magistrsko delo Management kakovosti, Management kakovosti storitev
Tatjana Kosten (Author), Zvone Balantič (Mentor), Mitja Lainščak (Co-mentor)

Abstract

Izhodišča Podhranjenost je velik problem bolnikov v bolnišnicah. Identificiramo jo lahko s prehranskim presejanjem. Bolniki s podhranjenostjo imajo daljšo ležalno dobo, slabši izid zdravljenja in slabšo prognozo, zato je pomembno, da podhranjenost prepoznamo in jo poskušamo obravnavati. Namen V raziskavi smo želeli preveriti, ali so vsa orodja za oceno prehranjenosti enaka in ali obstaja povezava med rezultati, pridobljenimi z orodji in izmerjeno telesno sestavo. Raziskovalna metodologija V prospektivno raziskavo, kjer smo primerjali šest presejalnih orodij za oceno prehranjenosti bolnikov, smo vključili 336 bolnikov. Oceno prehranjenosti smo opravili s šestimi orodji za oceno prehranjenosti: MNA - Mini Nutritional Assessment, NRS 2002 - Nutritional Risk Screening 2002, MUST- Malnutrition Universal Screening Tool, NRI - Nutritional Risk Index, SGA - Subjective Global Assessment in GNRI - Geriatric Nutritional Risk Factor. Opravili smo antropometrične meritve, merjenje telesne sestave z bioelektrično impedanco in pridobili rezultate ostalih preiskav. Iz medicinske dokumentacije smo povzeli podatke o demografskih značilnostih in sočasnih obolenjih. Podatke smo analizirali s programom SPSS 19.0 (SPSS INC, 2010, USA) in Excell 2010. Numerične spremenljivke smo predstavili s srednjo vrednostjo in standardnim odklonom, kategorične spremenljivke pa smo predstavili z absolutnim številom in odstotkom. Razlike med spremenljivkami smo analizirali s Student´s t testom, Mann Whitneyjevim U-testom in hi-kvadrat testom. Morebitne povezave med spremenljivkami smo ocenjevali z metodo korelacije in izračunali koeficient kapa. Rezultati Povprečna starost vključenih bolnikov je bila 67,42 ± 13,68 let, 52,4 % je bilo moških. Podhranjenih glede na orodja MNA, NRS 2002, MUST, SGA, NRI, GNRI je bilo 8,6 %, 9,5 %, 15,5 %, 8,3 %, 25,5 %, 3,6 % vključenih bolnikov. Tveganje za podhranjenost smo opazili pri 34,5 %, 0%, 12,2 %, 43,2 %, 6,7 % in 6,2 % bolnikov. Pri vseh orodjih so imeli dobro prehranjeni bolniki značilno boljše 6-mesečno preživetje od podhranjenih bolnikov. (p < 0,001 za vse). Bolniki s podhranjenostjo ocenjeni z MNA, NRS 2002 in NRI so imeli statistično značilno daljšo ležalno dobo od dobro prehranjenih bolnikov (p < 0,05). Dobro prehranjeni bolniki so imeli značilno višji FFMI od bolnikov s podhranjenostjo. Zaključki Ugotovili smo, da z različnimi orodji za prehransko presejanje identificiramo različne odstotke podhranjenih bolnikov. Pri vprašalnikih MNA, NRI, SGA, MUST in NRS 2002 imajo podhranjeni bolniki slabše preživetje od bolnikov s tveganjem za podhranjenost in od dobro prehranjenih bolnikov. Pri vseh orodjih imajo podhranjeni bolniki daljšo ležalno dobo in nižji FFMI kot dobro prehranjeni bolniki.

Keywords

prehranjenost;orodja za oceno prehranjenosti;pusta mišična masa;

Data

Language: Slovenian
Year of publishing:
Typology: 2.09 - Master's Thesis
Organization: UM FOV - Faculty of Organizational Sciences
Publisher: [T. Kosten]
UDC: 613.2
COBISS: 7601171 Link will open in a new window
Views: 1976
Downloads: 272
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Other data

Secondary language: English
Secondary title: Comparison of nutritional status screening tools in Clinik Golnik hospitalized patients
Secondary abstract: Background Malnutrition is a major problem of hospitalized patients. We identify them with nutritional screening tools. Patients with malnutrition have a longer hospital stay, a worse clinical outcome, more complications and it is therefore important to identify malnutrition and try to treat it. Aim The aim of the study was to compare six tools for the assessment of the nutritional status by means of body composition measurements. We wanted to determine which tool is the most appropriate for patients at the University Clinic Golnik. Methods The prospective study, in which we compared six screening tools used to assess the nutritional status of patients, included 336 patients. We used six tools for the assessment of the nutritional status: MNA (Mini Nutritional Assessment), NRS 2002 (Nutritional Risk Screening 2002), MUST (Malnutrition Universal Screening Tool), NRI (Nutritional Risk Index) and SGA (Subjective Global Assessment) and GNRI (Geriatric Nutritional Risk Factor). We performed antropometric measurements, measured the body composition by bioelectric impedance and obtained the results of other examinations. We obtained data on demographic characteristics and contemporary diseases from medical records. Data was analyzed with the SPSS 19.0 (SPSS INC 2010, USA) and Excel 2010. Numerical variables were presented with the mean and standard deviation. Categorical variables were presented with the absolute number and percentage. Differences between the variables were analyzed with the Student's t test, the Mann-Whitney U test and the chi-square test. We evaluated potential links between the variables with correlation method, and we calculated the kappa coefficient. Results The average age of participating patients was 67.42 ± 13.68 years, 52.4% were male. We identified malnourished patients with MNA, NRS 2002, MUST, SGA, NRI, GNRI in 8.6 %, 9.5 %, 15.5 %, 8.3 %, 25.5 %, 3.6 % of patients, respectively. The risk of malnutrition was detected in 34.5 %, 0 %, 12.2 %, 43.2 %, 6.7 % and 6.2 % of patients, respectively. Well- nourished patients had a significantly better 6-month survival compared to malnourished patients (p < 0.001 for all) according to all tools. Malnourished patients assessed with MNA, NRS 2002, NRI had a significantly longer length of hospital stay than well-nourished patients (p < 0.05). Well-nourished patients had a significantly higher FFMI compared to patients with malnutrition. Conclusions We have discovered that a variety of tools for nutritional screening identifies different percentages of malnourished patients. In the MNA, NRI, SGA, MUST and NRS 2002 questionnaires malnourished patients have a worse survival rate compared to patients at risk of malnutrition and compared to well-nourished patients. Malnourished patients have a longer length of hospital stay and lower FFMI than well-nourished patients according to all tools.
Secondary keywords: nutrition;screening tools for nutritional status;fat-free mass;nutritional assessment;fat-free mass index;
URN: URN:SI:UM:
Type (COBISS): Master's thesis
Thesis comment: Univ. v Mariboru, Fak. za organizacijske vede
Pages: 76 f.
ID: 9140660