In this cross-sectional study, we primarily aimed to assess prevalence of malnutrition by the Patient Generated Subjective Global Assessment (PGSGA), and muscle strength in haemodialysis patients. Second, we explored to which extent these patients are able to complete the patient component of the PG-SGA, aka PG-SGA Short Form (SF) (weight, intake, symptoms, activities/functioning) independently.
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PURPOSE: Malnutrition is frequent in hospitalized patients and is related to functional decline and poorer clinical outcomes. The Patient-Generated Subjective Global Assessment (PG-SGA) is a globally implemented malnutrition tool. We aimed to perform a linguistic and content validation of the translation and cultural adaptation of the PG-SGA for the Spanish language setting.METHODS: This study was conducted in Mexico and Spain. Cancer patients and healthcare professionals (HCPs) of both countries were enrolled. We followed the 10 steps of the International Society for Pharmacoeconomics and Outcomes Research Principles. Patients and HCPs evaluated comprehensibility (Item: I-CI, Scale: S-CI) and difficulty (Item: I-DI, Scale: S-DI) of the Spanish version of the PG-SGA. HCPs also evaluated content validity (i.e., relevance) of the Spanish PG-SGA (Item: I-CVI, Scale: S-CVI). The data were collected by a questionnaire.RESULTS: The study enrolled 84 HCPs and 196 cancer patients from both countries. HCPs rated comprehensibility and difficulty of the professional component as excellent (S-CI = 0.95, S-DI = 0.92), and content validity of the full PG-SGA also as excellent. Patients rated comprehensibility (S-CI) and difficulty (S-DI) of the patient-generated component, that is, the PG-SGA Short Form, as "excellent" (S-CI = 0.98 and S-DI = 0.98).CONCLUSION: Translation and cultural adaptation of the PG-SGA to the Spanish setting according to the International Society for Pharmacoeconomics and Outcomes Research Principles resulted in an instrument perceived as clear and easy to complete by cancer patients and relevant by HCPs to assess the nutritional status.
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Rationale: The Patient-Generated Subjective Global Assessment (PG-SGA) is a validated instrument to assess malnutrition and its risk factors in clinical populations. Its patient component, PG-SGA Short Form (SF), can be used as screening instrument. In this cross-sectional study we aimed to assess agreement between the PG-SGA SF, Malnutrition Universal Screening Tool (MUST), and Short Nutritional Assessment Questionnaire (SNAQ) in patients at the University Medical Center Groningen, The Netherlands.Methods: Malnutrition risk was assessed by PG-SGA SF, MUST, and SNAQ in 81 patients from the Departments Ear Nose Throat (ENT), Oral and Maxillofacial Surgery (OMS) and Orthopedics. Point scores of PG-SGA SF=4-8, MUST=1, and SNAQ=2 were classified as ‘medium malnutrition risk’, and PG-SGA SF≥9, MUST ≥2, and SNAQ ≥3 as ‘high malnutrition risk’. Agreement in classification for malnutrition risk was assessed by weighted kappa (κ) and intra-class correlation coefficient (ICC). A p-value of <0.05 was considered statistically significant.Results: According to the PG-SGA SF, MUST and SNAQ, respectively 65%, 81%, and 80% of all patients were classified as ‘low malnutrition risk’; 24%, 8% and 6% as ‘medium malnutrition risk’; 11%, 10% and 14% as ‘high malnutrition risk’.Agreement between PG-SGA SF and MUST (κ=0.452, ICC=0.448; p<0.001), and between PG-SGA SF and SNAQ (κ=0.395, ICC=0.395; p<0.001) were both fair. In patients from the Departments ENT and OMS, PG-SGA SF classified more patients at medium/high malnutrition risk (n=26) as compared to the MUST (n=12) or SNAQ (n=14).Conclusion: We found only fair agreement between the PG-SGA SF and MUST and SNAQ, respectively. The PG-SGA SF classified three and four times more patients at medium malnutrition risk, compared to MUST and SNAQ respectively, due to its scoring on symptoms and activities/functioning. Hence, the PG-SGA SF may help facilitate proactive prevention of malnutrition.
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