Mini Nutritional Assessment tool validation project
Data files
Apr 10, 2023 version files 72.85 KB
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MNA_tool_validation_project.rar
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README.md
Abstract
Background: The health status of older people is usually overlooked in many low-income countries like Ethiopia. Appropriate nutritional assessment improves the health of old age people. The Mini Nutritional Assessment tool is a noninvasive and cheap practical evaluation tool that provides a simple and quick method of evaluating the nutritional status of old age people. The tool has multiple versions of confirmed validity in diverse languages, except in Amharic. Furthermore, the tool has still not been properly validated for Ethiopian old age people.
Objective: The purpose of this study was to translate the Mini Nutritional Assessment tool into the Amharic language and validate it among old age people in Bahir Dar City.
Methods: This tool translation and validation study followed normal COSMIN Study design and reporting guidelines. The study was conducted in three stepwise phases from January 16 to March 13, 2021. The first phase was reviewing and selecting nutritional assessment tools for old age people. In the second phase, the selected Mini Nutritional Assessment tool was translated and reviewed by experts. Using the heterogenous purposive sample, ten healthcare specialists with professional experience in the care of old age people were chosen for this step. The experts examined the face and content validity of the Amharic version of the instrument in two rounds of the Delphi technique. Finally, after incorporating the experts’ suggestions and comments, a cross-sectional study was conducted among old age people for psychometric validation. The participant-to-variables ratio of the 10:1 rule of thumb was followed for the minimum sample size. Since the Mini Nutritional Assessment tool has 18 items, 180 community-dwelling old-age people were selected in multistage cluster sampling from Belay Zeleke, one of the sub-cities of Bahir Dar City. Principal component analysis was used to measure construct validity while Cronbach's alpha was employed to assess internal consistency reliability.
Results: As experts reviewed, all items in the translated tool are socially acceptable and have no taboo or sensitive words. The translated tool's content validity ratio was 0.93, and its scale validities (S-CVI/Ave and S-CVI/AU) were 0.97 and 0.83, respectively. Moreover, 180 community-dwelling old age people aged 60 to 90 years old participated in a psychometric evaluation study. Construct validity of the tool was confirmed with factor loadings ranging from 0.47 to 0.89 with a Cronbach’s alpha of 0.65. The tool had a sensitivity and specificity of 97% and 83%, respectively.
Conclusion: The Amharic version of the Mini Nutritional Assessment tool showed good cross-cultural adaption, internal consistency reliability, and construct validity in Bahir Dar community-dwelling old age people. The tool can be used in regular care activities for aged people.
Methods
Study design and period
A cross-sectional study design was conducted from January 16 to March 13, 2021.
Study population
This study utilized two groups of the population. The first group was health care experts used for content validation, and the second group was community-dwelling old age people for psychometric validation.
Sample size and sampling procedures
For the expert judgment, 10 healthcare experts were selected based on the guideline recommendation for the Delphi technique. Two health care professionals each from human nutrition and clinical pharmacy trained at masters’ degree level, nurses trained at BSc level, general medical practitioners, and internists were selected as the panelists. These professionals were selected based on the maximum variation or heterogeneous purposive sampling for their professional experience in the care of old age people. Furthermore, their familiarity with research (at least in his/her graduate paper) and a minimum of one year of working experience were considered as inclusion criteria.
For the psychometric validation, a participant-to-variables ratio of 10:1 was followed as a rule of thumb. The rule states that at least 10 participants are required for each questionnaire item for factor analysis. Since MNA has 18 items, a minimum of 180 study participants were selected for this validity test. Community-dwelling old age people selected in multistage cluster sampling from Belay Zeleke, one of the sub-cities of Bahir Dar City, were used for this study. Community-dwelling old age people who fulfill the following inclusion criteria were selected for the study: age 60 years and above, living in the city administration at least for six months, being capable of describing their lived experience, and being able to understand and speak the Amharic (local) language. This study excluded participants who had significant spine curvature (scoliosis or kyphosis) and had both extremities amputated.
Usage notes
The International Business Machines Corporation Statistical Package for the Social Sciences (IBM SPSS) version 23 was used to analyze the data.