| Summary: | 碩士 === 亞洲大學 === 健康產業管理學系長期照護組 在職專班 === 99 === Background and Purpose: Malnutrition is common in patients on hemodialysis and routine monitoring of their nutritional status is important for preventing protein-calorie malnutrition in these patients. Although the Mini-Nutritional Assessment (MNA) is a multifunctional nutritional assessment scale, the short-form underestimates the risk of malnutrition when used in hemodialysis patients. The purpose of this study was to modify the MNA so that it would be suitable for use in hemodialysis patients.
Methods: Subjects were 100 hemodialysis outpatients (18-97 years, 43 men and 57 women) from a district hospital in Central Taiwan. After obtaining their consent, subjects were interviewed and rated with the long form-MNA, short form-MNA, and modified short-form MNA and determined for biochemical values. The modification was done on the basis of the dietary characteristics of hemodialysis patients. In order to maintain the integrity of MNA, the modification was limited to exchanging non-short-form items for short-form items. The ability of the short-form versions to predict the long-form MNA (T2) was tested with Wilconxon Signed-Rank Test, Pearson's correlation analysis and the cross-tabulation test.
Results: The study showed that the original short-form MNA did underestimate the risk of malnutrition in patients on hemodialysis. However, a modified short-form version by exchanging item O (self-rated nutritional status) for item D (stress) or item O for item E (dementia) restored its predictive ability. The modified short-form performed relatively well compared to the long-form MNA-T2.
Conclusions: Results suggest that a simple modification of the MNA can greatly improve the predictive ability of the scale in patients on hemodialysis. This modified short-form version should be useful for routine monitoring of nutritional risk of patients on hemodialysis. However, its applicability to patients on peritoneal dialysis and chronic kidney patients remains to be determined.
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