How do spinal cord injury centres manage malnutrition? A cross-sectional survey of 12 regional centres in the United Kingdom and Ireland

Wong, S. S.; Derry, F.; Grimble, G.; Forbes, Alastair

doi:10.1038/sc.2011.118

Cited by 13 publications

(22 citation statements)

References 6 publications

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“…Limited knowledge among medical staff and variation in dietetic provision in SCIC are probably barriers to effective weight management. 4 Without proper guidelines and training, it is unlikely that healthcare staff will have sufficient Obesity prevention and management S Wong et al knowledge to identify at-risk patients or to offer appropriate treatment. This study reinforces the need to consider collaborating with national professional bodies to develop SCI-specific weight management guidelines which include clear guidance on optimal dietetic service provision within the SCICs.…”

Section: Resultsmentioning

confidence: 99%

“…1 Yet in clinical practise, many patients, allied health professionals and hospital managers do not realise how common obesity is in hospitalised patients. 4,5 If ignored, this will cause a greater problem with the development of chronic nutrition-related complications. 1 Among medical staff, knowledge of attitudes towards and practices in the management of obesity have been studied in various English-speaking countries, especially among general practitioners.…”

Section: Introductionmentioning

confidence: 98%

“…4 We therefore conducted this international survey in order to include all the SCICs in four western European countries including Belgium, the Republic of Ireland, the Netherlands and the United Kingdom as we assume that we share similar management approaches for SCI care. The aims of the study were: (i) to examine the opinions on weight management among medical staff working in SCICs; (ii) to evaluate their knowledge, attitudes and practices towards obesity prevention and management; (iii) to report the number of dietitians per bed available at each SCIC.…”

Section: Introductionmentioning

confidence: 99%

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Knowledge, attitudes and practices of medical staff towards obesity management in patients with spinal cord injuries: an International survey of four western European countries

et al. 2014

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Objective: To (1) examine the opinions of medical staff working in spinal cord injury (SCI) centres (SCICs); (2) evaluate their knowledge, attitudes and practices towards obesity prevention and management; (3) report the number of beds and dietitians available at each SCIC. Methods: A 37-item questionnaire was sent to 23 SCICs in the UK, the Netherlands, Belgium and the Republic of Ireland between September 2012 and January 2013. Results: Eighteen SCICs returned the questionnaires for analysis. All respondents stated that they had an interest in obesity treatment but only 2.3% of the respondents received training in obesity management. Sixty-one percent of staff did not consider body mass index (BMI) to be appropriate for use in SCI patients and subsequently less than half of the respondents use BMI routinely. The majority of respondents reported that they are confident in dealing with overweight (74.5%) and obese (66.1%) SCI adults, less than half (44.1%) are confident in treating overweight and obese SCI children. Respondents also indicated the need for nationally adopted guidelines and a lack of physical activity provision. There were 17.5 whole-time equivalent (WTE) dietitians recorded in 22 SCICs, equivalent to 47.8 beds per WTE dietitians (range 10–420). Non-UK SCIC dietitians are significantly better resourced than in UK SCICs (beds per WTE dietitian: 36 vs 124, P=0.035). Conclusion: Medical staff expressed the need to participate in obesity prevention and management. Appropriate training should be considered for all medical staff and the development of specific weight management guidelines and dietetic provision should be considered

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Knowledge, attitudes and practices of medical staff towards obesity management in patients with spinal cord injuries: an International survey of four western European countries

et al. 2014

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“…1 Despite its importance, malnutrition is rarely identified by clinicians working in general hospitals 2 or in SCI centres (SCIC). 3 We reported previously that the provision of dietetic resources in SCIC is suboptimal, 4 and therefore, it is imperative that hospital catering staff in conjunction with ward-based personnel are proficient in optimising menu design, and in adapting menus, that they have the ability to improve the mealtime atmosphere, and are able to deal with individual patient needs as well as offering a balanced menu that meets patients' nutritional requirements.…”

Section: Introductionmentioning

confidence: 99%

Meal provision in a UK National Spinal Injury Centre: a qualitative audit of service users and stakeholders

et al. 2012

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Study design: A single centre survey. Objectives: The objective of this study is to (1) assess patients' food intake and (2) measure satisfaction with current food provision, as judged by patients and by stakeholders (medical and nursing staff, managers and catering staff). Methods: Standardised questionnaires were used to record food intake over a 24-h period, and to evaluate the quality, ordering, delivery and overall acceptability of food provided. Results: The food intake of 67 patients with spinal cord injury (SCI) was recorded (64% response rate) and 166 evaluations (50% response rate) were returned. Twenty-nine patients (48%) consumed three full meals a day, 17 (26%) received oral nutritional supplements, 22 (34%) received vitamin/mineral supplements, and 23 (35%) required assistance to eat. Some patients and stakeholders expressed satisfaction with the current food provision: taste good: 25 versus 17% (for patients and stakeholders, respectively); appropriate texture: 22 versus 21%; appropriate temperature: 55 versus 72% (P ¼ 0.002); well presented: 43 versus 28%; good choice: 49 versus 59%; received meal ordered: 65 versus 37% (Po0.001); meal served on time: 71 versus 58%; and no interruption during mealtimes: 62 versus 46%. Principal component analyses of item scores identified three main factors (food quality, food presentation and food delivery (logistics). Conclusion: The present study identified some areas where there appeared to have been improvement in SCI hospital catering, but with much still to be achieved. Hospital-catering systems should be tailored to meet the demands of the different patient groups to optimise nutritional intake. Periodic quality control is essential to meet recommendations and patients' expectations.

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Validation of the modified Spinal Nutrition Screening Tool (SNST-2) in patients with Spinal Cord Injuries

et al. 2015

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Spinal Cord Injury Centres (SCICs) report different practices in nutritional screening (1) . A modified disease specific nutrition screening tool: the Spinal Nutrition Screening Tool (SNST-2) based on eight parameters (body mass index; age; level of SCI; presence of co-morbidities; skin conditions; diet; appetite and ability to eat) has been developed for use in SCICs. Its reliability and agreement with the previously validated, published tool (SNST-1) (2) needs to be assessed before its use is implemented in SCICs. The aim of the study was to test validity of the modified SNST-2. (3) Patients' baseline clinical data, anthropometric measurements and SNST-2 score were assessed in a SCIC in the Republic of Ireland during a 6 months period. The validity of SNST-2 was tested by (i) comparison with the previously validated SNST-1 (2) (concurrent validity) and (ii) an additional SNST-2 was completed by the research dietitian and ward nurses to assess inter-and intra-rater reliability. Agreement was tested using Cohen's κ-statistics (4) . 30 patients (aged 20-90 years, median: 54 years, 63·2% female; 23·3% tetraplegic SCI) were studied. Using SNST-2 on admission, 7 patients (23·3%) were at risk of undernutrition. The SNST-2 had "substantial agreement" with SNST-1 (κ: 0·902, 95% CI: 0·714-1·000). The SNST-2 had substantial reliability (inter-rater reliability (dietitian vs nurse) κ: 0·902, 95% CI: 0·714-1·0). The SNST-2 may be an acceptable (valid and reliable) tool in identifying SCI patients at risk of malnutrition. Further investigation with a larger sample size is warranted to test its predictive validity.The authors would like to thank the patients and staff from Our Lady's Ward and Spinal Cord System of Care Programme for facilitating the study. We would like to thank Anthony Twist, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Philippa Bearne, Salisbury District Hospital for development of the modified SNST.

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How do spinal cord injury centres manage malnutrition? A cross-sectional survey of 12 regional centres in the United Kingdom and Ireland

Cited by 13 publications

References 6 publications

Knowledge, attitudes and practices of medical staff towards obesity management in patients with spinal cord injuries: an International survey of four western European countries

Knowledge, attitudes and practices of medical staff towards obesity management in patients with spinal cord injuries: an International survey of four western European countries

Meal provision in a UK National Spinal Injury Centre: a qualitative audit of service users and stakeholders

Validation of the modified Spinal Nutrition Screening Tool (SNST-2) in patients with Spinal Cord Injuries

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