How Trustworthy are Diagnoses of Malnutrition in Hospitalized Cancer Patients? A Comparison of Medical Record Diagnoses and Three Nutritional Assessment Indices

2.50
Hdl Handle:
http://hdl.handle.net/10755/164652
Category:
Abstract
Type:
Presentation
Title:
How Trustworthy are Diagnoses of Malnutrition in Hospitalized Cancer Patients? A Comparison of Medical Record Diagnoses and Three Nutritional Assessment Indices
Author(s):
Popp, J .; Brown, J.; Possinger, C.; Platek, M.; Savage, W.
Author Details:
J. Popp, University of Applied Sciences, Hamburg, Germany; J. Brown; C. Possinger; M. Platek; W. Savage
Abstract:
Malnutrition is a complex symptom management problem in cancer care, and the accurate diagnosis of malnutrition is critical to planning nursing interventions. Purpose: The purpose of our study was to examine the clinical differences in five accepted methods of diagnosing malnutrition. Theoretical/Scientific Framework: Using the First Law of Thermodynamics, physiological mechanisms, and the Quality Health Outcomes Model as a theoretical base, Methods: our correlational study compared the malnutrition diagnoses of physicians and dietitians with diagnoses based on three nutritional assessment indices in a retrospective analysis of medical record data of 288 admissions of lung, gastrointestinal or head and neck cancer patients at a comprehensive cancer care center in Buffalo, NY. The medical record data were abstracted by two RNs and one RD with interrater agreement of >90%. The nutritional assessment indices were body mass index (BMI); Swails et al. method using weight change, percent ideal body weight, and albumin; and the method described in the Manual of Clinical Dietetics using Swails’ indicators plus transferrin. Data Analysis: The prevalence of malnutrition according to each method was calculated, the diagnoses were compared to each other, and physiological indicators were correlated to physicians’ and dietitians’ diagnoses. Findings and Implications: The sample was 55.6% male with a mean age of 63 years (SD=13.5). The prevalence of malnutrition ranged from 5.9% according to physician diagnoses to 50.7% according to the Manual of Clinical Dietetics. The BMI index detected nearly twice as many malnourished cases (11.1%) as the physicians; whereas dietitians diagnosed 27.4% cases as malnourished. All methods agreed in diagnosing only one case as malnourished. Comparing the diagnoses of the methods with each other, the ratio of agreement versus disagreement ranged from 1.07 to 7.73. Dietitians’ diagnoses were weakly related (r = -.33 to -.42), and physicians’ diagnoses had no or very small relationships (r = -.07 to -.25) with physiologic indicators of malnutrition. Conclusions: There were enormous differences in the outcomes among different methods of diagnosing malnutrition. To base nutritional interventions on creditable diagnoses, consensus is needed on indicators used for nutritional assessment, and then they must be consistently applied in clinical practice.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2004
Conference Name:
29th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Anaheim, California, USA
Sponsors:
Funded by the ONS Foundation.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleHow Trustworthy are Diagnoses of Malnutrition in Hospitalized Cancer Patients? A Comparison of Medical Record Diagnoses and Three Nutritional Assessment Indicesen_GB
dc.contributor.authorPopp, J .en_US
dc.contributor.authorBrown, J.en_US
dc.contributor.authorPossinger, C.en_US
dc.contributor.authorPlatek, M.en_US
dc.contributor.authorSavage, W.en_US
dc.author.detailsJ. Popp, University of Applied Sciences, Hamburg, Germany; J. Brown; C. Possinger; M. Platek; W. Savageen_US
dc.identifier.urihttp://hdl.handle.net/10755/164652-
dc.description.abstractMalnutrition is a complex symptom management problem in cancer care, and the accurate diagnosis of malnutrition is critical to planning nursing interventions. Purpose: The purpose of our study was to examine the clinical differences in five accepted methods of diagnosing malnutrition. Theoretical/Scientific Framework: Using the First Law of Thermodynamics, physiological mechanisms, and the Quality Health Outcomes Model as a theoretical base, Methods: our correlational study compared the malnutrition diagnoses of physicians and dietitians with diagnoses based on three nutritional assessment indices in a retrospective analysis of medical record data of 288 admissions of lung, gastrointestinal or head and neck cancer patients at a comprehensive cancer care center in Buffalo, NY. The medical record data were abstracted by two RNs and one RD with interrater agreement of >90%. The nutritional assessment indices were body mass index (BMI); Swails et al. method using weight change, percent ideal body weight, and albumin; and the method described in the Manual of Clinical Dietetics using Swails’ indicators plus transferrin. Data Analysis: The prevalence of malnutrition according to each method was calculated, the diagnoses were compared to each other, and physiological indicators were correlated to physicians’ and dietitians’ diagnoses. Findings and Implications: The sample was 55.6% male with a mean age of 63 years (SD=13.5). The prevalence of malnutrition ranged from 5.9% according to physician diagnoses to 50.7% according to the Manual of Clinical Dietetics. The BMI index detected nearly twice as many malnourished cases (11.1%) as the physicians; whereas dietitians diagnosed 27.4% cases as malnourished. All methods agreed in diagnosing only one case as malnourished. Comparing the diagnoses of the methods with each other, the ratio of agreement versus disagreement ranged from 1.07 to 7.73. Dietitians’ diagnoses were weakly related (r = -.33 to -.42), and physicians’ diagnoses had no or very small relationships (r = -.07 to -.25) with physiologic indicators of malnutrition. Conclusions: There were enormous differences in the outcomes among different methods of diagnosing malnutrition. To base nutritional interventions on creditable diagnoses, consensus is needed on indicators used for nutritional assessment, and then they must be consistently applied in clinical practice.en_GB
dc.date.available2011-10-27T12:04:34Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:04:34Z-
dc.conference.date2004en_US
dc.conference.name29th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationAnaheim, California, USAen_US
dc.description.sponsorshipFunded by the ONS Foundation.-
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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