您的位置：山东大学 -> 科技期刊社 -> 《山东大学学报（医学版）》

山东大学学报 (医学版) ›› 2018, Vol. 56 ›› Issue (9): 77-82.doi: 10.6040/j.issn.1671-7554.0.2018.430

• • 上一篇    

微型营养评价量表在社区老年人群中的信效度评价

袁华财1,张甜甜2,郭冬梅3,张欢欢2,沈德嫱4,陈立勇5,蔺新英1   

  1. 1.山东大学公共卫生学院营养与食品卫生学系, 山东 济南 250012;2.山东大学附属生殖医院临床营养科, 山东 济南 250001;3.山东大学公共卫生学院预防医学教学实验中心, 山东 济南 250012;4.连云港市第一人民医院临床营养科, 江苏 连云港 222002;5.山东大学附属省立医院临床营养科, 山东 济南 250021
  • 发布日期:2022-09-27
  • 通讯作者: 蔺新英. E-mail:xy00819@163.com
  • 基金资助:
    科技部基础专项(2015FY111600)

Reliability and validity of MNA scale used in community elderly

YUAN Huacai1, ZHANG Tiantian2, GUO Dongmei3, ZHANG Huanhuan2, SHEN Deqiang4, CHEN Liyong5, LIN Xinying1   

  1. 1. Department of Nutrition and Food hygiene, School of Public Health, Shandong University, Jinan 250012, Shandong, China;
    2. Department of Clinical Nutrition, Center for Reproductive Medicine, Shandong University, Jinan 250001, Shandong, China;
    3. Experimental Teaching Center of Preventive Medicine, School of Public Health, Shandong University, Jinan 250012, Shandong, China;
    4. Department of Clinical Nutrition, the First Hospital of Lianyungang, Lianyungang 222002, Jiangsu, China;
    5. Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
  • Published:2022-09-27

PDF (PC)

44

摘要： 目的 评价微型营养评价(MNA)量表在社区老年人群中的信效度,为研制符合我国社区老年人特点的营养评价工具进行前期探索。 方法 随机抽取济南市社区老年人550例,最终获得有效样本544例。应用MNA量表评价其营养状况,检测人体测量指标和实验室指标,评价MNA量表的信度、结构效度、校标关联效度。 结果 MNA量表Cronbachs α系数0.287,探索性因子分析得到9个公因子,累积因子贡献率60.94%。因子分析显示条目MNA14、MNA17因子载荷低于0.4,MNA得分与体质量指数、上臂肌围、小腿围等客观指标具有相关性,以BMI和血清白蛋白作为营养状况的评价客观标准,MNA量表发现营养不良风险老年人的灵敏度0.884,特异度为0.683,两种方法评价营养状况的kappa值为0.215。条目分析显示条目MNA6、MNA9、MNA10、MNA12与总分的关联程度不密切。 结论 MNA量表信度和效度不理想,不适用于直接评价济南社区老年人的营养状况,但可以此为基础进行改良。

关键词: 微型营养评价法, 社区老年人, 信度, 效度, 营养状况

Abstract: Objective To assess the reliability and validity of mini nutritional assessment(MNA)scale in community elderly, and to lay the foundation for the development of the new nutrition screening tool suitable for Chinese community elderly. Methods A total of 550 elderly in communities of Jinan were randomly selected and 544 were finally analyzed in our study. MNA scale was used to assess the nutrition status. Anthropometric parameters and laboratory indexes were also measured. The reliability, construct validity and criterion-related validity were calculated and assessed. Results Cronbachs α coefficient of MNA scale was 0.287. Factor analysis yields 9 common factors. Cumulative factor contribution rate was 60.94%. Factor analysis indicated that the factor loads of some items(MNA14 and MNA17)were less than 0.4. There were significant correlations between total MNA score and BMI, MAC and CC. Using BMI and serum 山 东 大 学 学 报 (医 学 版)56卷9期 -袁华财,等.微型营养评价量表在社区老年人群中的信效度评价 \=-albumin as objective criteria for assessing nutritional status, the sensitivity of malnutrition by MNA in older adults was 0.884 with a specificity of 0.683. Kappa value of two methods above for evaluating nutritional status was 0.215. Item analysis suggested that the scores of MNA6, MNA9, MNA10 and MNA12 were not related to total score. Conclusion Although the reliability and validity of MNA indicate this scale is not a reliable assessment tool for nutrition assessment of Chinese community elderly, it is still the cornerstone of the following revise process.

Key words: Mini-nutritional assessment, Community elderly, Reliability, Validity, Nutrition status

中图分类号: 

  • R153.3
[1] WHO. EN ageing: facts about ageing [EB/OL].(2014-9-30)[2018-6-15] http://www.portal.pmnch.org/ageing/about/facts/en.html.
[2] Shpata V, Ohri I, Nurka T, et al. The prevalence and consequences of malnutrition risk in elderly Albanian intensive care unit patients[J]. Clin Interv Aging, 2015, 10: 481-486. doi: 10.2147/CIA.S77042.
[3] Ritt M, Schwarz C, Kronawitter V, et al. Analysis of Rockwood et als Clinical Frailty Scale and Fried et als frailty phenotype as predictors of mortality and other clinical outcomes in older patients who were admitted to a geriatric ward[J]. J Nutr Health Aging, 2015, 19(10): 1043-1048.
[4] Zhou JD, Wang M, Wang HK, et al. Comparison of two nutrition assessment tools in surgical elderly inpatients in Northern China[J]. Nutr J, 2015, 14(1): 68-76.
[5] 张琴. 重庆市社区老年人营养不良状况调查分析[J]. 保健医学研究与实践, 2014, 11(1): 17-19.
[6] Poulia KA, Yannakoulia M, Karageorgou D, et al. Evaluation of the efficacy of six nutritional screening tools to predict malnutrition in the elderly[J]. Clin Nutr, 2012, 31(3): 378-385
[7] Christner S, Ritt M, Volkert D, et al. Evaluation of the nutritional status of older hospitalised geriatric patients: a comparative analysis of a Mini Nutritional Assessment(MNA)version and the Nutritional Risk Screening(NRS 2002)[J]. J Hum Nutr Diet, 2016, 29(6): 704-713.
[8] Donini LM, Marrocco W, Marocco C, et al. Validity of the self- mini nutritional assessment(Self- MNA)for the evaluation of nutritional risk. A cross- sectional study conducted in general practice[J]. J Nutr Health Aging, 2018, 22(1): 44-52.
[9] Slee A, Birch D, Stokoe D. A comparison of the malnutrition screening tools, MUST, MNA and bioelectrical impedance assessment in frail older hospital patients[J]. Clin Nutr, 2015, 34(2): 296-301.
[10] 陈艳秋, 宗敏, 韩维嘉,等. 微型营养评定法(MNA)在老年住院患者中可靠性的探讨[C] // 中国营养学会. 中国营养学会第九次全国营养学术会议论文摘要汇编. 北京:中国营养学会, 2004: 141-142.
[11] Broen MP, Moonen AJ, Kuijf ML, et al. Factor analysis of the Hamilton Depression Rating Scale in Parkinsons disease[J]. Parkinsonism Relat Disord, 2015, 21(2): 142-146.
[12] Jones MC, Williams B, Rattray J, et al. Extending the assessment of patient-centredness in health care: development of the updated Valuing Patients as Individuals Scale using exploratory factor analysis[J]. J Clin Nurs, 2018, 27(1-2): 65-76.
[13] 吴庆菊. 基于微型营养评定法的护理干预对老年椎髋骨骨折患者营养状况的影响[D]. 郑州:郑州大学, 2016.
[14] 何芳, 王蕾蕾, 孟雪杉, 等. 肿瘤患者营养状况及对临床结局的影响[J]. 肿瘤代谢与营养电子杂志, 2016, 3(3): 166-169.
[15] 郭秀花. 实用医学调查分析技术[M]. 北京:人民军医出版社, 2014: 256-276.
[16] 赵斐然, 周天驰, 张俊颖, 等. 量表(问卷)信度、效度评价在我国医学领域的应用与展望[J]. 中华中医药杂志, 2014, 29(7): 2280-2283. ZHAO Feiran, ZHOU Tianchi, ZHANG Junying, et al. Prospect and application of evaluation about reliability and validity assessment on scale or questionnaire applied in the medical domain[J]. China Journal of Traditional Chinese Medicine & Pharmacy, 2014, 29(7): 2280-2283.
[17] 苏中华, 李四劝, 成义仁. 量表评估的内部一致性与克朗巴赫α系数的应用评价[J]. 临床心身疾病杂志, 2009, 15(1): 85-86.
[18] Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: the Mini Nutritional Assessment as part of the geriatric evaluation[J]. Nutr Rev, 1996, 54(1): S59-S65.
[19] Kuzuya M, Kanda S, Koike T, et al. Evaluation of Mini-Nutritional Assessment for Japanese frail elderly[J]. Nutrition, 2005, 21(4): 498-503.
[20] Ghazi L, Fereshtehnejad SM, Abbasi FS, et al. Mini Nutritional Assessment(MNA)is rather a reliable and valid instrument to assess nutritional status in Iranian healthy adults and elderly with a chronic disease[J]. Ecol Food Nutr, 2015, 54(4): 342-357.
[21] Marshall S, Young A, Bauer J, et al. Malnutrition in geriatric rehabilitation: prevalence, patient outcomes, and criterion validity of the scored patient-generated subjective global assessment and the Mini Nutritional Assessment[J]. J Acad Nutr Diet, 2016, 116(5): 785-794.
[22] Aparecida Leandro-Merhi V, Luiz Braga de Aquino J, Gonzaga Teixeira de Camargo J. Agreement between body mass index, calf circumference, arm circumference, habitual energy intake and the MNA in hospitalized elderly[J]. J Nutr Health Aging, 2012, 16(2): 128-132.
[23] 张欢欢, 王翠平, 赵敏, 等. 利用微型营养评价法和微型营养评价精法评价社区老年人的营养状况[J]. 山东大学学报(医学版), 2017, 55(11): 65-70. ZHANG Huanhuan, WANG Cuiping, ZHAO Min, et al. Mini-Nutritional Assessment and Short-Form Mini-Nutritional Assessment in evaluating nutritional status of the elderly in community[J]. Journal of Shandong University(Health Sciences), 2017, 55(11): 65-70.
[24] 何夏阳, 刘雪琴. 微型营养评估表和营养筛查表的信度和效度评价[J]. 解放军护理杂志, 2010, 27(12): 894-896. HE Xiayang, LIU Xueqin. Evaluation of reliability and validity of Mini-nutritional Assessment and Chinese nutrition screen[J]. Nursing Journal of Chinese Peoples Liberation Army, 2010, 27(12): 894-896.
[25] 闫茂华. 从西方饮食文化到东方传统膳食的思考[J]. 安徽农业科学, 2014(23): 7996-7999.
[1] 叶艺,张洁,赵秋阁,范秀珍. 老年服务择业动机量表在毕业学年大学生中的修订及信效度检验[J]. 山东大学学报 (医学版), 2022, 60(2): 75-80.
[2] 张云雪,解子惠,吕高荣,申世玉,厉萍. 中文简版共同反刍问卷在1 354名护生中应用的信效度评价[J]. 山东大学学报 (医学版), 2021, 59(7): 85-90.
[3] 吕岩,于潇,蔺新英,赵琦,王保珍. 聊城市老年女性膳食模式与抑郁症状的关系[J]. 山东大学学报 (医学版), 2020, 58(11): 103-108.
[4] 张欢欢,王翠平,赵敏,郭冬梅,陈立勇,蔺新英. 利用微型营养评价法和微型营养评价精法评价社区老年人的营养状况[J]. 山东大学学报（医学版）, 2017, 55(11): 65-70.
[5] 张灿灿, 苏永刚, 张红静. 文化适应压力量表中文版的修订[J]. 山东大学学报（医学版）, 2015, 53(11): 89-94.
[6] 王会1，王菊生2，时一民1，姚子明3，孙云1，肖合存1，赵晓田4，赵长峰4. 维持性血液透析患者营养状况分析[J]. 山东大学学报(医学版), 2011, 49(9): 59-.
[7] 王欣欣1， 贾存显1，2，庄茂强1 ，高琦1，刘丽媛1，刘慧1，韩梅1. 在农村自尊量表评价以及自尊与自杀死亡的病例对照研究[J]. 山东大学学报(医学版), 2011, 49(7): 159-162.
[8] 成媛媛1，唐茂芹2. 简明幸福与生活质量满意度问卷在焦虑障碍患者中的信效度[J]. 山东大学学报(医学版), 2011, 49(7): 147-150.
[9] 韩梅1，贾存显1,2，邱惠敏3，马吉祥4，路长飞1，刘慧1. 简易应对方式量表评价及其与农村自杀死亡关系研究[J]. 山东大学学报(医学版), 2011, 49(10): 160-164.
[10] 王东芳1，贾存显1，徐爱强2，张吉玉2，路长飞1，王欣欣1. 特质焦虑量表在农村自杀死亡及其对照组中的信度和效度评价[J]. 山东大学学报(医学版), 2011, 49(1): 111-.
[11] 刘保锋1，袁长海1，于敬敏2，秦敬柱1，郭丽1，耿文革3. SF-36量表在三峡移民生命质量测定中的信度和效度评价[J]. 山东大学学报(医学版), 2010, 48(7): 129-132.
[12] 陈翠，张红静，江虹，李文杰，吕丽. 一般健康问卷（GHQ-28）应用于大学生心理健康研究的信效度检验[J]. 山东大学学报(医学版), 2010, 48(3): 159-162.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
版权所有 © 2018 《山东大学学报(医学版)》编辑部　
地址:山东大学科技期刊社（济南市历城区山大南路27号山东大学中心校区明德楼B座721室） 电话: 0531-88366918 E-mail: xbyxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发