scholarly journals P3-11-02 - Barriers and facilitators to nutritional risk screening of older adults in primary care

2019 ◽  
Author(s):  
Christine Mills
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Barriers And Facilitators ◽  
Nutritional Risk ◽  
Risk Screening ◽  
Nutritional Risk Screening

scholarly journals Barriers and facilitators to nutritional risk screening of older adults in primary care

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Christine Mills
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Grey Literature ◽  
Community Dwelling ◽  
Barriers And Facilitators ◽  
Nutritional Risk ◽  
Term Care ◽  
Risk Screening ◽  
Google Search ◽  
Nutritional Risk Screening

AbstractIntroduction:Over one-third of these community-dwelling older adults in Canada are at increased nutritional risk. Worldwide, two-thirds of older adults are at increased nutritional risk, although this figure includes those who are hospitalized or in long term care. Nutritional risk can lead to malnutrition; this occurs when an individual's food intake has an imbalance of energy, protein, or other nutrients. Nutritional risk and malnutrition are associated with poor quality of life, increased hospitalization, and premature mortality. Since malnutrition starts in the community, primary care is the ideal location for nutritional risk screening. If nutritional risk is identified early, before it progresses to malnutrition, it can be more easily treated. It is therefore important to understand barriers and facilitators to nutritional risk screening in primary care.Materials and Methods:The peer-reviewed and grey literature were searched. The databases CINAHL, Embase, Medline, and Google Scholar were used to identify articles related to barriers and facilitators to nutritional risk screening of older adults in primary care. A Google search identified publications from the grey literature related to nutritional risk screening of older adults. Key informants consisting of health care professionals working in primary care were asked to identify additional barriers. The Theoretical Domains Framework (TDF) was used to classify the barriers and facilitators.Results:Nine barriers and nine facilitators relating to nutritional risk screening of older adults in primary care were identified. These barriers and facilitators were located within the following domains of the TDF: knowledge; skills; social/professional role and identity; beliefs about capabilities; beliefs about consequences; motivation and goals; memory, attention and decision processes; environmental context and resources; social influences; emotions; behavioural regulation; and nature of the behaviours.Discussion:The TDF can be used to examine the barriers and facilitators to nutritional risk screening of older adults in primary care. Identification and classification of these barriers and facilitators can aid in the development and implementation of interventions designed to improve rates of nutritional risk screening in primary care. Identifying older adults at nutritional risk can help to prevent malnutrition, by intervening early when poor dietary intake may still be relatively easy and inexpensive to address. Screening is the first step in this identification.

scholarly journals Nutritional Risk Screening Tools for Older Adults with COVID-19: A Systematic Review

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2956 ◽  
Author(s):  
David Franciole Oliveira Silva ◽  
Severina Carla Vieira Cunha Lima ◽  
Karine Cavalcanti Mauricio Sena-Evangelista ◽  
Dirce Maria Marchioni ◽  
Ricardo Ney Cobucci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Predictive Validity ◽  
High Sensitivity ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Nutritional Screening ◽  
Risk Screening ◽  
Nrs 2002 ◽  
Nutritional Risk Screening

Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in older people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants’ ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment (MNA), the MNA-short form (MNA-sf), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Index (NRI), the Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in older adults with COVID-19.

scholarly journals Discriminative power of an adapted version of Nutritional Risk Screening 2002 applied to Brazilian older adults

2020 ◽  
Vol 18 ◽  
Author(s):  
Midori Cabral Sugaya ◽  
Regiane Maio ◽  
Bruna Lúcia de Mendonça Soares ◽  
Cinthia Katiane Martins Calado ◽  
Glaucia Queiroz Morais ◽  
...  
Keyword(s):  
Older Adults ◽  
Nutritional Risk ◽  
Discriminative Power ◽  
Risk Screening ◽  
Nutritional Risk Screening 2002 ◽  
Nutritional Risk Screening

Nutritional Risk Screening 2002: sinnvolles Messinstrument in der Pneumologie?

Pneumologie ◽  
2011 ◽  
Vol 65 (S 01) ◽  
Author(s):  
C Priegnitz ◽  
I Kietzmann ◽  
K Richter ◽  
M Treml ◽  
WJ Randerath ◽  
...  
Keyword(s):  
Nutritional Risk ◽  
Risk Screening ◽  
Nutritional Risk Screening 2002 ◽  
Nutritional Risk Screening

Mangelernährung bei geriatrischen Traumapatienten

2014 ◽  
Vol 23 (01) ◽  
pp. 5-10
Author(s):  
E.C. Bliemel ◽  
R. Aigner ◽  
C. Rolfes ◽  
S. Ruchholtz ◽  
B. Buecking ◽  
...  
Keyword(s):  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Nutritional Risk ◽  
Risk Screening ◽  
Prädiktive Validität ◽  
Nutritional Risk Screening

ZusammenfassungDie Inzidenz von Mangelernährung geriatrischer Patienten wird im Allgemeinen mit über 50 % angegeben. Mangelernährung bei geriatrischen Traumapatienten rangiert im Kollektiv der proximalen Femurfrakturen zwischen 30 und 50 %. Insgesamt erscheinen sowohl die angegebenen Häufigkeiten als auch die angewandten Messinstrumente inhomogen. Malnutrition führt zu einer Verschlechterung der Wundheilung, einer längeren postoperativen Immobilität, einem verlängerten Krankenhausaufenthalt sowie zu einer Steigerung der Mortalität. Unter Hinzuziehung bestehender Leitlinien erreichen das Mini Nutritional Assessment (MNA) sowie das Nutritional Risk Screening (NRS) eine ausreichende prädiktive Validität in diesem geriatrischen Patientengut, um ein Screening auf Mangelernährung durchzuführen. Bezüglich möglicher therapeutischer Interventionen ist die Studienlage limitiert: Vorhandene Studien zeigen oft eine geringe Patientenzahl und demente Patienten, die besonders häufig mangelernährt sind, wurden häufig ausgeschlossen. Eine Leitlinie explizit für dieses spezielle Patientengut existiert aktuell nicht. Ein suffizientes Screening des Ernährungszustandes sowie Daten zur Durchführbarkeit und Effizienz einer kurzfristigen perioperativen Nahrungsergänzung könnten einen wichtigen Beitrag zur Stabilisierung dieser oft multimorbiden und fragilen Patienten leisten.

Clinical and Seasonal Variations of Nutritional Risk Screening in Patients Scheduled for Rehabilitation after Heart Surgery

2013 ◽  
Vol 16 (6) ◽  
pp. 336
Author(s):  
Marko Boban ◽  
Viktor Persic ◽  
Zeljko Jovanovic ◽  
Niksa Drinkovic ◽  
Milan Milosevic ◽  
...  
Keyword(s):  
Weight Loss ◽  
Heart Surgery ◽  
Nutritional Risk ◽  
Risk Scores ◽  
Risk Screening ◽  
Climate Effects ◽  
Seasonal Climate ◽  
Nrs 2002 ◽  
The Impact ◽  
Nutritional Risk Screening

<p><b>Background:</b> Current knowledge on the pervasiveness of increased nutritional risk in cardiovascular diseases is limited. Our aim was to analyze the characteristics of nutritional risk screening in patients scheduled for rehabilitation after heart surgery. Prevalence and extent of nutritional risk were studied in connection with patients' characteristics and seasonal climate effects on weight loss dynamics.</p><p><b>Methods:</b> The cohort included 65 consecutive patients with an age range of 25-84 years, 2-6 months after surgical treatment for ischemic or valvular heart disease. Nutritional risk screening was appraised using a standardized NRS-2002 questionnaire. Groups were analyzed according to a timeline of rehabilitation according to the "cold" and "warm" seasons of the moderate Mediterranean climate in Opatija, Croatia.</p><p><b>Results:</b> Increased nutritional risk scores (NRS-2002) of >3 were found in 96% of studied patients. Mean NRS-2002 of patients was 5.0 � 1.0, with a percentage weight loss history of 11.7% � 2.2% (4.6-19.0). Risk was found to be more pronounced during the warmer season, with NRS-2002 scores of 5.3 � 0.7 versus 4.8 � 1.1 (<i>P</i> = 0.136) and greater loss of weight of 13.0% � 3.2% versus 10.6% � 3% (<i>P</i> = 0.005), respectively. Increased nutritional risk correlated significantly with creatinine concentrations (rho = 0.359; <i>P</i> = 0.034 versus 0.584; <i>P</i> = 0.001, respectively). Significant discordance in correlations was found between NRS-2002 and the decrease in left ventricle systolic function (rho correlation coefficient [rho-cc] = -0.428; <i>P</i> = 0.009), the increase in glucose concentrations (cc = 0.600; <i>P</i> < 0.001), and the decrease in erythrocyte counts (cc = -0.520; <i>P</i> = 0.001) during the colder season.</p><p><b>Conclusion:</b> Increased nutritional risk was found to be frequently expressed in the course of rehabilitation after heart surgery. Although seasonal climate effects influenced the weight loss dynamics, the impact on reproducibility of NRS-2002 was clinically less important. Further studies on the connection of nutritional risk with composited end points might offer improvements in overall quality of treatment.</p>

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