Testing two self-care-related instruments among older home-dwelling people in Norway

Artikkelen rapporterer en studie hvor hensikten var å teste reliabilitet og validitet av de norske versjonene av de to egenomsorgsrelaterte instrumentene "Self‐care Ability Scale for the Elderly" (SASE) og "Nutritional Form For the Elderly" (NUFFE) blant eldre hjemmeboende personer.Older persons’ ability and agency for self‐care is an important issue. Therefore, the development of reliable and valid instruments to measure self‐care with regard to both clinical nursing practice and personal health is important for nursing research and practice. To test reliability and validity of the Norwegian versions of the two self‐care‐related instruments, the Self‐care Ability Scale for the Elderly (SASE) and the Nutritional Form For the Elderly (NUFFE) among older home‐dwelling individuals. A postal questionnaire that contained these instruments, background variables, health‐related questions and two other self‐care‐related instruments was completed by a randomised sample of 158 older persons in southern Norway. Reliability was assessed as internal consistency and validity as concurrent and construct validity. SASE reached a Cronbach’s alpha coefficient of 0.85 and significant Spearman’s rank correlations for 16 of 17 items. For NUFFE, a Cronbach’s alpha coefficient of 0.64 was obtained and significant correlations for 13 of 15 items. Validity was supported for both instruments. An appropriate cut‐off was found for SASE. For NUFFE, a low cut‐off point was obtained. SASE was shown to have sufficient psychometric properties and can be used in research and clinical practice among older persons. The psychometric properties of NUFFE can be assessed as sufficient, but further studies are needed regarding the cut‐off point

Living alone, receiving help, helplessness, and inactivity are strongly related to risk of undernutrition among older home-dwelling people

Published version of an article in the journal: International Journal of General Medicine. Also available from the publisher at: http://dx.doi.org/10.2147/IJGM.S28507 Open Access.Background: Being at risk of undernutrition is a global problem among older people. Undernutrition can be considered inadequate nutritional status, characterized by insufficient food intake and weight loss. There is a lack of Norwegian studies focusing on being at risk of undernutrition and self-care ability, sense of coherence, and health-related issues among older home-dwelling people. Aim: To describe the prevalence of being at risk of undernutrition among a group of older home-dwelling individuals in Norway, and to relate the results to reported self-care ability, sense of coherence, perceived health and other health-related issues. Methods: A cross-sectional design was applied. A questionnaire with instruments for nutritional screening, self-care ability, and sense of coherence, and health-related questions was sent to a randomized sample of 450 persons (aged 65+ years) in southern Norway. The study group included 158 (35.1%) participants. Data were analysed using statistical methods. Results: The results showed that 19% of the participants were at medium risk of undernutrition and 1.3% at high risk. Due to the low response rate it can be expected that the nonparticipants can be at risk of undernutrition. The nutritional at-risk group had lower self-care ability and weaker sense of coherence. Living alone, receiving help regularly to manage daily life, not being active and perceived helplessness emerged as predictors for being at risk of undernutrition. The results indicate difficulties in identifying people at nutritional risk and supporting self-care activities to maintain a good nutritional status. Conclusion: Health care professionals have to be able to identify older home-dwelling people at risk of undernutrition, support self-care activities to enable people at risk to maintain a sufficient nutritional status, and be aware that older people living alone, who receive help, feel helpless, and are inactive are especially vulnerable

Psychometric testing of the Norwegian version of the Nutritional Form For the Elderly among older home-dwelling people

Artikkelen rapporterer en studie hvor hensikten var å teste reliabilitet og validitet av den norske versjonen av Nutritional Form For Eldre (NUFFE-NO) blant hjemmeboende eldre, og å bruke kortformen av Mini Nutritional Assessment (MNA-SF) som en standard.Nutritional screening instruments need to be evaluated in terms of reliability and validity and being able to demonstrate sensitivity and specificity for use in clinical practice and research. The aims of this study were to test the reliability and validity of the Norwegian version of the Nutritional Form For the Elderly (NUFFE-NO) in a sample of older home-dwelling people, and to use the short form of the Mini Nutritional Assessment (MNA-SF) as a standard. A postal questionnaire, including the two instruments, background variables, and health-related questions, was sent to 6033 home-dwelling older people (65+ years) in southern Norway. In total, 2106 persons responded and were included. Data were analyzed statistically regarding homogeneity, concurrent and construct validity, sensitivity, and specificity of NUFFE-NO. A Cronbach's alpha coefficient of 0.71 and significant item-to-total correlations were obtained as measures of homogeneity. Concurrent validity was assessed by a correlation coefficient of -0.37 (P < 0.001) between NUFFE-NO and MNA-SF. NUFFE-NO could separate known nutritional at-risk groups as a measure of construct validity. A cut-off point of ≥4 for identification of older people at nutritional risk was found for NUFFE-NO with MNA-SF as a standard. NUFFE-NO shows adequate psychometric properties regarding homogeneity and construct validity. MNA-SF was not found to be the most suitable standard to use, because a low correlation coefficient was obtained as a measure of concurrent validity and a lower cut-off point was found compared with another study using the Mini Nutritional Assessment (MNA(®)) as a standard for NUFFE-NO. The obtained cut-off point of ≥4 is not recommended for use in practice or research, because many false positive nutritional at-risk persons would then be identified. Further studies with suitable design have to be performed among older home-dwelling people using the MNA as a standard

Lived experiences of self-care among older, home-dwelling individuals identified to be at risk of undernutrition

Published version of an article from the journal:Journal of Multidisciplinary Healthcare. Also available from Dove Press:http://dx.doi.org/10.2147/jmdh.s38474 Open AccessIntroduction: In a society where most older people live in their own homes, it may be expected of older individuals to exercise their potential to take care of themselves in daily life. Nutrition is a central aspect of self-care, and groups of older, home-dwelling people are at risk of undernutrition. Aim: The aim of this study was to describe the lived experiences of self-care and features that influence health and self-care among older, home-dwelling individuals identified to be at risk of undernutrition. Methods: Qualitative interviews were performed with eleven home-dwelling individuals who had been identified as being at risk of undernutrition. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method. Findings: Self-care as a lived experience among older, home-dwelling individuals identified to be at risk of undernutrition is about being aware of food choices and making decisions about taking healthy steps or not. In the presence of health problems, the appetite often decreases. Being able to take care of oneself in daily life is important, as is receiving help when needing it. Working at being physically and socially active and engaged may stimulate the appetite. Having company at meals is important and missed when living alone. Being present and taking each day by day, as well as considering oneself in the light of past time and previous experiences and looking ahead, is central, even when having fears for the future and the end of life. Conclusion: Health care professionals should be aware of these findings in order to support self-care in older people, and they should pay attention to the social aspects at meals. Keywords: aged, health promotion, phenomenology, qualitative interview

Lived experiences of self-care among older, home-dwelling individuals identified to be at risk of undernutrition

Introduction: in a society where most older people live in their own homes, it may be expected of older individuals to exercise their potential to take care of themselves in daily life. Nutrition is a central aspect of self-care, and groups of older, home-dwelling people are at risk of undernutrition. Aim: the aim of this study was to describe the lived experiences of self-care and features that influence health and self-care among older, home-dwelling individuals identified to be at risk of undernutrition. Methods: qualitative interviews were performed with eleven home-dwelling individuals who had been identified as being at risk of undernutrition. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method. Findings: self-care as a lived experience among older, home-dwelling individuals identified to be at risk of undernutrition is about being aware of food choices and making decisions about taking healthy steps or not. In the presence of health problems, the appetite often decreases. Being able to take care of oneself in daily life is important, as is receiving help when needing it. Working at being physically and socially active and engaged may stimulate the appetite. Having company at meals is important and missed when living alone. Being present and taking each day by day, as well as considering oneself in the light of past time and previous experiences and looking ahead, is central, even when having fears for the future and the end of life. Conclusion: health care professionals should be aware of these findings in order to support self-care in older people, and they should pay attention to the social aspects at meals

Nutritional self-care in two older Norwegian males: a case study

Background: knowledge about how to support nutritional self-care in the vulnerable elderly living in their own homes is an important area for health care professionals. The aim of this case study was to evaluate the effects of nutritional intervention by comparing perceived health, sense of coherence, self-care ability, and nutritional risk in two older home-dwelling individuals before, during, and after intervention and to describe their experiences of nutritional self-care before and after intervention. Methods: a study circle was established to support nutritional self-care in two older home-dwelling individuals (≥65 years of age), who participated in three meetings arranged by health professionals over a period of six months. The effects of this study circle were evaluated using the Nutritional Form For the Elderly, the Self-care Ability Scale for the Elderly (SASE), the Appraisal of Self-care Agency scale, the Sense of Coherence (SOC) scale, and responses to a number of health-related questions. Qualitative interviews were performed before and after intervention to interpret the changes that occurred during intervention. Results: a reduced risk of undernutrition was found for both participants. A higher total score on the SASE was obtained for one participant, along with a slightly stronger preference for self-care to maintain sufficient food intake, was evident. For the other participant, total score on the SASE decreased, but the SOC score improved after intervention. Decreased mobility was reported, but this did not influence his food intake. The study circle was an opportunity to express personal views and opinions about food intake and meals. Conclusion: an organized meeting place for dialogue between older home-dwelling individuals and health care professionals can stimulate the older person’s engagement, consciousness, and learning about nutritional self-care, and thereby be of importance in reducing the risk of undernutrition

Psychometric testing of the Norwegian version of the Nutritional Form For the Elderly among older home-dwelling people

Nutritional screening instruments need to be evaluated in terms of reliability and validity and being able to demonstrate sensitivity and specificity for use in clinical practice and research. The aims of this study were to test the reliability and validity of the Norwegian version of the Nutritional Form For the Elderly (NUFFE-NO) in a sample of older home-dwelling people, and to use the short form of the Mini Nutritional Assessment (MNA-SF) as a standard. A postal questionnaire, including the two instruments, background variables, and health-related questions, was sent to 6033 home-dwelling older people (65+ years) in southern Norway. In total, 2106 persons responded and were included. Data were analyzed statistically regarding homogeneity, concurrent and construct validity, sensitivity, and specificity of NUFFE-NO. A Cronbach's alpha coefficient of 0.71 and significant item-to-total correlations were obtained as measures of homogeneity. Concurrent validity was assessed by a correlation coefficient of -0.37 (P < 0.001) between NUFFE-NO and MNA-SF. NUFFE-NO could separate known nutritional at-risk groups as a measure of construct validity. A cut-off point of ≥4 for identification of older people at nutritional risk was found for NUFFE-NO with MNA-SF as a standard. NUFFE-NO shows adequate psychometric properties regarding homogeneity and construct validity. MNA-SF was not found to be the most suitable standard to use, because a low correlation coefficient was obtained as a measure of concurrent validity and a lower cut-off point was found compared with another study using the Mini Nutritional Assessment (MNA(®)) as a standard for NUFFE-NO. The obtained cut-off point of ≥4 is not recommended for use in practice or research, because many false positive nutritional at-risk persons would then be identified. Further studies with suitable design have to be performed among older home-dwelling people using the MNA as a standard