one diet adherence outcome were telephone follow-up, video, contract, feedback, nutritional tools, and more complex interventions, including multiple interventions. However, these interventions also show no difference in some diet adherence outcomes compared to a control/usual care group, making inconclusive results about the most effective intervention to enhance dietary advice. There was no significant effect on longterm adherence or outcomes. Studies investigating interventions such as a group session, individual session, reminders, restriction, and behavior change techniques reported no diet adherence outcome showing a statistically significant difference favoring the intervention group. Overall, the studies were generally of short duration and low quality, and adherence measures varied widely. Conclusions The authors concluded that there is a need for long-term, good-quality studies using more standardized and validated measures of adherence to identify the interventions that should be used in practice to enhance adherence to dietary advice in the context of a variety of chronic diseases. NR449 Evidence Based Practice Skills Module Guidelines PURPOSE To encourage critical thinking, problem solving, and collaboration through the use of a Evidence Based Practice studies. COURSE OUTCOMES This assignment enables the student to meet the following course outcomes. 1. Examine the sources of knowledge that contribute to professional nursing practice. 2. Apply research principles to the interpretation of the content of published research studies. 3. Identify ethical issues common to research involving human subjects. 4. Evaluate published nursing research for credibility and clinical significance related to evidence-based practice. 5. Recognize the role of research findings in evidence-based practice. DUE DATE Refer to Course Calendar for details. The Late Assignment Policy applies to this assignment. TOTAL POINTS POSSIBLE -150 Points REQUIREMENTS o o o Computer with internet access Access to ATI Recommend using Firefox browser and clearing your cookies and cache if you are accessing ATI on a laptop or desktop computer PREPARING THE ASSIGNMENT View and read any relevant resource material that could help you better understand the concept or solve the problem(s) given. You can review the module but this is not a priority for this assignment. Log into ATI and select the “Learn” tab. Click on Skills Modules and title “Nutrition Feeding and Eating”. Click on the “lesson” tab and then open the “Evidence Based Research” tab at the top of the page. Your instructor will provide guidance on the best way to submit this assignment. NR449 Skills Guidelines.docx Revised 01/12/18 CSS DIRECTIONS AND ASSIGNMENT CRITERIA There are five main topics and the accompanying studies identified under the Evidence Based Practice tab. They are as follows: 1. Evaluating Nutritional Status a. Formative evaluation of the feedback component of Children’s and Adolescents’ Nutrition Assessment and Advice on the Web (CANAA-W) among parents of schoolchildren b. Validation of the Diet Quality Index for adolescents by comparison with biomarkers, nutrient and food intakes: the HELENA study 2. Identifying those at risk for malnutrition a. Beyond malnutrition screening: Appropriate methods to guide nutrition care for aged care residents b. Population-specific short-form mini nutritional assessment with body mass index or calf circumference can predict risk of malnutrition in community-living or institutionalized elderly people in Taiwan c. Comparison of the prevalence of malnutrition diagnosis in head and neck, gastrointestinal and lung cancer patients by three classification methods 3. Malnutrition associated with specific health conditions a. Malnutrition in a sample of community-dwelling people with Parkinson’s disease b. Nutritional risk index as a predictor of postoperative wound complications after gastrectomy c. Risk of malnutrition is associated with mental health symptoms in community living elderly men and women: The Tromso Study 4. Outcomes associated with nutritional status a. Role of nutritional status in predicting quality of life outcomes in cancer – a systematic review of the literature b. Nutritional support for liver disease 5. Interventions to improve nutritional status a. Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults Please choose one of the topics and identify one study under that topic. Read the study and answer one of the following questions, according to the topic chosen, in a 300-word summary. Topic 1 – What methods can be used to assess nutritional status? Topic 2- What methods can be used to identify those at risk for malnutrition? Topic 3- What specific health conditions increase the risk of malnutrition? Topic 4- What associations exist between nutritional status and health outcomes? Topic 5- What type of interventions improve adherence to recommendations on nutritional intake? The Summary must include the following headings (See rubric for criteria under each heading): a. Introduction and Key Points (10 Points) b. Article Search (25 Points) c. Article Findings (25 Points) d. Evidence for Practice (25 Points) e. Sharing of Evidence (25 Points) f. Conclusion (20 Points) NR449 Skills Guidelines.docx Revised 01/19/18 CSS 2 g. APA Style (10 Points) h. Writing mechanics (10 Points) Assignment Criteria Points % Description Pick one of the topics and answer the topic question along with providing a current research article, which supports this topic question, and 300word summary. The Summary must include the following headings (See rubric for criteria under each heading): 150 100 *Student grades will be based on completing ALL criteria listed and according to the rubric. Please see rubric for specific requirement to achieve full points for this assignment. a. Introduction and Key Points (10 Points) b. Article Search (25 Points) c. Article Findings (25 Points) d. Evidence for Practice (25 Points) e. Sharing of Evidence (25 Points) f. Conclusion (20 Points) g. APA Style (10 Points) h. Writing mechanics (10 Points) Total NR449 Skills Guidelines.docx 150 Revised 01/19/18 CSS 100 3 GRADING RUBRIC NR449 ATI Skills Assignment Headings Points for Heading 1 1. Introduction and Key Points 10 Points 7.5 Points 5 Points 2.5 Points 0 Points All 4 criteria met 3 of 4 criteria met 2 of 4 criteria met 1 of 4 criteria met Not done 25 Points 20 Points 15 Points 10 Points 0 Points All 4 criteria met 3 of 4 criteria met 2 of 4 criteria met 1 of 4 criteria met Not done 25 Points 20 Points 15 Points 10 Points 0 Points All 4 criteria met 3 of 4 criteria met 2 of 4 criteria met 1 of 4 criteria met Not done – Choose one of assigned Topics and Question – Defines the Topic and Question – States why it is a problem. – Information presented in logical sequence. Points for Heading 2 2. Article Search -Current and credible resource -Database search-terms and methods -Number of articles located -Source outside of ATI module Points for Heading 3 3. Article Findings – How it addresses the topic – Type of Research conducted – Findings of research NR449 Skills Guidelines.docx Revised 01/19/18 CSS 4 – Why this article chosen Points for Heading 4 4. Evidence for Practice 25 Points 20 Points 15 Points 10 Points 0 Points All 4 criteria met 3 of 4 criteria met 2 of 4 criteria met 1 of 4 criteria met Not done 20 Points 15 Points 10 Points 0 Points 20 Points 15 Points 10 Points 5 Points 0 Points All 4 criteria met 3 of 4 criteria met 2 of 4 criteria met 1 of 4 criteria met Not done – Summary of evidence – How it will improve practice – How will this evidence decrease a gap to practice – Any concerns or weaknesses located in the evidence Points for Heading 5 5. Sharing of Evidence 25 Points All 4 criteria met – Who would you share the information with – How would you share this information – What resources would you need to accomplish this sharing of evidence – Why would it be important to share this evidence with the nursing profession Points for Heading 6 6. Conclusion – Summarizes the theme of the paper. – Information presented in logical sequence. – All key points addressed. NR449 Skills Guidelines.docx Revised 01/19/18 CSS 5 – Conclusion shows depth of understanding. Points for APA 7. APA Style 10 Points 7.5 Points 5 Points 2.5 Points 0 Points All 4 criteria met 3 of 4 criteria met 2 of 4 criteria met 1 of 4 criteria met Not done 10 Points 7.5 Points 5 Points 2.5 Points 0 Points All 4 criteria met 3 of 4 criteria met 2 of 4 criteria met 1 of 4 criteria met Not done – APA style used properly for citations – APA style used properly for references – APA style used properly for quotations – All references are cited, and all citations have references. Points for Writing Mechanics 8. Writing mechanics – No spelling errors – No grammatical errors, including verb tense and word usage – No writing errors, including sentence structure, and formatting. – Must be all original work. Total =150 Points NR449 Skills Guidelines.docx Score= Revised 01/19/18 CSS 6 NR449 Skills Guidelines.docx Revised 01/19/18 CSS 7 PAGE 2-TOPIC AND STUDY PAGE Please choose one of the topics and identify one study under that topic. Read the study and answer one of the following questions, according to the topic chosen, in a 300-word summary. References to the article are located in the 1st line under the study data section. Evaluating nutritional status Study 1 Formative evaluation of the feedback component of Children’s and Adolescents’ Nutrition Assessment and Advice on the Web (CANAA-W) among parents of schoolchildren Study data Vereecken, C., Covents, M., Maes, L. & Moyson, T. (2013). Public Health Nutrition, 16(1), 15-26. The purpose of this study was to evaluate an online nutrition tailoring instrument, The Children’s and Adolescents’ Nutrition Assessment and Advice on the Web (CANAA-W) among parents of schoolchildren. Parents (n = 46) of pre-primary and primary-school children recorded their child’s food intake over a 3-day period with CANAA-W and completed the evaluation questionnaire online. A subsample participated in focus group discussions. The findings of the study suggested that parents were enthusiastic about the CANAA-W and a majority (81%) found the advice comprehensible, logical, and useful. They also indicated that the advice was helpful to improve their children’s eating habits, and they intend to use it. Conclusions The authors concluded that the CANAA-W is a feasible modality for assessing nutritional status in children and adolescents, and may be used to provide guidance for parents. Further studies evaluating the outcomes of using the CANAA-W are needed. Study 2 Validation of the Diet Quality Index for adolescents by comparison with biomarkers, nutrient and food intakes: the HELENA study Study data Vyncke, K., Cruz, F. E., Fajo-Pascual, M., Cuenca-Garcia, M., De Keyzer, W., Gonzalez-Gross, M., et al., (2012). British Journal of Nutrition, 1-12. https://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8729138 The purpose of this study was to determine whether the Diet Quality Index for Adolescents (DQI-A) is a good surrogate measure for adherence to food-based dietary guidelines. Participants (n = 1,804) were recruited in the Health Lifestyle in Europe by Nutrition in Adolescence study. Dietary intake was assessed by two nonconsecutive 24-hour recalls, and a DQI- score was calculated considering the dietary quality, diversity, and equilibrium. Associations between the DQI-A score, food and nutrient intake, and serum biomarkers were investigated. There was a positive association between the DQI-A score and intake of nutrient-dense food items, but not total fat intake. The DQI-A score also had a positive association with some serum biomarkers, including 25-hydorxyvitamin D, holotranscobalamin, and n-3 fatty acid. Conclusions The authors concluded that the data supported good validity of the DQI-A by confirming expected associations with food and nutrient intake and some serum biomarkers. Further research evaluating the application of this tool in clinical practice is needed to determine clinically meaningful outcomes. Identifying those at risk for malnutrition STUDY 1 Beyond malnutrition screening: Appropriate methods to guide nutrition care for aged care residents Study data Isenring, E. A., Banks, M., Ferguson, M., & Bauer, J. D. (2012). Journal of the Academy of Nutrition and Dietetics, 112(3), 376-381. The purpose of this study was to determine the concurrent validity of several malnutrition screening tools and anthropometric parameters against validated nutrition assessment tools in aged care residents. In this observational study, 127 long-term residents over 50 years of age underwent a nutritional assessment using screening tools and anthropometric measurements to evaluate risk of malnutrition. The nutrition screening tools evaluated included the Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), Mini Nutritional Assessment-Short Form (MNA-SF), and the Simplified Nutritional Assessment Questionnaire. Nutritional status was assessed by Subjective Global Assessment (SGA), Mini Nutritional Assessment (MNA), body mass index (BMI), corrected arm muscle area, and calf circumference. Residents were rated as either well-nourished or malnourished according to each nutrition assessment tool. Conclusions The authors concluded that the MST, MUST, MNA-SF, and anthropometric screens corrected arm muscle area and calf circumference have acceptable concurrent validity compared with validated nutrition assessment tools and can be used to triage nutrition care in the long-term care setting. STUDY 2 Population-specific short-form mini nutritional assessment with body mass index or calf circumference can predict risk of malnutrition in community-living or institutionalized elderly people in Taiwan Study data Tsai, A. C., Chang, T. L., Wang, Y. C., & Liao, C. Y. (2010). Journal of the American Dietetic Association, 110(9), 1328-1334. The purpose of this study was to determine whether the cut points for body mass index (BMI) based on the population or calf circumference as an alternative would improve the predictive ability of the shortform Mini Nutritional Assessment (MNA). The study used a convenience sample of 301 community-living, 109 care center-living, and 68 nursing home-living people, 65 years or older. The researchers evaluated the short-form MNA in three versions: the original, a Taiwan version that used population-specific BMI cut points, and a Taiwan version that substituted calf circumference for BMI. The results were compared with the long-form MNA as a reference. The results showed that using population-specific BMI cut points improved the predictive ability of the short-form MNA, whereas replacement of BMI with calf circumference further improved the predictive ability of the scale. Conclusions The authors concluded that using BMI cut points of the target population improves the predictive ability of the Mini Nutritional Assessment, and that calf circumference can be an acceptable alternative to BMI. Because measuring calf circumference is easier and less time-consuming than measuring BMI, the modified tool can make periodic nutritional screening an easier job and routine nutritional screening a more realistic goal in geriatric care. STUDY 3 Comparison of the prevalence of malnutrition diagnosis in head and neck, gastrointestinal and lung cancer patients by three classification methods Study data Platek, M. E., Popp, J. V., Possinger, C. S., DeNysschen, C. A., Horvath, P., & Brown, J. K. (2011). Cancer Nursing, 34(5), 410-416. The purpose of this study was to compare the prevalence of malnutrition diagnosis by three classification methods using data from medical records of comprehensive cancer center. The records of 227 patients hospitalized with head and neck, gastrointestinal, or lung cancer were reviewed for malnutrition using three methods of evaluating malnutrition: diagnosed malnutrition ICD-9 codes, in-hospital nutritional assessment conducted by registered dietitians, and body mass index (BMI). The prevalence of malnutrition ranged from 8.8% based on BMI to 26% of all cases based on dietitian assessment. Conclusions The authors concluded that implementing a validated tool that can be used by various healthcare practitioners, including nurses, should be considered in order to meet the Joint Commission requirement of a nutritional screening of patients within 24 hours of admission. Malnutrition associated with specific health conditions STUDY 1 Malnutrition in a sample of community-dwelling people with Parkinson’s disease Study data Sheard, J. M., Ash, S., Mellick, G. D., Silburn, P. A., & Kerr, G. K. (2013). PLOS One, 8(1), e53290. The purpose of this study was to provide an estimate of the extent of malnutrition in community-dwelling people who have Parkinson’s disease. The Subjective Global Assessment (SGA) and Patient Generated Subjective Global Assessment (PG-SGA) were used to assess nutritional status in 125 participants who have Parkinson’s disease. In addition, body weight, standing or knee height, mid-arm circumference, and waist circumference were measured. There were 19 (15.2%) who were moderately malnourished. The symptoms most influencing intake were loss of appetite, constipation, early satiety, and problems swallowing. Conclusions The authors concluded that malnutrition remains under-recognized and undertreated in people who have Parkinson’s disease, and that regular screening of nutritional status is needed, with a focus on identifying problems that affect intake so that appropriate interventions can be implemented. STUDY 2 Nutritional risk index as a predictor of postoperative wound complications after gastrectomy Study data Oh, C. A., Kim, D. H., Oh, S. J., Choi, M. g., Noh, J. H., Sohn, T. S., Bae, J. M., & Kim, S. (2012). World Journal of Gastroenterology, 18(7), 673-678. The purpose of this study was to determine the association between the nutritional risk index score and postoperative wound complications in patients undergoing gastrectomy. Patients undergoing curative gastrectomy (N = 669) were included in this retrospective study. Medical records of the patients were analyzed to determine the nutritional risk index score on the fifth postoperative day and the rate of postoperative wound complications. The nutritional risk index score showed a malnutrition rate of 84.6% among postoperative patients. However, postoperative wound complications only occurred in 9.86% of the sample. Of the patients with wound complications, 94% were malnourished. Conclusions The authors concluded that malnutrition immediately after surgery may play a significant role in the development of wound complications in patients undergoing gastrectomy. Interventions designed to address malnutrition in this population are needed to determine whether they can decrease wound complications postoperatively. STUDY 3 Risk of malnutrition is associated with mental health symptoms in community living elderly men and women: The Tromso Study Study data Kvamme, J., Gronli, O., Florholmen, J., & Jacobsen, B. K. (2011). BMC Psychiatry, 11, 112. The purpose of this study was to evaluate the relationship between malnutrition and mental health in community-living elderly individuals. A cross-sectional survey with 1,558 men and 1,553 women aged 65 to 87 years was conducted to assess nutritional status using the Malnutrition Universal Screening Tool (MUST) and mental health using the Symptoms Check List 10. The risk of malnutrition was found in 5.6% of men and 8.6% of women. Significant mental health symptoms were reported by 3.9% of men and 9.1% of women. There was a positive association between the risk of malnutrition and both significant and subthreshold mental health symptoms in men and women. Conclusions The authors concluded that impaired mental health was strongly associated with the risk of malnutrition in community-living elderly men and women. Interventions to address malnutrition should also incorporate methods of addressing mental health, particularly anxiety and depression. Outcomes associated with nutritional status STUDY 1 Role of nutritional status in predicting quality of life outcomes in cancer – a systematic review of the literature Study data Lis, C. G., Gupta, D., Lammersfeld, C. A., Markman, M., & Vashi, P. G. (2012). Nutrition Journal, 11, 27. The purpose of this systematic review was to determine the role of nutritional status in predicting quality of life in cancer patients. Major databases were used to identify publications of research studies that used nutritional status as one of the predictor variables and quality of life as one of the outcome measures. Of the 26 included studies, 24 concluded that better nutritional status was associated with a better quality of life. One study supported this association only in high-risk patients, and one study did not support an association between nutritional status and quality of life. Conclusions The authors concluded that nutritional status is a strong predictor of quality of life in cancer patients and recommended that more providers implement the American Society of Parenteral and Enteral Nutrition (ASPEN) guidelines for oncology patients, including nutritional screening, nutrition assessment, and intervention as appropriate. STUDY 2 Study data Koretz, R. L., Avenell, A., & Lipman, T. O. (2012). Cochrane Database of Systematic Reviews, 2012, Articles 5, CD008344 The purpose of this systematic review was to assess the beneficial and harmful effects of parenteral, enteral, and oral nutritional supplements on the mortality and morbidity of patients who have underlying liver disease. Randomized clinical trials comparing groups of patients with any underlying liver disease who did or did not receive parenteral, enteral, or oral nutritional supplements were identified through large databases. Of the 37 trials identified, only one was at low risk of bias. Most of the findings did not find any significant differences. There were several trials suggesting improved serum nutritional biomarkers, lower rates of infection, and fewer complications with parenteral or enteral nutrition. However, the one trial of low risk for bias found an increased risk of death in patients receiving supplements. Conclusions The authors concluded that the data on providing parenteral, enteral, or oral nutritional supplements to patients with liver disease do not provide compelling evidence to justify routine use. Data from welldesigned randomized controlled trials with an untreated control group are needed in order to determine recommendations. Interventions to improve nutritional status STUDY 1 Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults Study data Desroches, S., Lapointe, A., Ratté, S., Gravel, K., Légaré, F., Turcotte, S. (2013). Cochrane Database of Systematic Reviews, 2013, Issue 2. Art. No.: CD008722. The purpose of this review was to assess the effects of interventions for enhancing adherence to dietary advice for preventing and managing chronic diseases in adults. Randomized controlled trials that evaluated interventions enhancing adherence to dietary advice for preventing and managing chronic diseases in adults were included if the primary outcome was the patient’s adherence to dietary advice. Of the studies identified, 38 were included involving 9,445 participants. Among studies that measured diet adherence outcomes between an intervention group and a control/usual care group, 32 out of 123 diet adherence outcomes favored the intervention group. Four favored the control group, whereas 62 had no significant difference between groups. Interventions shown to improve at least one diet adherence outcome were telephone follow-up, video, contract, feedback, nutritional tools, and more complex interventions, including multiple interventions. However, these interventions also show no difference in some diet adherence outcomes compared to a control/usual care group, making inconclusive results about the most effective intervention to enhance dietary advice. There was no significant effect on longterm adherence or outcomes. Studies investigating interventions such as a group session, individual session, reminders, restriction, and behavior change techniques reported no diet adherence outcome showing a statistically significant difference favoring the intervention group. Overall, the studies were generally of short duration and low quality, and adherence measures varied widely. Conclusions The authors concluded that there is a need for long-term, good-quality studies using more standardized and validated measures of adherence to identify the interventions that should be used in practice to enhance adherence to dietary advice in the context of a variety of chronic diseases.
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