Comparison of a novel, simple nutrition screening tool for adult oncology inpatients and the Malnutrition Screening Tool (MST) against the Patient-Generated Subjective Global Assessment (PG-SGA).

BACKGROUND: Oncology inpatients are at high risk of malnutrition. Identification of at risk patients by nutrition screening requires a practical and easy to use tool. In this study, we have compared a simple, novel nutrition screening tool designed for an oncology inpatient setting and the Malnutrition Screening Tool (MST) against the Patient-Generated Subjective Global Assessment (PG-SGA). METHODS: This was an observational study to compare assessment of nutritional status by PG-SGA with nutrition screening using the Royal Marsden Nutrition Screening Tool (RMNST) and the MST. Patients were recruited from a single tertiary cancer centre. RESULTS: One hundred and twenty-six oncology inpatients underwent a full nutritional assessment and nutrition screening. The PG-SGA tool identified 90 (71%) patients as malnourished or at risk and 36 (29%) patients as well-nourished. The RMNST had a sensitivity of 93% and a specificity of 53%, and the MST had a sensitivity of 66% and a specificity of 83 %. Predictive value (ROC AUC) of both screening tools was excellent at 0.84 and 0.83 for RMNST and MST, respectively. CONCLUSIONS: This study identified a high prevalence of malnutrition in the population with 71% of patients being identified as malnourished or at risk of malnutrition. The RMNST had an excellent sensitivity for identifying patients who were malnourished or at risk of malnutrition in the inpatient setting although it had a poor specificity. The MST had a poorer sensitivity of 66 %. We would recommend that the RMNST is trialled in other oncology inpatient settings and also in the outpatient setting.

Attack on America: children's reactions and parents' responses.

INTRODUCTION: When disaster strikes, as it did September 11, 2001, children react to both the actual event and their parents' distress. The purpose of this study was to find out how children were affected by these recent events and how parents responded to their children's concerns. This study is a sequel to a previous study on parents' and children's perceptions to the President Clinton situation and the Starr Report. METHOD: Eighty-eight school-aged children and 51 parents were recruited for this descriptive, qualitative study that used community-based snowball sampling. Parents and children were asked a series of questions about the attacks on the World Trade Center and Pentagon, including how they heard about it and how it made them feel. RESULTS: Children's responses indicated feelings of fear about their safety and their future; wanting to take revenge; feeling sad and disappointed; and empathy for the victims. Parents realized they had to comfort their children in spite of their own feelings of dismay. Many parents reported difficulty in reacting to their child's concerns regarding fairness and justice. DISCUSSION: Pediatric nurse practitioners need to understand parents' and children's responses to such events in order to provide optimal health care, support, and counseling within the context of normal growth and development.