<p>Syfte: Undersöka den kriterierelaterade validiteten, mellanbedömarreliabiliteten och användarvänligheten för MEONF, ett screeninginstrument för bedömning av risk för undernäring. Metoder: Hundra patienter inkluderades och nutritionsstatus bedömdes med Mini Nutritional Assessment (MNA) som här anses vara golden standard samt screenades med Malnutrition Universal Screening Tool (MUST) och Minimal Eating Observation and Nutrition Form (MEONF). Resultat: Sjuksköterskorna ansåg MEONFs instruktioner och frågor lätta att förstå, svara på (100 %) samt att frågorna var angelägna (98 %). Instrumentet hade acceptabel sensitivitet (0.83) och specificitet (0.78) jämfört med MNA. Sensitiviteten var högre än den som fanns mellan MUST och MNA (0.57). När BMI ersattes med vadomkrets erhölls likvärdiga resultat (sensibilitet 0.83 specificitet 0.79) för MEONF i förhållande till MNA. Mellanbedömarreliabiliteten var hög (kappa 0.81). Sammanfattning: MEONF har bra validitet jämfört med MNA, med hög mellanbedömarreliabilitet. När BMI ersattes med vadomkrets bibehölls precisionen vilket är viktigt när vikt och längd är svåra att erhålla. Hög sensitivitet är angeläget vid screening för undernäring och i det avseendet fungerar MEONF bättre än MUST. En fundamental vinst med MEONF är att instrumentets kriterier upplevs som meningsfulla, för att vissa svårigheter kan avhjälpas med omvårdnadsåtgärder.</p><p>Syfte: Undersöka den kriterierelaterade validiteten, mellanbedömarreliabiliteten och användarvänligheten för MEONF, ett screeninginstrument för bedömning av risk för undernäring.</p><p>Metoder: Hundra patienter inkluderades och nutritionsstatus bedömdes med Mini Nutritional Assessment (MNA) som här anses vara <em>golden standard</em> samt screenades med Malnutrition Universal Screening Tool (MUST) och Minimal Eating Observation and Nutrition Form (MEONF).</p><p>Resultat: Sjuksköterskorna ansåg MEONFs instruktioner och frågor lätta att förstå, svara på (100 %) samt att frågorna var angelägna (98 %). Instrumentet hade acceptabel sensitivitet (0.83) och specificitet (0.78) jämfört med MNA. Sensitiviteten var högre än den som fanns mellan MUST och MNA (0.57). När BMI ersattes med vadomkrets erhölls likvärdiga resultat (sensibilitet 0.83 specificitet 0.79) för MEONF i förhållande till MNA. Mellanbedömarreliabiliteten var hög (kappa 0.81).</p><p>Sammanfattning: MEONF har bra validitet jämfört med MNA, med hög mellanbedömarreliabilitet. När BMI ersattes med vadomkrets bibehölls precisionen vilket är viktigt när vikt och längd är svåra att erhålla. Hög sensitivitet är angeläget vid screening för undernäring och i det avseendet fungerar MEONF bättre än MUST. En fundamental vinst med MEONF är att instrumentets kriterier upplevs som meningsfulla, för att vissa svårigheter kan avhjälpas med omvårdnadsåtgärder.</p> / <p>Rationale: Analyse the criterion related validity, interrater reliability and the usefulness of MEONF, an instrument for undernutrition risk screening. Methods: 100 patients were included and assessed with Mini Nutritional Assessment (MNA) regarded as golden standard and screened with Malnutrition Universal Screening Tool (MUST) as well as Minimal Eating Observation and Nutrition Form (MEONF). Results: Nurses regarded MEONF instructions and questions easy to understand, easy to answer (100%) and questions as being important (98%). It had acceptable sensitivity (0.83) and specificity (0.78) in relation to MNA. Sensitivity was higher than found between MUST and MNA (0.57). Replacing BMI with Calf Circumference (CC) gave equivalent results (sensibility 0.83, specificity 0.79) in relation to MNA. Interrater reliability was high (kappa 0.81). Conclusions: MEONF has good validity in relation to MNA and high interrater reliability. If replacing BMI with CC the precision is maintained, which is important in cases were weight or height is difficult to obtain. Having high sensitivity is a major concern for nutritional screening instruments and in that respect MEONF works better than MUST. One fundamental gain with MEONF is that the instruments criteria are experienced as clinically meaningful, in that some observed difficulties can be managed by nursing interventions.</p>

Syfte: Undersöka den kriterierelaterade validiteten, mellanbedömarreliabiliteten och användarvänligheten för MEONF, ett screeninginstrument för bedömning av risk för undernäring. Metoder: Hundra patienter inkluderades och nutritionsstatus bedömdes med Mini Nutritional Assessment (MNA) som här anses vara golden standard samt screenades med Malnutrition Universal Screening Tool (MUST) och Minimal Eating Observation and Nutrition Form (MEONF). Resultat: Sjuksköterskorna ansåg MEONFs instruktioner och frågor lätta att förstå, svara på (100 %) samt att frågorna var angelägna (98 %). Instrumentet hade acceptabel sensitivitet (0.83) och specificitet (0.78) jämfört med MNA. Sensitiviteten var högre än den som fanns mellan MUST och MNA (0.57). När BMI ersattes med vadomkrets erhölls likvärdiga resultat (sensibilitet 0.83 specificitet 0.79) för MEONF i förhållande till MNA. Mellanbedömarreliabiliteten var hög (kappa 0.81). Sammanfattning: MEONF har bra validitet jämfört med MNA, med hög mellanbedömarreliabilitet. När BMI ersattes med vadomkrets bibehölls precisionen vilket är viktigt när vikt och längd är svåra att erhålla. Hög sensitivitet är angeläget vid screening för undernäring och i det avseendet fungerar MEONF bättre än MUST. En fundamental vinst med MEONF är att instrumentets kriterier upplevs som meningsfulla, för att vissa svårigheter kan avhjälpas med omvårdnadsåtgärder. Syfte: Undersöka den kriterierelaterade validiteten, mellanbedömarreliabiliteten och användarvänligheten för MEONF, ett screeninginstrument för bedömning av risk för undernäring. Metoder: Hundra patienter inkluderades och nutritionsstatus bedömdes med Mini Nutritional Assessment (MNA) som här anses vara golden standard samt screenades med Malnutrition Universal Screening Tool (MUST) och Minimal Eating Observation and Nutrition Form (MEONF). Resultat: Sjuksköterskorna ansåg MEONFs instruktioner och frågor lätta att förstå, svara på (100 %) samt att frågorna var angelägna (98 %). Instrumentet hade acceptabel sensitivitet (0.83) och specificitet (0.78) jämfört med MNA. Sensitiviteten var högre än den som fanns mellan MUST och MNA (0.57). När BMI ersattes med vadomkrets erhölls likvärdiga resultat (sensibilitet 0.83 specificitet 0.79) för MEONF i förhållande till MNA. Mellanbedömarreliabiliteten var hög (kappa 0.81). Sammanfattning: MEONF har bra validitet jämfört med MNA, med hög mellanbedömarreliabilitet. När BMI ersattes med vadomkrets bibehölls precisionen vilket är viktigt när vikt och längd är svåra att erhålla. Hög sensitivitet är angeläget vid screening för undernäring och i det avseendet fungerar MEONF bättre än MUST. En fundamental vinst med MEONF är att instrumentets kriterier upplevs som meningsfulla, för att vissa svårigheter kan avhjälpas med omvårdnadsåtgärder. / Rationale: Analyse the criterion related validity, interrater reliability and the usefulness of MEONF, an instrument for undernutrition risk screening. Methods: 100 patients were included and assessed with Mini Nutritional Assessment (MNA) regarded as golden standard and screened with Malnutrition Universal Screening Tool (MUST) as well as Minimal Eating Observation and Nutrition Form (MEONF). Results: Nurses regarded MEONF instructions and questions easy to understand, easy to answer (100%) and questions as being important (98%). It had acceptable sensitivity (0.83) and specificity (0.78) in relation to MNA. Sensitivity was higher than found between MUST and MNA (0.57). Replacing BMI with Calf Circumference (CC) gave equivalent results (sensibility 0.83, specificity 0.79) in relation to MNA. Interrater reliability was high (kappa 0.81). Conclusions: MEONF has good validity in relation to MNA and high interrater reliability. If replacing BMI with CC the precision is maintained, which is important in cases were weight or height is difficult to obtain. Having high sensitivity is a major concern for nutritional screening instruments and in that respect MEONF works better than MUST. One fundamental gain with MEONF is that the instruments criteria are experienced as clinically meaningful, in that some observed difficulties can be managed by nursing interventions.

Introdução: O aumento da idade é considerado risco para subnutrição, em idosos. Objetivo: Identificar a incidência de subnutrição e risco para subnutrição e associação com variáveis sociodemográficas e clínicas, em idosos domiciliados no município de São Paulo/Brasil, em 2000 e 2006. Métodos: Foram utilizados dados do Estudo SABE Saúde, Bem-estar e Envelhecimento, de coorte, epidemiológico, de base domiciliar, realizado em 2000 (n=2.143) e em 2006 (n=1.115), entrevistando idosos ( 60 anos), de ambos os sexos, selecionados por amostra probabilística. Foram incluídos idosos que apresentaram todos os dados necessários, para identificação de subnutrição e risco para subnutrição, pela Mini Avaliação Nutricional, considerando subnutrição (MAN® < 17 pontos), risco para subnutrição (MAN® 17 a 23,5 pontos), e que, em 2000, não apresentaram esse distúrbio nutricional. As variáveis analisadas foram: dependente - subnutrição e risco para subnutrição, explanatórias - sexo, grupos etários (60 a 74; 75), renda, depressão (Escala de Depressão Geriátrica), declínio cognitivo (Mini Exame do Estado Mental), companhia no domicílio e número de doenças referidas (câncer, diabete melito, hipertensão arterial, doença coronariana, doença pulmonar crônica, doença vascular cerebral, doença articular e osteoporose). Para identificar a associação entre as variáveis, utilizou-se teste Rao & Scott, para amostra complexa, e regressão logística múltipla (p<0,05) e o programa Stata/SE 10.0 for Windows. Resultados: Foram reavaliados 636 idosos e a taxa de incidência de subnutrição e risco para subnutrição foi 17,1/1.000 pessoas/ano. A maior proporção (21,40 por cento ) de indivíduos subnutridos ou com risco para subnutrição, era composta pelo grupo 75 anos (p=0,002) e que apresentavam sintomas depressivos (23,5 por cento ) (p=0,000). A subnutrição e o risco para subnutrição associou-se, diretamente, ao grupo etário 75 (OR= 2,47; IC=1,42-4,29) e à depressão (OR= 2,90; IC=1,64-5,13). Conclusão: A subnutrição e o risco para subnutrição apresentaram incidência elevada e associação direta com depressão e grupo etário 75 / Introduction: Increasing age is considered risk for undernutrition in the elderly. Objective: Identify the incidence of undernutrition and risk for undernutrition in the elderly, living in São Paulo / Brazil, in 2000 and 2006, and association with sociodemographic and clinical variables.Methods: We used data from the SABE Survey: Health, Wellbeing and Aging, cohort, epidemiological, household-based, conducted in 2000 (n = 2,143) and 2006 (n = 1,115), interviewing the elderly ( 60 years) of both sexes, selected by random sample. The study included individuals who had all the necessary data for identification of undernutrition and risk for undernutrition by the Mini Nutritional Assessment (MNA®), considering undernutrition (MNA® <17 points), risk for undernutrition (MNA® 17 - 23.5 points), and that in 2000, did not show this nutritional disorder. The variables were: dependent - undernutrition and risk for undernutrition, explanatory - gender, age groups (60 - 74; 75), income, depression (Geriatric Depression Scale), dementia (Mini Mental State Examination) home company and number of reported illnesses (cancer, diabetes mellitus, hypertension, coronary disease, chronic pulmonary disease, cerebrovascular disease, joint disease and osteoporosis To identify the association among the variables, it was applied the Rao Scott test, for complex samples, multiple logistic regression (p<0.05) and statistical software Stata/SE 10.0 for Windows. Results: We reviewed 636 elderly and the incidence rate of undernutrition and risk for undernutrition was 17.1 / 1,000 person-years. The largest proportion (21,4 per cent ) of undernourished individuals or risk for undernutrition, was composed by the group 75 years (p = 0.002) and depressive symptoms (23,5 per cent ) (p=0,000). Undernutrition and risk for undernutrition were associated directly to the age group 75 (OR = 2.47, CI = 1.42 to 4.29) and depression (OR = 2.90, CI = 1.64 - 5.13).Conclusion: Undernutrition and risk for undernutrition had high incidence and direct association with depression and age 75

Introdução: O aumento da idade é considerado risco para subnutrição, em idosos. Objetivo: Identificar a incidência de subnutrição e risco para subnutrição e associação com variáveis sociodemográficas e clínicas, em idosos domiciliados no município de São Paulo/Brasil, em 2000 e 2006. Métodos: Foram utilizados dados do Estudo SABE Saúde, Bem-estar e Envelhecimento, de coorte, epidemiológico, de base domiciliar, realizado em 2000 (n=2.143) e em 2006 (n=1.115), entrevistando idosos ( 60 anos), de ambos os sexos, selecionados por amostra probabilística. Foram incluídos idosos que apresentaram todos os dados necessários, para identificação de subnutrição e risco para subnutrição, pela Mini Avaliação Nutricional, considerando subnutrição (MAN® < 17 pontos), risco para subnutrição (MAN® 17 a 23,5 pontos), e que, em 2000, não apresentaram esse distúrbio nutricional. As variáveis analisadas foram: dependente - subnutrição e risco para subnutrição, explanatórias - sexo, grupos etários (60 a 74; 75), renda, depressão (Escala de Depressão Geriátrica), declínio cognitivo (Mini Exame do Estado Mental), companhia no domicílio e número de doenças referidas (câncer, diabete melito, hipertensão arterial, doença coronariana, doença pulmonar crônica, doença vascular cerebral, doença articular e osteoporose). Para identificar a associação entre as variáveis, utilizou-se teste Rao & Scott, para amostra complexa, e regressão logística múltipla (p<0,05) e o programa Stata/SE 10.0 for Windows. Resultados: Foram reavaliados 636 idosos e a taxa de incidência de subnutrição e risco para subnutrição foi 17,1/1.000 pessoas/ano. A maior proporção (21,40 por cento ) de indivíduos subnutridos ou com risco para subnutrição, era composta pelo grupo 75 anos (p=0,002) e que apresentavam sintomas depressivos (23,5 por cento ) (p=0,000). A subnutrição e o risco para subnutrição associou-se, diretamente, ao grupo etário 75 (OR= 2,47; IC=1,42-4,29) e à depressão (OR= 2,90; IC=1,64-5,13). Conclusão: A subnutrição e o risco para subnutrição apresentaram incidência elevada e associação direta com depressão e grupo etário 75 / Introduction: Increasing age is considered risk for undernutrition in the elderly. Objective: Identify the incidence of undernutrition and risk for undernutrition in the elderly, living in São Paulo / Brazil, in 2000 and 2006, and association with sociodemographic and clinical variables.Methods: We used data from the SABE Survey: Health, Wellbeing and Aging, cohort, epidemiological, household-based, conducted in 2000 (n = 2,143) and 2006 (n = 1,115), interviewing the elderly ( 60 years) of both sexes, selected by random sample. The study included individuals who had all the necessary data for identification of undernutrition and risk for undernutrition by the Mini Nutritional Assessment (MNA®), considering undernutrition (MNA® <17 points), risk for undernutrition (MNA® 17 - 23.5 points), and that in 2000, did not show this nutritional disorder. The variables were: dependent - undernutrition and risk for undernutrition, explanatory - gender, age groups (60 - 74; 75), income, depression (Geriatric Depression Scale), dementia (Mini Mental State Examination) home company and number of reported illnesses (cancer, diabetes mellitus, hypertension, coronary disease, chronic pulmonary disease, cerebrovascular disease, joint disease and osteoporosis To identify the association among the variables, it was applied the Rao Scott test, for complex samples, multiple logistic regression (p<0.05) and statistical software Stata/SE 10.0 for Windows. Results: We reviewed 636 elderly and the incidence rate of undernutrition and risk for undernutrition was 17.1 / 1,000 person-years. The largest proportion (21,4 per cent ) of undernourished individuals or risk for undernutrition, was composed by the group 75 years (p = 0.002) and depressive symptoms (23,5 per cent ) (p=0,000). Undernutrition and risk for undernutrition were associated directly to the age group 75 (OR = 2.47, CI = 1.42 to 4.29) and depression (OR = 2.90, CI = 1.64 - 5.13).Conclusion: Undernutrition and risk for undernutrition had high incidence and direct association with depression and age 75