|
1
|
Pemau RC, González-Palacios P, Kerr KW. How quality of life is measured in studies of nutritional intervention: a systematic review. Health Qual Life Outcomes 2024; 22:9. [PMID: 38267976 PMCID: PMC10809546 DOI: 10.1186/s12955-024-02229-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Nutrition care can positively affect multiple aspects of patient's health; outcomes are commonly evaluated on the basis of their impact on a patient's (i) illness-specific conditions and (ii) health-related quality of life (HRQoL). Our systematic review examined how HRQoL was measured in studies of nutritional interventions. To help future researchers select appropriate Quality of Life Questionnaires (QoLQ), we identified commonly-used instruments and their uses across populations in different regions, of different ages, and with different diseases. METHODS We searched EMCare, EMBASE, and Medline databases for studies that had HRQoL and nutrition intervention terms in the title, the abstract, or the MeSH term classifications "quality of life" and any of "nutrition therapy", "diet therapy", or "dietary supplements" and identified 1,113 studies for possible inclusion.We then reviewed titles, abstracts, and full texts to identify studies for final inclusion. RESULTS Our review of titles, abstracts, and full texts resulted in the inclusion of 116 relevant studies in our final analysis. Our review identified 14 general and 25 disease-specific QoLQ. The most-used general QoLQ were the Short-Form 36-Item Health Survey (SF-36) in 27 studies and EuroQol 5-Dimension, (EQ-5D) in 26 studies. The European Organization for Research and Treatment of Cancer Quality of life Questionnaire (EORTC-QLQ), a cancer-specific QoLQ, was the most frequently used disease-specific QoLQ (28 studies). Disease-specific QoLQ were also identified for nutrition-related diseases such as diabetes, obesity, and dysphagia. Sixteen studies used multiple QoLQ, of which eight studies included both general and disease-specific measures of HRQoL. The most studied diseases were cancer (36 studies) and malnutrition (24 studies). There were few studies focused on specific age-group populations, with only 38 studies (33%) focused on adults 65 years and older and only 4 studies focused on pediatric patients. Regional variation in QoLQ use was observed, with EQ-5D used more frequently in Europe and SF-36 more commonly used in North America. CONCLUSIONS Use of QoLQ to measure HRQoL is well established in the literature; both general and disease-specific instruments are now available for use. We advise further studies to examine potential benefits of using both general and disease-specific QoLQ to better understand the impact of nutritional interventions on HRQoL.
Collapse
Affiliation(s)
| | - Patricia González-Palacios
- Department of Nutrition and Food Science, University of Granada, Granada, Spain
- Biomedical Research Institute (IBS), Granada, Spain
| | - Kirk W Kerr
- Abbott Nutrition, 2900 Easton Square Place, Columbus, OH, 43219, USA.
| |
Collapse
|
|
2
|
Gheri CF, Scalfi L, Biffi B, Pancani S, Madiai S, Di Vincenzo O, Ghaderi M, Celoni R, Dalladonna M, Draghi F, Maccanti D, Macchi C, Romoli AM, Cecchi F, Hakiki B, Luisi MLE. Relationship between Nutritional Risk, Clinical and Demographic Characteristics, and Pressure Ulcers in Patients with Severe Acquired Brain Injuries Attending a Rehabilitative Program. Nutrients 2023; 15:3336. [PMID: 37571274 PMCID: PMC10421108 DOI: 10.3390/nu15153336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Preliminary evidence in the literature suggests a high prevalence of malnutrition (undernutrition) in patients with severe acquired brain injuries (sABI), with an expected negative impact on clinical outcomes and pressure ulcers (PUs) in particular. In a retrospective cohort study on patients discharged from intensive care units (ICU) and admitted to an intensive rehabilitation unit (IRU), the risk of malnutrition was systematically assessed, in addition to standard clinical procedures (including PUs evaluation), using two different tools: the Malnutrition Universal Screening Tool (MUST) and the Controlling Nutritional Status (CONUT) tool. Eighty-eight patients were included in the analysis. A high proportion (79.5%) of patients with sABI suffered from PUs, being older and more frequently men, with a longer ICU stay between the event and admission to IRU, and a greater MUST score. At discharge, when compared to patients whose PUs had healed, those with persisting PUs were more often men and had the worst cognitive performance at admission. As for nutritional risk, the baseline CONUT score was identified as an independent negative predictor of PUs at discharge by the logistic regression model. In conclusion, the assessment of nutritional risk using simple standard tools may be useful in the clinical evaluation of sABI patients with PUs.
Collapse
Affiliation(s)
- Chiara Francesca Gheri
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
| | - Luca Scalfi
- Human Nutrition and Dietetics, Department of Public Health, Federico II University, 80131 Naples, Italy; (L.S.); (O.D.V.)
- Santa Maria del Pozzo Private Hospital, Somma Vesuviana, 80049 Naples, Italy
| | - Barbara Biffi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
| | - Silvia Pancani
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
| | - Sara Madiai
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
| | - Olivia Di Vincenzo
- Human Nutrition and Dietetics, Department of Public Health, Federico II University, 80131 Naples, Italy; (L.S.); (O.D.V.)
| | - Michele Ghaderi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
| | - Rebecca Celoni
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
| | - Mara Dalladonna
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
| | - Francesca Draghi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
| | - Daniela Maccanti
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 50134 Florence, Italy
| | - Anna Maria Romoli
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 50134 Florence, Italy
| | - Bahia Hakiki
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
| | - Maria Luisa Eliana Luisi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy (S.P.); (M.G.); (R.C.); (M.D.); (F.D.); (D.M.); (C.M.); (A.M.R.); (F.C.); (B.H.); (M.L.E.L.)
| |
Collapse
|
|
3
|
Shakhshir M, Alkaiyat A. Healthcare providers' knowledge, attitude, and practice on quality of nutrition care in hospitals from a developing country: a multicenter experience. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:15. [PMID: 36879345 PMCID: PMC9990276 DOI: 10.1186/s41043-023-00355-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Despite the fact that malnutrition can affect both recovery and outcome in acute care patients, little is known about malnutrition in Palestine, and even less is known about the assessment of malnutrition knowledge, attitudes, and practices (M-KAP) toward healthcare providers and nutrition care quality measures in hospitalized patients. Therefore, this study aimed to evaluate the M-KAP of physicians and nurses in routine clinical care and determine the influencing factors. METHODS From April 1 to June 31, 2019, cross-sectional research was performed at governmental (n = 5) and non-governmental (n = 4) hospitals in the North West Bank of Palestine. Data were collected using a structured self-administered questionnaire from physicians and nurses to collect information on knowledge, attitude, and practices related to malnutrition and nutrition care, alongside sociodemographic characteristics. RESULTS A total of 405 physicians and nurses were participated in the study. Only 56% of participants strongly agreed that nutrition was important, only 27% strongly agreed that there should be nutrition screening, only 25% felt food helped with recovery, and around 12% felt nutrition as part of their job. Approximately 70% of participants said they should refer to a dietitian, but only 23% knew how and only 13% knew when. The median knowledge/attitude score was 71, with an IQR ranging from 65.00 to 75.00, and the median practice score was 15.00 with an IQR of 13.00-18.00. The mean knowledge attitude practice score was 85.62 out of 128 with SD (9.50). Respondents who worked in non-governmental hospitals showed higher practice scores (p < 0.05), while staff nurses and ICU workers showed the highest practice score (p < 0.001). Respondents with younger age categories, working in non-governmental hospitals in the ICU as practical and staff nurses, showed the highest KAP score (p < 0.05). Significance positive correlations were found between respondents' knowledge/attitude and practice scores regarding the quality of nutrition care in hospitals (r = 0.384, p value < 0.05). In addition, the result also revealed that almost half of respondents believed that the most important barriers to inadequate intake of food at the bedside are related to food appearance, taste, and aroma of meals served (58.0%). CONCLUSIONS The research revealed that inadequate knowledge was perceived as a barrier to effective nutrition care to the patient. Many beliefs and attitudes do not always translate into practice. Although the M-KAP of physicians and nurses is lower than in some other countries/studies, it highlights a strong need for more nutrition professionals in the hospital and increasing nutrition education to improve nutrition care in hospitals in Palestine. Furthermore, establishing a nutrition task force in hospitals elaborated by dietitians as the unique nutrition care provider will assure to implementation of a standardized nutrition care process.
Collapse
Affiliation(s)
- Muna Shakhshir
- Department of Nutrition, An-Najah National University Hospital, Nablus, 44839 Palestine
- Health Division, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Abdulsalam Alkaiyat
- Health Division, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| |
Collapse
|
|
4
|
García-Almeida JM, García-García C, Ballesteros-Pomar MD, Olveira G, Lopez-Gomez JJ, Bellido V, Bretón Lesmes I, Burgos R, Sanz-Paris A, Matia-Martin P, Botella Romero F, Ocon Breton J, Zugasti Murillo A, Bellido D. Expert Consensus on Morphofunctional Assessment in Disease-Related Malnutrition. Grade Review and Delphi Study. Nutrients 2023; 15:nu15030612. [PMID: 36771319 PMCID: PMC9920608 DOI: 10.3390/nu15030612] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/27/2023] Open
Abstract
Disease-related malnutrition (DRM) affects approximately a third of hospitalized patients and is associated with an increased risk of morbimortality. However, DRM is often underdiagnosed and undertreated. Our aim is to evaluate the prognostic value of morphofunctional tools and tests for nutritional assessment in clinical practice. A systematic literature review was conducted to identify studies relating to the morphofunctional assessment of nutritional status and mortality or complications. Evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) method. Twelve GRADE recommendations were made and divided into seven topics: food intake and nutrient assimilation, anthropometry, biochemical analysis, hand grip strength, phase angle, muscle imaging, and functional status and quality of life. From these recommendations, 37 statements were developed and scored in a two-survey Delphi method by 183 experts. A consensus was reached on accepting 26/37 statements. Surveys had high internal consistency and high inter-rater reliability. In conclusion, evidence-based recommendations were made on the prognostic value of morphofunctional assessment tools and tests to assess malnutrition, most of which were found to be feasible in routine clinical practice, according to expert opinions.
Collapse
Affiliation(s)
- José Manuel García-Almeida
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de la Victoria, 29010 Málaga, Spain
- IBIMA, Instituto de Investigación Biomédica y Plataforma en Nanomedicina, BIONAND, 29590 Málaga, Spain
- CIBEROBN, Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y Nutrición, 28029 Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Quirónsalud, 29004 Málaga, Spain
- Facultad de Medicina, University of Málaga, 29010 Málaga, Spain
| | - Cristina García-García
- PhD Program in Biomedicine, Translational Research and New Health Technologies, Faculty of Medicine, University of Málaga, 29071 Málaga, Spain
- Medical Director, Persan Farma, 35007 Las Palmas de Gran Canaria, Spain
- Correspondence: ; Tel.: +34-670326887
| | - María D. Ballesteros-Pomar
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, 24071 León, Spain
| | - Gabriel Olveira
- IBIMA, Instituto de Investigación Biomédica y Plataforma en Nanomedicina, BIONAND, 29590 Málaga, Spain
- Facultad de Medicina, University of Málaga, 29010 Málaga, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- CIBERDEM, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 29010 Málaga, Spain
- Department of Medicine and Dermatology, University of Málaga, 29016 Málaga, Spain
| | - Juan J. Lopez-Gomez
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Virginia Bellido
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain
| | - Irene Bretón Lesmes
- Department of Endocrinology and Nutrition, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Rosa Burgos
- Nutritional Support Unit, Vall d’Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
| | - Alejandro Sanz-Paris
- Department of Endocrinology and Nutrition, University Hospital Miguel Servet, 50009 Zaragoza, Spain
- Instituto de Investigación Sanitaria (IIS) Aragón, 50009 Zaragoza, Spain
| | - Pilar Matia-Martin
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, 28040 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
- Medicine Department, Universidad Complutense, 28040 Madrid, Spain
| | - Francisco Botella Romero
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Albacete, 02006 Albacete, Spain
| | - Julia Ocon Breton
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain
| | - Ana Zugasti Murillo
- Nutrition Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Diego Bellido
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Ferrol, 15405 Ferrol, Spain
| |
Collapse
|