Dataset Information

The state of nutrition care in outpatient hemodialysis settings in Malaysia: a nationwide survey.

ABSTRACT:

Background

This study aimed to assess the situational capacity for nutrition care delivery in the outpatient hemodialysis (HD) setting in Malaysia by evaluating dietitian accessibility, nutrition practices and patients' outcomes.

Methods

A 17-item questionnaire was developed to assess nutrition practices and administered to dialysis managers of 150 HD centers, identified through the National Renal Registry. Nutritional outcomes of 4362 patients enabled crosscutting comparisons as per dietitian accessibility and center sector.

Results

Dedicated dietitian (18%) and visiting/shared dietitian (14.7%) service availability was limited, with greatest accessibility at government centers (82.4%)?>?non-governmental organization (NGO) centers (26.7%)?>?private centers (15.1%). Nutritional monitoring varied across HD centers as per albumin (100%)?>?normalized protein catabolic rate (32.7%)?>?body mass index (BMI, 30.7%)?>?dietary intake (6.0%). Both sector and dietitian accessibility was not associated with achieving albumin ?40?g/L. However, NGO centers were 36% more likely (p?=?0.030) to achieve pre-dialysis serum creatinine ?884??mol/L compared to government centers, whilst centers with dedicated dietitian service were 29% less likely (p?=?0.017) to achieve pre-dialysis serum creatinine ?884??mol/L. In terms of BMI, private centers were 32% more likely (p?=?0.022) to achieve BMI???25.0?kg/m² compared to government centers. Private centers were 62% less likely (p?ConclusionsThere were clear discrepancies in nutritional care in Malaysian HD centers. Changes in stakeholder policy are required to ensure that dietitian service is available in Malaysian HD centers.

SUBMITTER: Khor BH

PROVIDER: S-EPMC6280465 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Publications

The state of nutrition care in outpatient hemodialysis settings in Malaysia: a nationwide survey.

Khor Ban-Hock BH Chinna Karuthan K Abdul Gafor Abdul Halim AH Morad Zaki Z Ahmad Ghazali G Bavanandam Sunita S Visvanathan Ravindran R Yahya Rosnawati R Goh Bak-Leong BL Bee Boon-Cheak BC Karupaiah Tilakavati T

BMC health services research 20181204 1

<h4>Background</h4>This study aimed to assess the situational capacity for nutrition care delivery in the outpatient hemodialysis (HD) setting in Malaysia by evaluating dietitian accessibility, nutrition practices and patients' outcomes.<h4>Methods</h4>A 17-item questionnaire was developed to assess nutrition practices and administered to dialysis managers of 150 HD centers, identified through the National Renal Registry. Nutritional outcomes of 4362 patients enabled crosscutting comparisons as ...[more]

PMID: 30514284

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Project description:ObjectiveTo examine a wide range of study designs and outcomes to estimate the extent to which interventions in outpatient perinatal care settings are associated with an increase in the uptake of depression care.Data sourcesPubMed, CINAHL, PsycINFO, ClinicalTrials.gov, and Scopus (EMBASE) were searched for studies published between 1999 and 2014 that evaluated mental health care use after screening for depression in perinatal care settings.Methods of study selectionInclusion criteria were: 1) English language; 2) pregnant and postpartum women who screened positive for depression; 3) exposure (validated depression screening in outpatient perinatal care setting); and, 4) outcome (mental health care use). Searches yielded 392 articles, 42 met criteria for full-text review, and 17 met inclusion criteria. Study quality was assessed using a modified Downs and Black scale.Tabulation, integration, and resultsArticles were independently reviewed by two abstractors and consensus reached. Study design, intervention components, and mental health care use were defined and categorized. Seventeen articles representing a range of study designs, including one randomized controlled trial and one cluster randomized controlled trial, were included. The average quality rating was 61% (31.0-90.0%). When no intervention was in place, an average of 22% (13.8-33.0%) of women who screened positive for depression had at least one mental health visit. The average rate of mental health care use was associated with a doubling of this rate with patient engagement strategies (44%, 29.0-90.0%), on-site assessments (49%, 25.2-90.0%), and perinatal care provider training (54%, 1.0-90.0%). High rates of mental health care use (81%, 72.0-90.0%) were associated with implementation of additional interventions, including resource provision to women, perinatal care provider training, on-site assessment, and access to mental health consultation for perinatal care providers.ConclusionScreening alone was associated with 22% mental health care use among women who screened positive for depression; however, implementation of additional interventions was associated with a two to fourfold increased use of mental health care. Although definitive studies are still needed, screening done in conjunction with interventions that target patient, health care provider, and practice-level barriers is associated with increased improved rates of depression detection, assessment, referral, and treatment in perinatal care settings.

Dataset Information

The state of nutrition care in outpatient hemodialysis settings in Malaysia: a nationwide survey.

Background

Methods

Results

Publications

The state of nutrition care in outpatient hemodialysis settings in Malaysia: a nationwide survey.

Similar Datasets

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