Reliability And Validity Of The Nutritional Assessment Form For The Community Elderly

ObjectivesAccording to the Chinese old people's lifestyle,dietary habits,physical constitution,medical treatment and health care system and other factors,and based on the mini nutritional assessment(MNA),Chinese Nutrition Screen(CNS)and other scales to improve the MNA.And we hope to make it more suitable,convenient and effective for evaluating the nutrition condition of the elderly in China evaluation scale,and then we will evaluate its reliability and validity.MethedsFirst,we used stratified random sampling method,studied in Shanghai City,and Lixia District,Shizhong District,Changqing District and Pingyin county in Ji'nan City of Shandong province.Each place was randomly selected 2 villages or towns,every village or town were randomly selected the elderly over the age of 60 years old.And then exclused the people who had blood transfusion,plasma or albumin nearly a month.Finally,we had 1162 samples,the effective samples were 941,efficiency was 80.98%.Among them,408 were males,533 were females,584 were urban and 357 were rural,their ages were from 60 years old to 92 years old,the average age is 68.76±6.21 years.Then the reliability and validity of MNA,CNS and MNA-SF scales were evaluated,and the optimal cut-off value of upper arm circumference and calf circumference was determined.Based on the MNA scale,the individual items were revised,and an improved version of MNA was made.Then,a cross-sectional cluster sampling method was used to investigate 576 community elderly people in Ji'nan.The survey included general conditions,revised MNA scales,anthropometric measurements,laboratory tests,and dietary surveys.A month after the investigation,the questionnaire survey was conducted among the elderly population in Ji'nan,and the reliability and validity of the revised scale were evaluated.SPSS 19.0 statistical software was used to evaluate the reliability and validity of the scale.The main methods of statistical analysis:using Cronbach's alpha coefficient to evaluate the content consistency,using the Pearson correlation analysis to evaluate the content validity,factor analysis evaluation was to be used to evaluate the structure validity,ROC curve analysis was to be used to evaluate thesensitivity and specificity.,independent sample t test was to be used to evaluate.the correlation of the scale and traditional nutritional index.Re ults1.The reliability and validity of MNA,CNS,MNA-SFMNA's Cronbach 's alpha is 0.335,and Cronbach' s alpha in the 4 dimensions is 0.186 to 0.282,CNS's Cronbach 's alpha is 0.217,and MNA-SF's Cronbach's alpha is 0.145.Compared with the objective evaluation criterion by BMI,the Kappa value of the MNA scale was 0.370,the Kappa value the CNS scale was 0.001,and t the Kappa value of the MNA-SF scale was 0.463.The MNA scale entries 1,4,7,and 10 had significantly correlation with total score(r>0.4).The CNS scale entries 1,4,7,and 10 had significantly correlation with total score(r>0.4).MNA-SF scales entries 1,2,and 3 had significantly correlation with total scores(r>0.4).The KMO statistic(Kaiser-Meyer-Olkin)of MNA is 0.498,Bartlett's Test is P<0.00,and cumulative interpretation contribution rate is 60.47%.The KMO statistic of CNS is 0.578,Bartlett 's Test is P<0.00,and cumulative interpretation contribution rate is 54.04%.The KMO statistic of MNA-SF is 0.507,Bartlett 's Test is,P<0.003 and the accumulative contribution rate is 38.17%.2.The best cut-off value of MAC and CCBased on the standard of BMI<18.5kg/m2,through the ROC curve analysis,the root of male upper arm circumference of AUC was 0.883(P=0.000),when the cutoff value of MAC is 27.75cm,the highest YI was 0.668,the sensitivity was 0.668,specificity was 1.The AUC of female upper arm circumference was 0.833(P=0.000).When the cutoff value of MAC was 25.45cm,the highest YI was 0.584,with a sensitivity of 0.851 and a specificity of 0.733.The AUC of male calf circumference was 0.936(P=0.000).When the cutoff value of CC was 32.6cm,the highest YI was 0.780,and the sensitivity was 0.833 and specificity was 0.947.The AUC of female calf girth was 0.806(P=0.000).When the cutoff value of CC was 31.55cm,the highest YI was 0.604,and the sensitivity was 0.837 and specificity was 0.767.3.The reliability and validity evaluation of improved version of MNA scale3.1 Reliability evaluationInternal consistency coefficient:the modified version of MNA 'Cronbach's alpha is 0.576,and the 4 dimension 'Cronbach' s alpha is 0.388 to 0.551.The revised version of MNA-SF's Cronbach 's alpha' is 0.793.Test-retest reliability:1 months after the end of the first survey,a total of 543 elderly people in Ji'nan were randomly selected for re-evaluation,and 317 valid questionnaires were obtained from 459 cases.The Kappa value of the revised MNA scale was 0.79,and the Kappa value of the revised version of the MNA-SF scale was 0.82.3.2 Validity evaluationContent validity:the correlation coefficient between the scores and the total score of the modified version of MNA was high.Items 2,3,4,9,12 and 14 had significantly correlation with the total score(r>0.75).The correlation coefficient between the scores and total scores of the revised MNA-SF scale was from 0.694 to 0.797.Construct validity:The KMO statistic of modified version MNA scale was 0.511,Bartlett's Test was p=0.00,and cumulative contribution rate was 55.52%.The modified version of MNA-SF scale had a KMO statistic of 0.510,Bartlett's Test was p=0.014,with a cumulative contribution rate of 55.74%.Predictive validity:the ROC curve analysis showed that the modified version of MNA had a AUC of 0.766(P=0.000),and when the revised version of MNA was 24.25,the YI was highest,it was 0.439,with a sensitivity of 0.839 and a specificity of 0.600.The AUC of modified version MNA-SF malnutrition was 0.706(P=0.000).When the revised version of MNA was 10.50,the highest YI was 0.334,with a sensitivity of 0.419 and a specificity of 0.914.4.The correlation with the traditional nutrition evaluation indexMNA,MNA-SF,MNA,the modified version of MNA,and the modified version of MNA-SF were positively correlated with BMI,MAC,CC,TSF,SSF and ALB(P<0.05),the correlation coefficient of the modified version of MNA and the modified version of MNA-SF with traditional nutritional evaluation index was slightly higher than that of MNA and MNA-SF.ConclusionThe reliability and validity of the MNA,CNS and MNA-SF scales in the elderly of the community are lower.The internal consistency,the correlation between each item and the total score,and the correlation of traditional nutrition evaluation index of the Modified version of MNA and modified MNA-SF scale were not bad,although the predictive validity is slightly lower,but generally speaking,the modified version of MNA and modified version of the MNA-SF had better reliability and validity.They were more convenient,suitable for evaluating the nutritional status of the elderly in the community.