[Screening for undernutrition among older adults receiving home care: an estimation of the diagnostic accuracy of indicators available in the Resident Assessment Instrument - Home Care adapted for Switzerland]

Rech Soins Infirm. 2018 Mar:(132):54-63. doi: 10.3917/rsi.132.0054.
[Article in French]

Abstract

Introduction: in homecare practice, nurses are central actors for the screening of individuals at risks of undernutrition.

Context: in Switzerland, homecare nurses estimate the nutritional status of care recipients by means of a standardized geriatric assessment done with the RAI-HC.

Aims: The aim of the study is to estimate the diagnostic accuracy of the « nutritional status » score, the body mass index and the weight loss documented from the RAI-HC.

Method: a sample of 267 homecare recipients aged 65 was assessed using the RAI-HC and the MNA-SF®. Sensitivity, specificity and area under the curve were estimated for the RAI-HC measures, with the MNA-SF® as the gold standard reference.

Results: for the scores considered, sensitivity varied between 16.51 % and 68.81 %, specificity between 66.94 % and 99.37 %, and areas under the curve between 0.579 at 0.708.

Discussion: the diagnostic accuracy of the RAI-HC indicators is not sufficient for an optimal screening of undernutrition in older homecare recipients.

Conclusion: an additional assessment with the MNA-SF® is recommended to optimize the early screening of individuals at risks of undernutrition.

MeSH terms

  • Aged
  • Geriatric Assessment / methods*
  • Home Care Services*
  • Humans
  • Malnutrition / diagnosis*
  • Mass Screening*
  • Nutrition Assessment*
  • Reproducibility of Results
  • Switzerland