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  • 151.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Norberg, Erika
    Central Hospital, Kristianstad.
    Hagell, Peter
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Diagnostic performance of the Minimal Eating Observation and Nutrition Form – Version II (MEONF-II) and Nutritional Risk Screening 2002 (NRS 2002) among hospital inpatients – a cross-sectional study2011Inngår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 10, 24- s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The usefulness of the nutritional screening tool Minimal Eating Observation and Nutrition Form – Version II (MEONF-II) relative to Nutritional Risk Screening 2002 (NRS 2002) remains untested. Here we attempted to fill this gap by testing the diagnostic performance and user-friendliness of the MEONF-II and the NRS 2002 in relation to the Mini Nutritional Assessment (MNA) among hospital inpatients. Methods: Eighty seven hospital inpatients were assessed for nutritional status with the 18- item MNA (considered as the gold standard), and screened with the NRS 2002 and the MEONF-II. Results: The MEONF-II sensitivity (0.61), specificity (0.79), and accuracy (0.68) were acceptable. The corresponding figures for NRS 2002 were 0.37, 0.82 and 0.55, respectively. MEONF-II and NRS 2002 took five minutes each to complete. Assessors considered MEONF-II instructions and items to be easy to understand and complete (96- 99%), and the items to be relevant (87%). For NRS 2002, the corresponding figures were 75-93% and 79%, respectively. Conclusions: The MEONF-II is an easy to use, relatively quick and sensitive screening tool to assess risk of undernutrition among hospital inpatients. With respect to user-friendliness and sensitivity the MEONF-II seems to perform better than the NRS 2002, although larger studies are needed for firm conclusions. The different scoring systems for undernutrition appear to identify overlapping but not identical patient groups. A potential limitation with the study is that the MNA was used as gold standard among patients younger than 65 years.

  • 152.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Norberg, Erika
    Departments of Nutrition and Health, Central Hospital, Kristianstad.
    Vallén, Christina
    Departments of Nutrition and Health, Central Hospital, Kristianstad.
    Hagell, Peter
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Cut-off scores for the Minimal Eating Observation and Nutrition Form – Version II (MEONF-II) among hospital inpatients2011Inngår i: Journal of Food and Nutrition Research, ISSN 1336-8672, E-ISSN 1338-4260, Vol. 55, 7289- s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND OBJECTIVE:

    The newly developed Minimal Eating Observation and Nutrition Form - Version II (MEONF-II) has shown promising sensitivity and specificity in relation to the Mini Nutritional Assessment (MNA). However, the suggested MEONF-II cut-off scores for deciding low/moderate and high risk for undernutrition (UN) (>2 and >4, respectively) have not been decided based on statistical criteria but on clinical reasoning. The objective of this study was to identify the optimal cut-off scores for the MEONF-II in relation to the well-established MNA based on statistical criteria.

    DESIGN:

    Cross-sectional study.

    METHODS:

    The study included 187 patients (mean age, 77.5 years) assessed for nutritional status with the MNA (full version), and screened with the MEONF-II. The MEONF-II includes assessments of involuntary weight loss, Body Mass Index (BMI) (or calf circumference), eating difficulties, and presence of clinical signs ofUN. MEONF-II data were analysed by Receiver Operating Characteristics (ROC) curves and the area under the curve (AUC); optimal cut-offs were identified by the Youden index (J=sensitivity+specificity-1).

    RESULTS:

    According to the MEONF-II, 41% were at moderate or high UN risk and according to the MNA, 50% were at risk or already undernourished. The suggested cut-off scores were supported by the Youden indices. The lower cut-off for MEONF-II, used to identify any level of risk for UN (>2; J=0.52) gave an overall accuracy of 76% and the AUC was 80%. The higher cut-off for identifying those with high risk for UN (>4; J=0.33) had an accuracy of 63% and the AUC was 70%.

    CONCLUSIONS:

    The suggested MEONF-II cut-off scores were statistically supported. This improves the confidence of its clinical use.

  • 153.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Norberg, Erika
    Departments of Nutrition and Health, Central Hospital, Kristianstad.
    Vallén, Christina
    Departments of Nutrition and Health, Central Hospital, Kristianstad.
    Hagell, Peter
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Cut-off scores for the Minimal Eating Observation and Nutrition Form - Version ll (MEONF ll) among hospital inpatients2011Konferansepaper (Fagfellevurdert)
  • 154.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Petersson, K.
    Lindholm, Christina
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Axelsson, Carolina
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Ulander, Kerstin
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    "Study circles" improves nutritional care and body mass index2008Inngår i: Clinical nutrition supplements, Volume 3, Supplement 1, 2008, page 61: 30th ESPEN Congress, 13-16 sept, 2008. Florence, Italy, 2008, 61- s.Konferansepaper (Fagfellevurdert)
    Abstract [en]

    The staffs’ knowledge, experiences and motivation are likely to be important and so is an adaptation to each unit’s context to achieve positive changes in nutritional practice. How do study circles (SCs) and policy documents (PD) affect nutritional interventions for persons with moderate or high risk for undernutrition (UN-risk) in special accommodations (SAs)?

     

    All SAs within six municipalities were involved. UN-risk was defined as the occurrence of at least two of; involuntary weight loss, Body Mass Index below limit (<20 if /=70 yrs) and/or presence of eating difficulties. In year 2005 and 2007 it was 361 (27%) out of 1337 and 322 (35%) out of 920 persons respectively that were at UN-risk and included in this study. Interventions: In 18 of the departments 39 SCs were implemented, involving 8 staff each, in total 315 persons. Each group met for 3 occasions (3 hours each time) to discuss eating and nutrition based on a manual (www.vardalinstitutet.net/scn). The SCs did not focus on the above definition of UN-risk. In four other SAs a PD was politically anchored. No intervention was implemented in the other SAs.

     

    SCs and PD increased the precision in provided nutritional actions significantly for persons at UN-risk.

     

    The precision (percent) in the provision of nutritional actions.

    Intervention

    Year 2005

    Year 2007

    P-value

    No intervention

    n=229, 86 y

    n=202, 87 y

     

      E-food

    10

    11

    .875

      Food supplement

    31

    29

    .751

      Eating assistance

    65

    67

    .611

     

     

     

     

    Study circles

    n=92, 87 y

    n=82, 87 y

     

      E-food

    16

    32

    .012 *

      Food supplement

    24

    39

    .045 *

      Eating assistance

    67

    69

    .870

     

     

     

     

    Policy document

    n=40, 86 y

    n=38, 85 y

     

      E-food

    5

    24

    .023 *

      Food supplement

    52

    53

    .999

      Eating assistance

    72

    68

    .805

    y = mean age in years, * = significant increase in provision (p<0.05), E-food = Energy Enriched

     

    Both study circles and policy documents improves the precision in the provision of correct nutritional actions for those at moderate or high risk for undernutrition. It is likely that a combination of study circles and policy documents can improve the precision of provision of nutritional actions even more.

  • 155.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Petersson, Karin
    Lindholm, Christina
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Axelsson, Carolina
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Ulander, Kerstin
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Overweight and risk for undernutrition among persons within special accommodations and hospital care – Year 2005 and 20072008Inngår i: Clinical nutrition supplements, Volume 3, Supplement 1, 2008, page 160-161.: 30th ESPEN Congress, 13-16 sept, 2008. Florence, Italy, 2008, 160-161 s.Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Rationale: Both undernutrition and overweight have major impacts on morbidity and mortality and are thus important to prevent. This study explores the prevalence of undernutrition and overweight among persons in special accommodations (SAs) and hospital care in the year of 2005 and 2007. Methods: Six hospitals and all of the SAs within six municipalities were involved. In the year of 2005, 2600 (88%) out of 2945 persons agreed to participate in the study, and in 2007 there were 2255 (81%) out of 2784 persons participating. Risk for undernutrition was defined as the occurrence of at least two of the following; involuntary weight loss, Body Mass Index (BMI) below limit (<20 if /=70 yrs) and/or presence of eating difficulties. Overweight was defined based on BMI (if /=25: if >/=70 yrs: BMI >/=27)[1]. Nursing students, clinical tutors and staff collected the data. Results: The mean age and the risk for undernutrition increased significantly in SAs between the two years. The prevalence of overweight increased with three percent in hospitals as well as in SAs although this increase was not statistically significant. Table:

    Percent of persons at risk for undernutrition and with overweight

     

    SAs2005 (n=1726)

    SAs2007 (n=1526)

    P-value

    Hospitals2005 (n=874)

    Hospitals2007 (n=728)

    P-value

     

    Agemean (SD)

    85 (8)

    86 (8)

    <0.001

    69 (18)

    69 (16)

    0.987

    At risk forundernutrition

    27

    35

    <0.001

    27

    28

    0.947

    Overweight

    30

    33

    0.089

    39

    42

    0.182

     

    SAs = Special Accommodations

    Conclusion: The society in general and health care professionals in specific needs to consider not only prevention for persons at risk for undernutrition, but also the prevention for persons becoming overweight. Reference(s) Only 3 Lines maximum: 1. Westergren A, Lindholm C, Axelsson C & Ulander K. Prevalence of eating difficulties and malnutrition among persons within hospital care and special accommodations. The Journal of Nutrition Health and Aging 2008, Vol 12, Number 1, Page 39-43.

  • 156.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna.
    Stuhr Olsson, Gunnel
    Findus Sverige AB.
    Kost och näring borde ta en större del av diskussionen om äldres livskvalitet2017Inngår i: Landskronaposten, ISSN 2001-7162, nr 12 oktober, A3- s.Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    Fokus på motion och läkemedel är givetvis bra för att förebygga fallolyckor bland äldre. Tyvärr har kost- och näringsaspekten fallit bort ur diskussionen. Det skriver Albert Westergren, professor vid Högskolan Kristianstad och Gunnel Stuhr Olsson, Findus Sverige AB.

  • 157.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Torfadóttir, Ólina
    Akureyri University Hospital.
    Hagell, Peter
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsmiljön PRO-CARE. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Malnutrition and nutritional care in an Icelandic teaching hospital2014Inngår i: Research, ISSN 2334-1009, nr 1, 1270- s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: About 30% of hospital inpatients are at undernutrition (UN) risk and it is important that sufficient nutritional treatment and care is provided in order to avoid a decline in health. Aim: To explore the prevalence of UN risk, the associations between UN-risk and other factors, and describe the nutritional treatment/care towards those at UN-risk at an Icelandic teaching hospital. An additional aim was to evaluate the user friendliness of a nutritional screening tool. Methods: Inpatients (n=56; median age 69 years; 29 women) were assessed by eight nurses using the Minimal Eating Observation and Nutrition form – version II (MEONF-II), a recently developed nursing nutritional screening tool. Results: In total 23% (n=13) were at moderate/high UN-risk. The prevalence of overweight/obesity was 57%. Among patients at UN-risk, 61% received energy dense food, oral nutritional supplements, and/or artificial nutrition; this figure was 35% among those at no/low risk. MEONF-II total scores correlated with dependency in activities of daily living (rs, 0.350), and UN-risk categories correlated with tiredness (rs, 0.426). The MEONF-II was regarded as easy to use and relevant. Conclusion: There is a need for interventions connecting the nutritional screening with individualised nutritional treatment and care in order to narrow the gap between screening and intervention. The Icelandic version of the MEONF-II is perceived as user-friendly.

  • 158.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Torfadóttir, Ólina
    Akureyri Hospital, Iceland.
    Ulander, Kerstin
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Axelsson, Carolina
    Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Naturvetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Lindholm, Christina
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Malnutrition prevalence and precision in nutritional care: an intervention study in one teaching hospital in Iceland2010Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, nr 13-14, 1830-1837 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. The aim of this study was to explore the point prevalence of malnutrition and the targeting of nutritional interventions in relation to undernutrition risk before and after an intervention. Background. Malnutrition risk and the precision in targeting nutritional treatment are indicators of quality of care. Knowledge regarding the in-hospital prevalence of malnutrition and nutritional treatment is meagre for Iceland. Design. Pre- and postintervention study. Methods. The study was performed during one day in 2006 (March) and one day in 2007 (April). In total, 95 (89%) and 92 (88%) patients agreed to participate. Moderate/high undernutrition risk was defined as the occurrence of at least two of the following: involuntary weight loss, body mass index below limit and eating difficulties according to Minimal Eating Observation Form - Version II. Being overweight was graded based on body mass index. Specific nutritional care actions were recorded. Intervention: A five-point programme for nutrition and eating was implemented. Results. Moderate/high risk for undernutrition was found in 25 and 17% in the two years (ns, not significant). A high body mass index was found in 53 and 54% (ns). The number of patients with a documented body mass index significantly increased between the two surveys (1 and 30%, p-value < 0 center dot 0005). The use of oral supplements increased from 11-40% (p < 0 center dot 0005) and especially among those at no/low undernutrition risk, with ingestion or deglutition difficulties (p < 0 center dot 0005 in both cases) but not among those with appetite and energy problems (ns). Conclusion. Implementing a nutritional programme does not necessarily affect the number of in-patients with malnutrition, but it is likely to increase the precision of nutritional care to some extent. Relevance to clinical practice. Greater efforts need to be taken to increase the precision of nutritional care among patients at moderate/high undernutrition risk and among those with appetite and energy problems.

  • 159.
    Williams, Lauren
    et al.
    University of Newcastle, Callaghan, NSW.
    Germov, John
    University of Newcastle, Callaghan, NSW.
    Freij, Maria
    University of Newcastle, Callaghan, NSW.
    Is the Slow Food movement driven by environmental sustainability, health concerns or conviviality?2010Inngår i: Nutrition & Dietetics, ISSN 1747-0080, Vol. 67, nr Suppl. 1, 18-19 s.Artikkel i tidsskrift (Fagfellevurdert)
1234 151 - 159 of 159
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