Measuring up. Could this simple nursing intervention help prevent osteoporosis?

Can self-reported height and weight be used among people living with HIV/AIDS?

To assess the reliability and validity of self-reported height and weight in adults living with HIV/AIDS (ALWHA) we assessed 508 ALWHA of both genders on antiretroviral therapy. Height and weight were directly measured in a subsample. Sensitivity and specificity analysis were performed to determine the validity of self-reported measures. Bland-Altman's method was used to calculate the limits of agreement between values while reliability was assessed using intraclass coefficients. Regression equations were devised to determine actual measures from self-reported values. Mean differences among measured and self-reported weight were -0.96 kg for men and -0.54 kg for women. Mean height differences were less than 2 cm, yielding good reliability for body mass index (BMI). Overweight (BMI ≥ 25 kg/m(2)) diagnosis sensitivity was 90.6% and specificity was 81.2%. Corrected measures determined by regression equations had stronger correlation with self-reported values (r > 0.980). Self-reported height and weight showed good reliability and validity compared with directly measured height and weight. However, measures should be corrected whenever possible to achieve higher accuracy.

Evaluation of the Accuracy of Height Assessment of Premenopausal and Menopausal Women

OBJECTIVE

To assess the accuracy of linear measurement of premenopausal and menopausal women.

DESIGN

Observational.

SETTING

OB/GYN practice in a university setting.

PARTICIPANTS

OB/GYN staff responsible for obtaining linear measurements.

MAIN OUTCOME MEASURES

Equipment utilized, technique for obtaining linear measurement, accuracy of linear measurement.

RESULTS

A research assistant observed six measurers measuring 64 women. Ninety four percent of measurements were inaccurate (p<.001) when compared to those of the research assistant. Measurements differed by as much as 18 cm from the research assistant (M=6.4 cm). Measurements obtained by measurers with more than 10 years of experience were significantly closer to the research assistant measurements than those obtained by less experienced measurers.

CONCLUSIONS

Inaccurate equipment, incorrect technique, and staff inexperience all contributed significantly to inaccuracy of linear measurement in a GYN practice. Correct equipment and staff education are needed. Accurate linear measurements must be obtained to allow for valid clinical decisions regarding the need for hormone replacement therapy based on loss of stature of menopausal women.

Osteoporosis prevention starts in adolescence

PURPOSE

To review the factors that influence the development of osteoporosis later in life, to relate those factors to adolescent health behaviors, and to provide nurse practitioners (NPs) with information on which to base evaluation and management decisions in primary care.

DATA SOURCES

Review of selected scientific literature with a focus on adolescent health and osteoporosis.

CONCLUSIONS

Osteoporosis is a major public health concern that affects more than 10 million people in the United States, resulting in annual costs to our health care system in excess of 13.5 billion dollars. Approximately 40% of women will experience a fracture due to osteoporosis. NPs should aim osteoporosis prevention efforts toward adolescents by encouraging habits that promote bone growth and development.

IMPLICATIONS FOR PRACTICE

It is imperative that female adolescents achieve adult peak bone mass prior to the age of 30, and the bone-building years before the age of 18 are especially important. NPs are ideally positioned to provide the screening and counseling to ensure that adolescents have the best chance to develop the habits that will result in peak adult bone mass.

Accuracy of self-reported height and weight in women: an integrative review of the literature

Height and weight are two of the most commonly used anthropometric measurements in clinical practice and research. Self-reported height and weight measurement is a simple, efficient, inexpensive, and non-invasive method of collecting data from large numbers of people. This integrative review of the published research examined the accuracy of self-reported height and weight measurements in women. Twenty-six studies examined the accuracy of self-reported height in 39,244 women. Twenty-one of the studies found that women overestimate height. Thirty-four studies reviewed the accuracy of self-reported weight in 57,172 women, and all 34 studies reported that women underestimated weight. Although mean variations between self-reported and measured values were small, a significant percentage of women in study groups had very large errors. Inaccurate measurements of both height and weight can cause significant inaccuracies in calculation of body mass index, which is used as a guide for identifying persons at risk for disease. These findings indicate that direct measurement of height and weight should be performed whenever possible for optimal measurements in clinical practice and clinically oriented research.

The relationship of actual height loss with health-seeking behaviors and risk factors in perimenopausal and menopausal women

PURPOSE

To explore whether there is a difference in the perceived height and actual height in the perimenopausal or menopausal woman and discover the difference's effect on osteoporosis health-seeking preventive behaviors and risk factor awareness.

DATA SOURCES

Sixty-three perimenopausal and menopausal women, aged 45-70 years, who presented at three Midwestern clinics for their annual physical exam. Data were collected with The Osteoporosis Questionnaire, which included the Osteoporosis Risk Questionnaire, Health-O-Meter height measuring stick, tape measure with inch-rule for arm span measurements, and balance scale for weight.

CONCLUSIONS

There were a significant relationship between actual height loss and osteoporosis risk factors (r = 0.41595, p = 0.0007) and a trend for a relationship between adjusted height loss and osteoporosis risk factors (r = 0.2407, p = 0.0574).

IMPLICATIONS FOR PRACTICE

Due to the great expense of current testing for bone mass density loss, the results of this study may help clinicians more readily identify markers for increased risk of osteoporosis through simple height measurements and osteoporosis risk factor assessments during annual visits.