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Development of a simple and valid nutrition screening tool for pediatric hospitalized patients with acute illness
Hoda Atef1, Rasha Abdel-Raouf1, Ahmed S Zeid1
1Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Insights
Developing a simple nutritional screening tool for hospitalized children is crucial. Appetite loss emerged as a key indicator for malnutrition risk across all pediatric age groups.
Area of Science:
- Pediatric Nutrition
- Clinical Assessment
- Malnutrition Screening
Background:
- Nutritional care is vital for hospitalized patients, focusing on identifying risks.
- Current lack of standardized tools for pediatric malnutrition risk assessment on admission.
- The study addresses the need for a valid and simple nutritional screening tool for children.
Purpose of the Study:
- To develop and validate a simple nutritional screening tool for pediatric patients upon hospital admission.
- To identify children at risk of developing malnutrition during their hospital stay.
- To provide age-specific screening questions for early detection of malnutrition.
Main Methods:
- Cross-sectional analytical study involving 161 children admitted to Cairo University Children Hospitals.
- A developed questionnaire was compared against Subjective Global Assessment (SGA) for accuracy.
- Validated screening tools using anthropometric measures for accuracy above 80%.
Main Results:
- For children under two years, valid screening questions included breastfeeding issues, scanty breast milk, and appetite loss.
- For early and late childhood, valid questions included appetite loss, meal skipping, and excessive screen time (over two hours/day).
- Appetite loss was identified as a valid screening tool across all age groups.
Conclusions:
- Effective pediatric nutritional screening tools vary by age group.
- A consistent and valid indicator for malnutrition risk across all pediatric ages is appetite loss.
- The developed tool aims to improve early identification and intervention for pediatric malnutrition.
Abstract:
Background: Nutritional screening, intervention and assessment in patients with undernutrition are key components of any nutritional care. The goal of any nutritional assessment is to determine the specific nutritional risk(s). Presently, there are no guidelines on any ideal screening tool to be used on admission for identification of children that are at risk of developing malnutrition during their hospital stay. The objective of the study was to develop a valid and simple nutritional screening tool which can be used on hospital admission to identify pediatric patients at risk of malnutrition .Methods: This study was cross sectional analytical that enrolled children (n:161) admitted with acute illness to the general wards at Cairo University Children Hospitals (CUCH). The answers to the developed questionnaire were compared to the Subjective Global Assessment (SGA), those with high accuracy (≥80%) were used for validity with anthropometric measures. Results: In the 'less than two years of age' group, the simple and valid nutritional screening tools were the following questions: (Is there a problem during breast-feeding?), (Is there scanty breast milk?), (Is there appetite loss?). The simple and valid nutritional screening tools during the 'early childhood' group were the following questions: (Is there appetite loss?), (Is there any skipping of meals?), (Are they watching TV, videotapes and/or playing computer games for more than two hours/day?). The simple and valid nutritional screening tools during the 'late childhood' group were the following questions: (Is there appetite loss?), (Are they watching TV, videotapes and/or playing computer games for more than two hours/day?). Conclusion: The simple and valid nutritional screening tools differ according to age groups. The one which is valid in all ages is the question about the appetite loss.
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