Nationwide survey of nutritional management in an Asian upper-middle income developing country government hospitals: Combination of quantitative survey and focus group discussion

Chittawatanarat, Kaweesak; Tosanguan, Kakanang; Chaikledkaew, Usa; Tejavanija, Sirakarn; Teerawattananon, Yot

doi:10.1016/j.clnesp.2016.04.031

Cited by 4 publications

(4 citation statements)

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“…Experts agree that early interventions ensure the effectiveness of nutritional therapy [ 9 ]. Furthermore, according to a nationwide study in Asia, whether or not to perform nutritional screening as a routine has a major impact on nutritional work processes and the methods of nutritional support [ 10 ]. That is why guidelines emphasize on routine nutritional screening on admission [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Current status of nutritional support for hospitalized children: a nationwide hospital-based survey in South Korea

2018

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BACKGROUND/OBJECTIVESThe prevalence of malnutrition among hospitalized children ranges between 12% and 24%. Although the consequences of hospital malnutrition are enormous, it is often unrecognized and untreated. The aim of this study was to identify the current status of in-hospital nutrition support for children in South Korea by carrying out a nationwide hospital-based survey.SUBJECTS/METHODSOut of 345 general and tertiary hospitals in South Korea, a total of 53 institutes with pediatric gastroenterologists and more than 10 pediatric inpatients were selected. A questionnaire was developed by the nutrition committee of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition. The questionnaires were sent to pediatric gastroenterologists in each hospital. Survey was performed by e-mails.RESULTSForty hospitals (75.5%) responded to the survey; 23 of them were tertiary hospitals, and 17 of them were general hospitals. Only 21 hospitals (52.5%) had all the required nutritional support personnel (including pediatrician, nutritionist, pharmacist, and nurse) assigned to pediatric patients. Routine nutritional screening was performed in 22 (55.0%) hospitals on admission, which was lower than that in adult patients (65.8%). Nutritional screening tools varied among hospitals; 33 of 40 (82.5%) hospitals used their own screening tools. The most frequently used nutritional assessment parameters were weight, height, hemoglobin, and serum albumin levels. In our nationwide hospital-based survey, the most frequently reported main barriers of nutritional support in hospitals were lack of manpower and excessive workload, followed by insufficient knowledge and experience.CONCLUSIONSAlthough this nationwide hospital-based survey targeted general and tertiary hospitals with pediatric gastroenterologists, manpower and medical resources for nutritional support were still insufficient for hospitalized children, and nutritional screening was not routinely performed in many hospitals. More attention to hospital malnutrition and additional national policies for nutritional support in hospitals are required to ensure appropriate nutritional management of hospitalized pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Current status of nutritional support for hospitalized children: a nationwide hospital-based survey in South Korea

2018

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“…as used in the PG-SGA form, were still difficult for professionals. In Thailand, the tools used for nutrition screening/ assessment were found to be varied and the PG-SGA at present does not appear to be a commonly used assessment tool (8). Therefore, training to improve the level of skills or knowledge and providing instruction for the professional component may improve the difficulty of the Thai PG-SGA in healthcare professionals (133).…”

Section: Agreement In the Classification Of Nutritional Status Betwee...mentioning

confidence: 99%

“…They tend to focus on treatments. Chittawatanarat et al ( 2012) mentioned that in Thailand nutrition screening and assessment tools are varied among hospitals, making data collection and standardization complicated and difficult to compare the results between them ( 8) . They studied gap analysis of diagnostic and treatment of hospital malnutrition in Thailand by sending the evaluation questionnaire covering accessibility of nutritional care during hospitalization to 273 government base hospitals across all region of Thailand.…”

Section: Introduction 11 Background and Rationalementioning

confidence: 99%

“…They studied gap analysis of diagnostic and treatment of hospital malnutrition in Thailand by sending the evaluation questionnaire covering accessibility of nutritional care during hospitalization to 273 government base hospitals across all region of Thailand. The report stated that only 38% of returned questionnaires provided nutrition screening and assessment in their units (8).…”

Section: Introduction 11 Background and Rationalementioning

confidence: 99%

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Translation, cross-cultural adaptation, and validation of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in Thai cancer patients

Nitichai

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The Scored Patient-Generated Subjective Global Assessment (PG-SGA) is a multidimensional tool to assess malnutrition and risk factors. At present, there is no official Thai translation and cultural adaptation of the PG-SGA available. Health professionals should be able to obtain and utilize valid and reliable tools matched with their own languages and cultures to further produce high quality patient care. The primary objective of this study is to translate and culturally adapt the original PG-SGA for the Thai setting and evaluate perceived comprehensibility, difficulty, content validity and intra-rater reliability of the Thai PG-SGA in cancer patients and healthcare professionals. In addition, this study aimed to determine the validity of the Thai version of the Scored PG-SGA and examine the correlations between clinical variables and nutritional instrument tools. The study consists of two parts. In the first part, the PG-SGA was translated and culturally adapted using the International Society for Pharmacoeconomics and Outcomes Research Principles. In 50 cancer patients and 50 healthcare professionals, perceived comprehensibility and difficulty of the Thai PG-SGA were assessed with the Scale Comprehensibility Index (S-CI) and Scale Difficulty Index (S-DI), using a 4-point scale. Content validity, i.e. relevance, was assessed in the professionals only, by Scale Content Validity Index (S-CVI). Intra-rater reliability (test-retest within 72 hours of admission) was tested by the Intraclass Correlation Coefficient (ICC) and weighted kappa (?). In the second part, 195 cancer patients were enrolled to the study. Nutritional status assessed by the Thai PG-SGA and Subjective Global Assessment (SGA), anthropometry, dietary intake, handgrip strength and laboratory data were collected. The results revealed that the systematically translated Thai version of PG-SGA needed 4 cultural adaptations. It showed excellent comprehensibility (S-CI=0.99) and difficulty (S DI=0.95) as perceived by patients. It also showed excellent comprehensibility (S-CI= 0.92) and borderline acceptable difficulty (S-DI=0.79) reflected by professionals. Its relevance in assessing malnutrition was excellent (S-CVI=0.95). Agreement between numerical scores was good to excellent (ICC=0.95), and between PG-SGA categories was very good (?=0.95). The Thai PG-SGA had high sensitivity (99%), specificity (86%) and accuracy (93%) compared to SGA. The prevalence of malnutrition assessed by using the Thai PG-SGA was 62%. It had perfect agreement with SGA in classification of nutritional status. In addition, the nutritional status by each instrument was correlated with anthropometric parameters, body fat, laboratory parameters, dietary intake and hand grip strength (p < 0.05). In conclusion, the Thai version of the PG-SGA is now available and considered very easy to complete by patients, very comprehensible and relevant by professionals, and as borderline acceptable regarding difficulty to complete. It is a valid and reliable nutrition instrument tool in predicting malnutrition among cancer patients.

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Characteristics of hospitalized patients prescribed oral nutrition supplements in Thailand: A cross-sectional nutrition day survey

Rattanachaiwong

Warodomwichit

Yamwong

et al. 2019

Clinical Nutrition ESPEN

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Nationwide survey of nutritional management in an Asian upper-middle income developing country government hospitals: Combination of quantitative survey and focus group discussion

Cited by 4 publications

References 19 publications

Current status of nutritional support for hospitalized children: a nationwide hospital-based survey in South Korea

Current status of nutritional support for hospitalized children: a nationwide hospital-based survey in South Korea

Translation, cross-cultural adaptation, and validation of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in Thai cancer patients

Characteristics of hospitalized patients prescribed oral nutrition supplements in Thailand: A cross-sectional nutrition day survey

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