Malnutrition in older people in clinical nursing diagnosis

Abstract

The aim of this study was to validate the actual nursing diagnosis of imbalanced nutrition: less than body requirements in older patients. It is a retrospective and comparative study. To validate the nursing diagnosis, we used the Fehring’s models: the Diagnostic Content Validity Model and the Patient-Focused Clinical Diagnostic Validity Model. They were used to find out the significance of the defining characteristics of the nursing diagnosis of imbalanced nutrition: less than body requirements. After data collection, we calculated a weighted score (WS) for each defining characteristic. There were two samples in the study. The first sample (n1) consisted of 101 nurses – experts according to the modified Fehring’s criteria. The second sample (n2) consisted of 50 hospitalized older patients who had fewer than 17 points (a score indicative of malnutrition) in the first and second parts of the standardised nutrition assessment tool – the MNA (Mini Nutritional Assessment). Out of 22 items, the nurses rated one item as major: food intake less than recommended daily allowance (0.87). In the sample of patients, they rated six items out of 17 as major. They are: insufficient interest in food (0.83), food aversion (0.82), alteration in taste sensation (0.78), decreased body weight (0.77), weight loss with adequate food intake (0.77), and food intake less than recommended daily allowance (0.76). As a result of this study, we suggest considering the inclusion of measurement tools that focus on early detection of malnutrition in all hospitalised older people with lower food intake.