Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Turkish Adaptation of Nutritional Form for the Elderly: A Methodological Study
Yaşlılar için Beslenme Formu'nun Türkçeye Uyarlanması: Metodolojik Bir Çalışma
Hülya KAMARLI ALTUNa, Gülen SUNAa, Seda ÇİFTÇİb
aDepartment of Nutrition and Dietetics, Akdeniz University Faculty of Health Sciences, Antalya, Türkiye
bDepartment of Nutrition and Dietetics, İzmir Democracy University Faculty of Health Sciences, İzmir, Türkiye
Turkiye Klinikleri J Health Sci. 2022;7(4):1135-42
doi: 10.5336/healthsci.2022-91423
Article Language: EN
Full Text
ABSTRACT
 Objective: To establish the validity and reliability of the Nutrition Form for the Elderly (NUFFE), which is a new, inexpensive, useful, and easily applicable malnutrition assessment tool for the elderly. Material and Methods: The study was conducted on 150 individuals aged 65 and over living in the community. The questionnaire form containing NUFFE and Mini Nutritional Assessment (MNA) form, which was validated and reliable in Turkish, was used to evaluate sociodemographic characteristics, anthropometric measurements as data collection tool. NUFFE is a form consisting of 15 items and 3 answer options for each question. The scale was first translated from English to Turkish by experts, and then reverse translated by different experts. Being evaluated by 10 experts with the Davis technique, the validity, reliability and internal consistency and correlation between MNA of the applied form were evaluated. Results: The mean age of the participants was 70.68±5.39 years. The suitability of the sample size for factor analysis was tested with Kaiser-Meyer-Olkin and the value of 0.778. Due to the low factor loads in the explanatory factor analysis, three items (N6, N8, N14) were removed from the scale and the remaining 12-item were collected in two sub-dimensions. The Cronbach's alpha coefficient of NUFFE-TR was found to be 0.741. A negative correlation was found between NUFFE-TR and total MNA scores (r=- 0.778; p<0.05). Conclusion: NUFFE-TR is a valid and reliable, simple, practical, and quick-to-apply form to assess the nutritional status of older adults living in Turkish society.

Keywords: Malnutrition; aged; validation studies; nutrition assessment; geriatric assessment
ÖZET
 Amaç: Yaşlı bireyler için yeni, ucuz, yararlı ve kolay uygulanabilir bir malnütrisyon değerlendirme aracı olan Yaşlılar İçin Beslenme Formu'nun [Nutrition Form for the Elderly (NUFFE)] geçerlilik ve güvenirliğinin yapılması amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya toplumda yaşayan 65 yaş ve üstü 150 birey dâhil edilmiş, veri toplama aracı olarak sosyodemografik özellikler, antropometrik ölçümler, Türkçe geçerlik ve güvenirliği yapılan NUFFE ile Mini Nütrisyonel Değerlendirme [Mini Nutritional Assessment (MNA)] Formu'nun bulunduğu anket formu kullanılmıştır. NUFFE, 15 madde ve her soru için 3 cevap şıkkından oluşan bir formdur. Ölçeğin uzmanlar tarafından önce İngilizceden Türkçeye çevirisi yapılmış, sonrasında farklı uzmanlar tarafından ters çevirisi yapılmıştır. Davis tekniği ile 10 uzman tarafından değerlendirildikten sonra son şekli verilerek, uygulanan formun geçerlilik, güvenirlik, iç tutarlılığı ve MNA ile arasındaki korelasyon değerlendirilmiştir. Bulgular: Katılımcıların yaş ortalaması 70,68±5,39'dur. Örneklem büyüklüğünün faktör analizine uygunluğu Kaiser-Meyer-Olkin ile test edilmiş ve bulunan 0,778 değeri örneklem sayısının yeterli olduğunu göstermiştir. Açıklayıcı faktör analizinde faktör yüklerinin düşük olması nedeniyle ölçekten 3 madde (N6, N8, N14) çıkarılmış ve kalan 12 madde, 2 alt boyutta toplanmıştır. On iki maddelik NUFFE-TR'nin Cronbach alfa katsayısı 0,741 bulunmuştur. NUFFE-TR ile toplam MNA puanları arasındaki negatif yönde bir korelasyon bulunmuştur (r=-0,778; p<0,05). Sonuç: NUFFE-TR, Türk toplumunda yaşayan yaşlı erişkinlerin beslenme durumunu değerlendirmek için geçerli ve güvenilir, basit, pratik ve hızlı uygulanabilecek bir formdur.

Anahtar Kelimeler: Malnütrisyon; yaşlı; geçerlilik çalışması; beslenme değerlendirmesi; geriatrik değerlendirme
REFERENCES:
  1. Samancı Tekin Ç, Kara F. Dünyada ve Türkiye'de yaşlılık [Aging in the world and Turkey]. Uluslararası Bilimsel Araştırmalar Dergisi. 2016;3(1):219-29. [Link] 
  2. TURKSTAT Turkish Statistical Institute. Elderly with Statistics. (accessed 23.01.2022). [Link] 
  3. Arıoğlu S. Yaşlılarda Malnütrisyon Kılavuzu. Ankara: Akademik Geriatri Derneği; 2013. [Link] 
  4. Corcoran C, Murphy C, Culligan EP, Walton J, Sleator RD. Malnutrition in the elderly. Sci Prog. 2019;102(2):171-80. [Crossref]  [PubMed] 
  5. Şahin H, Çiçek B, Yılmaz M, Ongan D, Kaya N, İnanç N. Kayseri ilinde yaşayan 65 yaş ve üzeri bireylerde beslenme durumu ve yaşam kalitesinin saptanması [Determining nutritional status andquality of life of 65 years and olderindividuals in Kayseri]. Turkish Journal of Geriatrics. 2013,16(3):322-9. [Link] 
  6. Balcı E, Şenol V, Eşel E, Günay O, Elmalı F. 65 yaş ve üzeri bireylerin depresyon ve malnutrisyon durumları arasındaki ilişki [The relationship between malnutrition and depression in people aged over 65 years]. Türkiye Halk Sağlığı Dergisi. 2012;10(1):37-43. [Link] 
  7. Ülger Z, Halil M, Kalan I, Yavuz BB, Cankurtaran M, Güngör E, et al. Comprehensive assessment of malnutrition risk and related factors in a large group of community-dwelling older adults. Clin Nutr. 2010;29(4):507-11. [Crossref]  [PubMed] 
  8. Simsek H, Meseri R, Sahin S, Ucku R. Prevalence of food insecurity and malnutrition, factors related to malnutrition in the elderly: a community-based, cross-sectional study from Turkey. European Geriatric Medicine. 2013;4(4):226-30. [Crossref] 
  9. Hao X, Li D, Zhang N. Geriatric Nutritional Risk Index as a predictor for mortality: a meta-analysis of observational studies. Nutr Res. 2019;71:8-20. [Crossref]  [PubMed] 
  10. Guigoz Y, Vellas B. The Mini Nutritional Assessment (MNA) for grading the nutritional state of elderly patients: presentation of the MNA, history and validation. Nestle Nutr Workshop Ser Clin Perform Programme. 1999;1:3-11; discussion 11-2. [Crossref]  [PubMed] 
  11. Duerksen DR, Laporte M, Jeejeebhoy K. Evaluation of nutrition status using the subjective global assessment: malnutrition, cachexia, and sarcopenia. Nutr Clin Pract. 2021;36(5):942-56. [Crossref]  [PubMed] 
  12. Koren-Hakim T, Weiss A, Hershkovitz A, Otzrateni I, Anbar R, Gross Nevo RF, et al. Comparing the adequacy of the MNA-SF, NRS-2002 and MUST nutritional tools in assessing malnutrition in hip fracture operated elderly patients. Clin Nutr. 2016;35(5):1053-8. [Crossref]  [PubMed] 
  13. Hersberger L, Bargetzi L, Bargetzi A, Tribolet P, Fehr R, Baechli V, et al. Nutritional risk screening (NRS 2002) is a strong and modifiable predictor risk score for short-term and long-term clinical outcomes: secondary analysis of a prospective randomised trial. Clin Nutr. 2020;39(9):2720-9. [Crossref]  [PubMed] 
  14. Ye XJ, Ji YB, Ma BW, Huang DD, Chen WZ, Pan ZY, et al. Comparison of three common nutritional screening tools with the new European Society for Clinical Nutrition and Metabolism (ESPEN) criteria for malnutrition among patients with geriatric gastrointestinal cancer: a prospective study in China. BMJ Open. 2018;8(4):e019750. [Crossref]  [PubMed]  [PMC] 
  15. Reber E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutritional risk screening and assessment. J Clin Med. 2019;8(7):1065. [Crossref]  [PubMed]  [PMC] 
  16. Xu YC, Vincent JI. Clinical measurement properties of malnutrition assessment tools for use with patients in hospitals: a systematic review. Nutr J. 2020;19(1):106. [Crossref]  [PubMed]  [PMC] 
  17. Söderhamn U, Dale B, Sundsli K, Tomstad ST, Söderhamn O. Psychometric testing of the Norwegian version of the Nutritional Form For the Elderly among older home-dwelling people. J Multidiscip Healthc. 2012;5:121-8. [Crossref]  [PubMed]  [PMC] 
  18. Söderhamn U, Söderhamn O. Developing and testing the nutritional form for the elderly. Int J Nurs Pract. 2001;7(5):336-41. [Crossref]  [PubMed] 
  19. Söderhamn U, Söderhamn O. Reliability and validity of the nutritional form for the elderly (NUFFE). J Adv Nurs. 2002;37(1):28-34. [Crossref]  [PubMed] 
  20. Hayran M, Hayran M. Sağlık Araştırmaları İçin Temel İstatistik. Ankara: Art Ofset Matbacılık; 2018.
  21. Erdoğan S, Nahçıvan. N, Esin MN. Hemşirelikte araştırma: süreç, uygulama ve kritik. Veri Toplama Yöntem ve Araçları ve Veri Toplama Araçlarının Güvenirlik ve Geçerliği. 1. Baskı. İstanbul: Nobel Tıp Kitapevi; 2014. p.217-30.
  22. Tavşancıl E. Tutumların Ölçülmesi ve SPSS ile Veri Analizi. 5. Baskı. Ankara: Nobel Yayınevi; 2014.
  23. Akdeniz Üniversitesi kampüsü 60+ Tazelenme Üniversitesi [İnternet]. [Erişim tarihi: 15 Haziran 2022]. Üniversite Hakkında. Erişim linki: [Link] 
  24. Gao H, Söderhamn U, Zhang L, Cui HX, Liu K. Reliability and validity of the chinese version of the nutritional form for the elderly. Public Health Nutr. 2015;18(14):2559-64. [Crossref]  [PubMed] 
  25. Sharifi F, Mirarefin M, Alizadeh-Khoei M, Nazari N, Najafi B, Fakhrzadeh H, et al. Psychometric properties of the Persian version of the nutritional form for the elderly (NUFFE) in nursing home residents. Med J Islam Repub Iran. 2018;32:105. [Crossref]  [PubMed]  [PMC] 
  26. Davis LL. Instrument review: getting the most from a panel of experts. Applied Nursing Research. 1992;5(4):194-7. [Crossref] 
  27. Almanasreh E, Moles R, Chen TF. Evaluation of methods used for estimating content validity. Res Social Adm Pharm. 2019;15(2):214-21. [Crossref]  [PubMed] 
  28. Kalaycı Ş. SPSS Uygulamalı Çok Değişkenli İstatistik Teknikleri. Ankara: Asil Yayın Dağıtım; 2005. (Baskı sayısı eklenmelidir.)
  29. Büyüköztürk Ş. Sosyal Bilimler İçin Veri Analizi El Kitabı İstatistik, Araştırma Deseni SPSS Uygulamaları ve Yorum. 2. Baskı. Ankara: Pegem Yayınları; 2002.
  30. Rakıcıoğlu N. Yaşlılık döneminde malnütrisyonun saptanması. Gökçe Kutsal Y, editör. Geriatri Yaşlı Sağlığına Multidisipliner Yaklaşım. TEB Eczacılık Akademisi; 2009. p.131-8.
  31. Tosun Taşar P, Şahin S. Nutrisyonel tarama yöntemleri ve değerlendirme [Nutritional screening methods and evaluation]. Turkiye Klinikleri J Geriatr-Special Topics. 2016;2(1):25-8. [Link] 
  32. Gombos T, Kertész K, Csíkos A, Söderhamn U, Söderhamn O, Prohászka Z. Nutritional form for the elderly is a reliable and valid instrument for the determination of undernutrition risk, and it is associated with health-related quality of life. Nutr Res. 2008;28(2):59-65. [Crossref]  [PubMed] 
  33. Söderhamn U, Flateland S, Jessen L, Söderhamn O. Norwegian version of the Nutritional Form for the Elderly: sufficient psychometric properties for performing institutional screening of elderly patients. Nutr Res. 2009;29(11):761-7. [Crossref]  [PubMed] 
  34. Cook Z, Kirk S, Lawrenson S, Sandford S. Use of BMI in the assessment of undernutrition in older subjects: reflecting on practice. Proc Nutr Soc. 2005;64(3):313-7. [Crossref]  [PubMed] 

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