Fatma NİŞANCI KILINÇ, Çiler ÖZENİR, Sevinç EŞER DURMAZ, Aylin BAYINDIR GÜMÜŞ, Biriz ÇAKIR

Hastaların Hastaneye Yatış Anındaki Malnütrisyon Durumunun ve Yaşam Kalitesinin Belirlenmesi

Malnütrisyon, artan mortalite ve morbidite ile ilişkilendirilmekle birlikte günlük yaşam aktiviteleri ve yaşam kalitesi üzerinde olumsuz etkileri olan bir sağlık sorunudur. Bu çalışmada, hastaneye yatışı yapılan hastaların malnütrisyon açısından değerlendirilmesi ve yaşam kalitesi düzeylerinin belirlenmesi amaçlanmıştır. Çalışma, Kırıkkale Üniversitesi Tıp Fakültesi Hastanesi’nde 19 yaş ve üzeri 407 (K:204, E:203) yeni yatışı yapılan hasta ile yürütülmüştür. Hastaların sosyodemografik bilgileri sorgulanmış, bazı antropometrik ölçümleri alınmıştır. Hastalara NRS-2002 formu ve Dünya Sağlık Örgütü Yaşam Kalitesi Değerlendirme Ölçeği (WHOQOL-BREF-TR) uygulanmıştır. Hastaların yaş ortalaması 59,2±17,1 yıldır. Beden kütle indeksi ve el kavrama gücü ortalaması sırasıyla 29,8±30,3 kg/m2 ve 25,5±22,8 kg’dır. Hastaların %13,6’sının malnütrisyonlu olduğu belirlenmiştir. Yaşlı hastaların malnütrisyon oranı daha yüksektir (P=0,009). El kavrama gücü genel ortalamanın altında olanlarda malnütrisyon risk oranı daha yüksektir (P<0,001). Hastaların ortalama NRS-2022 puanı 1,2±1,3 olup, WHOQOL-BREF-TR yaşam kalitesi puanı 2,8±1,1’dir. Kadın ve erkeklerin NRS-2022, WHOQOL-BREF-TR bedensel, ruhsal ve sosyal alan ortalama puanları arasında istatistiksel açıdan önemli farklılık bulunmuştur (P<0,05). Kadınlarda NRS-2002 puan ortalaması erkeklerden fazla iken, yaşam kalitesi puan ortalamaları düşüktür. Yaş ve bel/boy oranı ile NRS-2002 puanları arasında pozitif yönde zayıf bir ilişki; BKİ, bel çevresi, boyun çevresi, bilek çevresi, üst orta kol çevresi ve el kavrama gücü arasında negatif yönde zayıf bir ilişki saptanmıştır (P<0,05). Yaş arttıkça yaşam kalitesi puanlarının azaldığı, negatif yönde zayıf bir ilişki olduğu belirlenmiştir (P<0,001). Yaşam kalitesini artırmak, malnütrisyonu önlemek veya tedavi etmek için hastanın hastaneye yatış anında beslenme durumu değerlendirilmeli ve gereken nütrisyonel destek verilmelidir.

Anahtar Kelimeler:

Malnütrisyon, NRS-2002, Yaşam kalitesi, WHOQOL-BREF

Determination of Malnutrition and Quality of Life at the Time of Hospitalization of Patients

Malnutrition is a health problem that is associated with increased mortality and morbidity, and has negative effects on activities of daily living and quality of life. In this study, it was aimed to evaluate hospitalized patients in terms of malnutrition and to determine their quality of life levels. The study was carried out with 407 (F: 204, M: 203) newly admitted patients aged 19 and over in Kırıkkale University Medical Faculty Hospital. Sociodemographic information of the patients was questioned and some anthropometric measurements were taken. The NRS-2002 form and the World Health Organization Quality of Life Assessment Scale (WHOQOL-BREF-TR) were administered to the patients. The mean age of the patients was 59.2±17.1 years. The mean body mass index and hand grip strength were 29.8±30.3 kg/m2 and 25.5±22.8 kg, respectively. It was determined that 13.6% of the patients were malnourished. Elderly patients have a higher malnutrition rate (P=0.009). The malnutrition risk rate is higher in those whose hand grip strength is below the general average (P<0.001). The mean NRS-2022 score of the patients was 1.2±1.3, and the WHOQOL-BREF-TR quality of life score was 2.8±1.1. A statistically significant difference was found between the mean scores of male and female in NRS-2022, WHOQOL-BREF-TR physical, mental and social domains (P<0.05). While the mean NRS-2002 score is higher in female than male, the mean quality of life score is lower. A weak positive correlation between age and waist/height ratio and NRS-2002 scores; there was a weak negative correlation between BMI, waist circumference, neck circumference, wrist circumference, upper middle arm circumference and hand grip strength (P<0.05). It was determined that quality of life scores decreased with increasing age, and there was a weak negative correlation (P<0.001). In order to improve the quality of life, prevent or treat malnutrition, the nutritional status of the patient should be evaluated at the time of hospitalization and the necessary nutritional support should be given.

Keywords:

Malnutrition, NRS-2002, Quality of life, WHOQOL-BREF,

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