目的:在康复环境中使用推荐的营养评估措施仍不清楚。这项研究探索了使用来自康复康复病房的全国调查数据来识别营养障碍的方法。
方法:这项横断面研究分析了年度调查,包括识别营养不良的方法,营养不良的风险,Kaifuki(康复期)康复病房的营养过剩。方法识别营养不良和营养不良风险被分组为营养筛查工具(NSTs),营养评估工具(NAT),营养不良诊断标准(DCM),和次优方法(例如,低蛋白血症)。NSTs,NAT,和DCM被进一步归类为“可接受的工具。\"应用可接受的工具之间的关联,基于医院的数据(例如,床的数量),和基于病房的数据(例如,营养状况评估者)通过逻辑回归分析和多重评估进行分析。
结果:总计,885家拥有Kaifuki康复病房的医院对调查做出了回应,754家医院被纳入分析.注册营养师评估了88%的医院的营养状况,而其他专业人士(例如,护士)评估其余的营养状况。NSTs(例如,迷你营养评估简表),NAT(例如,主观全球评估),DCM(例如,全球营养不良标准领导力倡议),13.1%的人使用了次优工具,5.4%,4.8%,74.6%的病例,分别。大多数医院使用可接受的措施(例如,体重指数)为营养过剩(91.2%)。多元逻辑回归分析显示,注册营养师的评估(调整后的比值比[OR]:2.20.95%置信区间[CI]:1.09-4.45)和医院拥有的食品服务,营养师临床实践时间有限的代表,与实施可接受措施的可能性较低相关(调整后OR:0.64,95CI:0.43-0.97).
结论:可接受的营养不良措施,包括NST,NAT,DCM,尚未广泛应用于康复康复设置。当注册营养师评估患者的营养状况时,可以促进识别营养不良的推荐工具的实施。
OBJECTIVE: The utilization of recommended nutritional assessment measures in rehabilitation settings remains unclear. This study explored methods for identifying nutritional disorders using data from a nationwide survey conducted in convalescent rehabilitation wards.
METHODS: This cross-sectional study analyzed the annual survey, including methods for identifying malnutrition, the risk of malnutrition, and overnutrition in Kaifukuki (convalescent) rehabilitation wards. Methods identifying malnutrition and risk of malnutrition were grouped into nutritional screening tools (NSTs), nutritional assessment tools (NATs), diagnostic criteria for malnutrition (DCM), and suboptimal methods (e.g., hypoalbuminemia). NSTs, NATs, and DCM were further categorized as \"acceptable tools.\" The association between applying acceptable tools, hospital-based data (e.g., the number of beds), and ward-based data (e.g., assessor for nutritional status) was analyzed by logistic regression analysis with multiple imputations.
RESULTS: In total, 885 hospitals with Kaifukuki rehabilitation wards responded to the survey, and 754 hospitals were included in the analysis. Registered dietitians assessed the nutritional status in 88% of the hospitals, whereas other professionals (e.g., nurses) evaluated the nutritional status in the remainder. NSTs (e.g., Mini Nutritional Assessment Short-Form), NATs (e.g., Subjective Global Assessment), DCM (e.g., Global Leadership Initiative on Malnutrition criteria), and suboptimal tools were used in 13.1%, 5.4%, 4.8%, and 74.6% of cases, respectively. Most hospitals used acceptable measures (e.g., body mass index) for overnutrition (91.2%). Multiple logistic regression analysis showed that assessments by registered dietitians (adjusted odds ratio[OR]: 2.20.95% confidence interval[CI]: 1.09-4.45) and hospital-owned food services, a proxy for limited clinical practice time of dietitians, were associated with a low likelihood of implementing acceptable measures (adjusted OR: 0.64, 95%CI: 0.43-0.97).
CONCLUSIONS: Acceptable malnutrition measures, including the NSTs, NATs, and DCM, have not been widely applied in convalescent rehabilitation settings. The implementation of recommended tools for identifying malnutrition may be promoted when registered dietitians assess the patients\' nutritional status.