Development, Validation and Reliability of the Simple Nutrition Screening Tool (SNST) for Adult Hospital Patient in Indonesia

Abstract

Malnutrition is one common problem for hospitalized patient in all over the world. Thus, patients with at risk of malnutrition are recommended to receive a nutritional therapy which are identified by using nutritional screening tool. Some of the existing screening tools cannot be performed in Indonesia because most of Indonesian people rarely check their weight in regular basis. Therefore it’s hard to know wether they lose or gain weight. The aim of this study was to develop a simple, valid and reliable screening tool that can be used to identify adult patients with risk of malnutrition. Four hundred and ninety five adult patients were screened by Simple Nutrition Screening Tool (SNST). This screening tool was developed in Sardjito General Hospital/Gadjah Mada University, Indonesia. The validity of SNST was tested by measuring the sensitivity and specificity value compared to Subjective Global Assessment (SGA), the interrater reliability value of the screening tool was also assessed by dietitian, nurse and food service officer in 73 patients. From the development process of SNST, 6 questions were obtained with sensitivity value 91.28 and specificity value 79.78. Subjects who were at risk of malnutrition, according to the SNST, had significantly lower mean values for the objective nutrition parameters (p = 0.001) and longer length of stays than subjects who were not at risk of malnutrition (p = 0.001). There was a good agreement in the assessment of at risk of malnutrition between dietitians (kappa = 0.803), dietitian and nurse (kappa=0.653) and between dietitian and food service officer (kappa=0.718). The SNST is a valid and reliable tool to identify patients with risk of malnutrition.