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Problems of nutritional assessment in the community

Published online by Cambridge University Press:  08 December 2008

Jacqueline Edington
Jacqueline Edington*
Affiliation:
Abbott Laboratories, Abbott House, Norden Road, Maidenhead, Berkshire SL6 4XE, UK
*
Corresponding author: Jacqueline Edington, fax +44 (0) 1628 644185, email [email protected]
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Abstract

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The present paper explores the problems associated with assessment of nutritional status in the community and reviews the literature related to this subject. The first problem is one of terminology, since a logical first step before assessment is screening, which identifies characteristics known to be associated with dietary or nutritional problems. Its purpose is to differentiate individuals who are at high nutritional risk or have poor nutritional status. There are certain factors which should alert the primary health care team to the fact that nutritional intake may be reduced and that risk of malnutrition is increased. These include disease condition, functional disabilities, inadequate or inappropriate food intake, poor dentition or difficulty swallowing, polypharmacy, alcoholism, depression, poor social circumstances or recent discharge from hospital. Patients suffering from these factors need to be identified so that screening becomes a routine part of their medical treatment. At-risk groups include the elderly, the chronically ill, those with cancer and neurological disorders, post-surgical patients and children with developmental disabilities. In the community, practice and community nurses see the majority of at-risk patients and should carry out screening. A number of screening tools have been developed for community use. Most are aimed at the elderly population, but there are others designed to assess nutritional risk in children with developmental disabilities and the general population. These are reviewed and problems of content and validity identified. Some problems associated with nutritional assessment are also reviewed.

Keywords

Nutritional status assessmentNutritional screening toolsMalnutrition
Type
Joint Symposium with the British Dietetic Association on ‘Implementing dietary change: theory and practice’ Session 1: Nutritional assessment
Information
Proceedings of the Nutrition Society , Volume 58 , Issue 1 , February 1999 , pp. 47 - 51
Copyright
Copyright © The Nutrition Society 1999

References

Achenbach, TM & Edelbrock, CS (1983) Manual for the Child Behavior Checklist and Revised Child Behavior Profile. Burlington, VT: Department of Psychiatry, University of Vermont.Google Scholar
Barrocas, A, Belcher, D, Champagne, C & Jastram, C (1995) Nutrition assessment practical approaches. Clinics in Geriatric Medicine 11, 675–713.Google Scholar
Bishop, CW, Bowen, PE & Ritchley, PI (1981) Norms for nutritional assessment of American adults by upper arm anthropometry. American Journal of Clinical Nutrition 34, 2530–2539.CrossRefGoogle ScholarPubMed
Bryan, F, Jones, JM & Russell, L (1998) Reliability and validity of a nutrition screening tool to be used with clients with learning difficulties. Journal of Human Nutrition and Dietetics 11, 41–50.CrossRefGoogle Scholar
Burr, ML & Phillips, KM (1984) Anthropometric norms in the elderly. British Journal of Clinical Nutrition 51, 165–169.Google Scholar
Campbell, MK & Kelsey, KS (1994) The PEACH survey: a nutrition screening tool for use in early intervention programs. Journal of the American Dietetic Association 94, 1156–1158.CrossRefGoogle ScholarPubMed
Chernoff, R (1994) Meeting the nutritional needs of the elderly in the institutional setting. Nutrition Reviews 52, 132–136.Google Scholar
Coulston, AM, Craig, L & Voss, AC (1996) Meals-on-wheels applicants are a population at risk for poor nutritional status. Journal of the American Dietetic Association 96, 570–573.CrossRefGoogle ScholarPubMed
Dwyer, JT (1991) Screening Older Americans’ Nutritional Health: Current Practices and Future Possibilities, pp. 1–136. Washington, DC: Nutrition Screening Initiative.Google Scholar
Edington, J, Kon, P & Martyn, CN (1996) Prevalence of malnutrition in patients in general practice. Clinical Nutrition 15, 60–63.Google Scholar
Edington, J, Kon, P & Martyn, CN (1997) Prevalence of malnutrition after major surgery. Journal of Human Nutrition and Dietetics 10, 111–116.CrossRefGoogle Scholar
Elmore, MF, Wagner, DR, Knoll, DM, Eizember, L, Oswalt, MA, Glowinski, EA & Rapp, PA (1994) Developing an effective adult nutrition screening tool for a community hospital. Journal of the American Dietetic Association 94, 1113–1118.CrossRefGoogle ScholarPubMed
Frisancho, AR (1981) New norms of upper limb fat and muscle areas for assessment of nutritional status. American Journal of Clinical Nutrition 34, 2540–2545.CrossRefGoogle ScholarPubMed
Gianino, S & St John, RE (1993) Nutritional assessment of the patient in the intensive care unit. Critical Care Nursing Clinics of North America 5, 1–16.CrossRefGoogle ScholarPubMed
Gilford, A & Khun Khun, R (1996) Development of nutritional risk screening in the community. British Journal of Community Health Nursing 1, 335–339.Google Scholar
Green, SM & McLaren, SG (1998) Nutritional assessment and screening: instrument selection. British Journal of Community Nursing 3, 233–242.Google Scholar
Grindel, CG & Costello, MC (1996) Nutrition screening: an essential assessment parameter. MEDSURG Nursing 5, 145–156.Google Scholar
Guigoz, Y, Vellas, B & Garry, PJ (1994) Mini Nutritional Assessment: a practical assessment tool for grading the nutritional state of elderly patients. Facts, Research and Intervention in Geriatrics 4, 15–59.Google Scholar
Guigoz, Y, Vellas, B & Garry, PJ (1996) Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation. Nutrition Reviews 54, S59–S65.Google Scholar
Ham, RJ (1994) The signs and symptoms of poor nutritional status. Primary Care; Clinics in Office Practice 21, 33–54.Google Scholar
Hasse, J, Strong, S, Gorman, MA & Liepa, G (1993) Subjective global assessment: alternative nutrition-assessment technique for liver-transplant candidates. Nutrition 9, 339–343.Google ScholarPubMed
Hickson, M & Hill, M (1997) Implementing a nutritional assessment tool in the community: a report describing the process, audit and problems encountered. Journal of Human Nutrition and Dietetics 10, 373–377.CrossRefGoogle Scholar
Jensen, GL, Kita, K, Fish, J, Heydt, D & Frey, C (1997) Nutrition risk screening characteristics of rural older persons: relation to functional limitations and health care charges. American Journal of Clinical Nutrition 66, 819–828.Google Scholar
Klein, S, Kinner, J, Jeejeebhoy, K, Alpers, D, Hellerstein, M, Murray, M & Twomey, P (1997) Nutrition support in clinical practice: review of published data and recommendations for future research. Summary of a conference sponsored by the National Institutes of Health, American Society for Parenteral and Enteral Nutrition, and American Society for Clinical Nutrition. Journal of Parenteral and Enteral Nutrition 21, 133–156.CrossRefGoogle Scholar
Lipschitz, DA (1994) Screening for nutritional status in the elderly. Primary Care; Clinics in Office Practice 21, 55–67.CrossRefGoogle ScholarPubMed
McWhirter, JP & Pennington, CR (1994) Incidence and recognition of malnutrition in hospital. British Medical Journal 308, 945–948.Google Scholar
Mullan, AP, Cleave, N, Kennedy-Haynes, L, Hackett, AF & Williams, G (1996) Validation of a simple nutrition risk score for use with the elderly in the community. Proceedings of British Dietetic Association Diamond Jubilee Conference, Poster 27 Abstr.Google Scholar
Nutrition Advisory Group for Elderly People (1992) Eating Through the 90s. Leeds: NAGE.Google Scholar
Posner, BM, Jette, AM, Smith, KW & Miller, DR (1993) Nutrition and health risks in the elderly: the nutrition screening initiative. American Journal of Public Health 83, 972–978.Google Scholar
Reilly, H (1996) Nutritional assessment. British Journal of Nursing 5, 18, 2024.Google Scholar
Reilly, HM, Martineau, JK, Moran, A & Kennedy, H (1995) Nutritional screening - Evaluation and implementation of a simple Nutrition Risk Score. Clinical Nutrition 14, 269–273.Google Scholar
Sahyoun, NR, Jacques, PF, Dallal, GE & Russell, RM (1997) Nutrition Screening Initiative Checklist may be a better awareness/educational tool than a screening one. Journal of the American Dietetic Association 97, 760–764.CrossRefGoogle ScholarPubMed
Scanlan, F, Dunne, J & Toyne, K (1994) No more cause for neglect. Introducing a nutritional assessment tool and action plan. Professional Nurse 9, 382–385.Google Scholar
The Nutrition Screening Initiative (1994) Incorporating Nutrition Screening and Intervention into Medical Practice: A Monograph for Physicians, no. 1–73. Columbus, OH: Ross Products Division, Abbott Laboratories.Google Scholar
Ward, J, Close, J, Little, J, Boorman, J, Perkins, A, Coles, SJ & Edington, J (1998) Development of a screening tool for assessing risk of undernutrition in patients in the community. Journal of Human Nutrition and Dietetics 11, 323–330.Google Scholar
Westin, T, Tradhgard, C, Andersson, K, Warnold, I & Edstrom, S (1988) Nutritional assessment of hospitalized patients with head and neck cancer. Journal of Oto-Rhino-Laryngology and its Related Specialties 50, 193–198.Google Scholar
White, JV (1994) Risk factors for poor nutritional status. Primary Care; Clinics in Office Practice 21, 19–31.CrossRefGoogle ScholarPubMed
Wolinsky, FD, Coe, RM, Chavez, MN, Prendergast, JM & Miller, DK (1986) Further assessment of the reliability and validity of a nutritional risk index: analysis of a three-wave panel study of elderly adults. Health Services Research 20, 977–990.Google Scholar
Wolinsky, FD, Coe, RM, McIntosh, WA, Kubena, KS, Prendergast, JM, Chavez, MN, Miller, DK, Romeis, JC & Landmann, WA (1990) Progress in the development of a nutrition risk index. Journal of Nutrition 120, 1549–1553.Google Scholar