Pembentukan alat peny aringan risiko malpemakanan hospital (MRST -H) untuk mengenalp asti malpemakanan di kalangan pesakit warga tua

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dc.contributor.authorHarith, Sakinah
dc.date.accessioned2015-06-09T05:15:02Z
dc.date.available2015-06-09T05:15:02Z
dc.date.issued2006
dc.description.abstractHospitalised elderly patients are at risk of malnutrition due to the presence of chronic diseases and inadequate food intake. Therefore, a malnutrition risk screening tool - hospital (MRST -H) was developed to identify malnutrition among elderly patients in hospital. The study involved four phases. The first phase focused on the validation of malnutrition risk screening tool which was formerly developed for community use (MRST-C). The validation study was conducted among 181 elderly patients (83 men, 98 women; mean age: 73.4 ± 6.2 years; range: 65 to 90 years) upon admission to University Malaya Medical Center (UMMC). The MRST -C was validated using standard indicators such as Subjective Global Assessment (SGA), Mini Nutritional Assessment-Short Form (MNA-SF), Body Mass Index (BMI), mid upper arm circumference (MUAC), calf circumference (CC), albumin, hemoglobin, total lymphocyte count and cholesterol. Results indicated the MRST -C had low validity and unsuitable for hospital use due to its low sensitivity (0.0- 19.1)%, specificity (84.8- 88.0)% and positive predictive values (0.0 - 40.0)%. In addition, MNA-SF also indicated low validity of sensitivity (0.0 - 80.8)%, specificity (77.9 - 90.6)% and positive predictive values (0.0- 75.0)% respectively. Therefore, in the second phase a new MRST i.e MRST -H for hospital use was developed using logistic regression analysis. The MRST -H consisted of five questions to screening the malnutrition which were 'had muscle wasting as assessed by mid upper arm circumference', 'had muscle wasting as assessed by calf circumference', 'weight loss during last month or six months ago', 'dependant on others for economic resources' and 'unable to eat without assistance'. A favourable result was obtained using MRST-H with better sensitivity, specificity and positive predictive values of 40.0%, 94.7% and 74.1 %, respectively. In the third phase, MRST-H was validated among 100 elderly patients (37 men, 63 women; mean age: 73.1 ± 6.0 years; range: 65 to 95 years) upon newly admitted to the ward in Kuala Lumpur Hospital. MRST -H was validated against SGA, BMI, MUAC and CC indicators. Results indicated that MRST-H was acceptable with high sensitivity (88.2- 100)%, specificity (83.1- 98.8)% and positive predictive values (54.8- 93.8)% respectively. In the fourth phase, MRST-H was tested for reliability by a researcher and two nurses. This test was performed among 40 elderly patients (1 0 men, 30 women; mean age: 74.8 ± 6.8 years; range: 66 to 92 years) in UMMC. Results indicated that the agreement percentage and Kappa index value were excellent and almost similar among the researcher and nurse B [87.5%, (kappa = 0.89)] and nurse A [81.3%, (kappa = 0.84)]. While, 'intra-class correlation' (ICC) (95% CI) value indicated an excellent response from the three raters [0.93 (0.88- 0.96) (p<0.0001)]. In summary, MRST-H is a valid and reliable screening tool and can be used widely by health professionals in clinical setting to identify hospitalised elderly patients at high risk of malnutrition.en_US
dc.identifier.urihttp://hdl.handle.net/123456789/798
dc.language.isootheren_US
dc.subjectAlat penyaringanen_US
dc.subjectMalpemakananen_US
dc.subjectWarga tuaen_US
dc.titlePembentukan alat peny aringan risiko malpemakanan hospital (MRST -H) untuk mengenalp asti malpemakanan di kalangan pesakit warga tuaen_US
dc.typeThesisen_US
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