Development and Validation of a Nutritional Risk Screening Scale for Stroke Patients

Abstract

IntroductionStroke is a global health problem, and around 62% of stroke patients suffer from malnutrition due to dysphagia, eating speed, or stress response. This study aimed to develop a Nutritional Risk Screening Scale for Stroke Patients (NRSS-SP).Material and methodsIn the current study we construct a theoretical framework by combining stroke characteristics, the risk factors of malnutrition in stroke patients, and clinical experience. Then, using the Delphi method, we formed a pool for entries and combined the opinions and suggestions discussed by experts in a research team. Next, we collected all of the data and information, categorized, merged, and split the pool of entry items' contents. Finally, we formed a pretest scale comprising 11 items after scoring their importance.ResultsThe pretest NRSS-SP comprised 10 items in three fields: physical, psychological, and independence. The score was assigned to each factor according to the evaluation results. (e.g., Disease severity, serum albumin and dysphagia: Score 3, age ≥70 years: Score 1). The cumulative effect of four factors (depression, anxiety, serum level of albumin, and body mass index (BMI)) was 65.512%. The item-level Content Validity Index (CVI) of the NRSS-SP ranged from 0.081 to 1.000, and the scale-level CVI was 0.912. The coefficient of Cronbach’s α ranged from 0.822 to 0.911.ConclusionsAn NRSS-SP (including National Institutes of Health Stroke Scale score, BMI, serum level of albumin, recent weight loss, recent food intake, dysphagia, age, depression, anxiety, and Barthel Index) score ≥6.5 was classified as a malnourishment risk; an NRSS-SP score <6.5 denoted normal nutrition.