Background: Despite recent advances in medical and surgical treatment, pre-existing state of nutrition is one aspect of pediatric heart disease that has received little attention. Children with heart disease are often observed to be small and undernourished. Several studies have examined height, weight, and protein status but there has been no detailed assessment of nutritional status.
Nutritional status is one of the major determinants of the magnitude of the metabolic response to surgery. It has become increasingly common to operate at an early age, by poor body reserves in these children may be an even more significant factor in militating against a successful outcome.
The aim of this study is to develop a Nurses' Nutritional Assessment Tool (NNAT) and test its validity and reliability. This is done to assess accurately the nutritional status of pediatric patients with heart disease upon admission at the Division of Pediatric Care.
Methods: The NNAT was field-tested on 50 patients ages 0 to 19 years old. The assessment tool has 6 components: feeding activities, economic status, dietary data, anthropometric measurements, clinical observations, and laboratory data. Four components (feeding activities, anthropometric, clinical, and laboratory were tested for validity by Pearson's r while other two components, economic status and dietary data wee not subjected to validity test because of its inadapatability to a scoring system.
Results/Conclusion: Controlling for age, Pearson's results improved and are statistically significant for anthropometric, p=.001** at .001 level of significance, for clinical, p=.000*** at .001 level of significance, for laboratory, p=.007** at .01 level of significance while feeding activity is no longer statistically significant. When age was not controlled, feeding activity has a p= -.3725 and was statistically significant at .01 level of significance.
Reliability was tested using the Cronbach's alpha which yielded and alpha of 0.1274. It is not a highly satisfactory result, although it fell between the normal range of 0.0 and +1.0. To form a scoring scale for nutritional status of very poor, poor, fair and good, factor analysis was done. It yielded a factor of .739 for feeding activity, .740 for anthropometric, .620 for clinical and .460 for laboratory.