Children with neurodisabilities are noted to be smaller and lighter than their nondisabled
peers. Many are chronically malnourished and few have had their
nutritional status assessed by a dietitian.
The aim of this study was to design a screening tool as a method of screening
children with neurodisabilities to ensure the early detection of malnutrition and
referral to dietetic services.
The tool was designed using the clinical characteristics of malnutrition for this
population. Content validity of the tool was undertaken using a nominal group
approach involving 12 expert dietitians. Face validity of the tool was tested with a
group of 5 school nurses.
The tool was piloted on 10 nurses and 22 children attending Chailey Heritage
School. Levels of agreement were measured using Kappa coefficient scores. The
scores highlighted the items on the tool that performed better in terms of having
higher levels of agreement with the dietitian, thus identifying malnutrition risk.
Inter-rater reliability was explored to determine whether the nurses were using the
tool in the same way. Verbal feedback was also sought from the tool users at the
end of the data collection period. These results led to several further refinements
including the removal of items which did not discriminate between a malnutrition
risk and no risk, and re-wording of other items to improve clarity of interpretation.
The refined tool now requires testing for its psychometric properties on a larger
group of children.
|Date of Award||Nov 2014|