Visual Observation Instead of Scales

Thursday, July 14, 2011: 10:35 AM

Shou-Sheng Tang, MD
Department of Respiratory Division, Yu Sheng Hospital, Tainan County, Taiwan
Wen-I Hou, Dietitian, MA
Department of Nutrition, Supervisor, St. Martin De Porres Hospital, Chiayi, Taiwan
Chia-Hsiu Chang, RN
Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
Chung-Hey Chen, PhD
Institute of Allied Health Sciences & Department of Nursing, Cheng Kung University, Tainan, Taiwan
Innchyn Her, PhD
Department of Mechanical & Electro-Mechanical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan

Learning Objective 1: The learner will be able to understand the specific wellness advantages of visual observations in assessing dietary consumption.

Learning Objective 2: The learner will be able to comprehend that the estimation of old adults' oral intake consumption is important to improve residents' nutritional statuses.

Purposed. As apposed to traditional methods (relying on the subjects’ memory or ability to conceptualize consumed food) to assess dietary intakes, visual observation (VO) is a proven means of assessing dietary consumption of western food among older adults. However, since Chinese food differs from western food, the VO consumption proportions had to be adapted accordingly. The aim of this study was to examine the effects of VO estimation of Chinese food plate waste as a measure of the proportion consumed, compared to scale measurements.

Methods. A quasi-experimental study of 38 nursing-home residents’ trays, utilized for plate waste estimates (n = 342 meals; i.e. 3 meals per day × 3 days). Five dietitian-research assistants were trained for two weeks in portion size estimation. All food proportion sizes given to residents were standardized by using standard serving utensils (plates, bowls, and cups). Two assistants were designated the experimental team to visually observe residents' plate waste and determine the net quantity, another two co-operated to use scale measurements (control), and the remaining assistant checked and recorded food taken from outside by family members. A correlation analysis, paired-t test, and ANOVA were used for interpreting the recorded data.

Results. No significant differences between visually estimated and weighed intakes of any meals, except for semi-liquid and chopped diets (e.g. rice porridge and chop suey), were found. The VO group also spent less time (average of 26.6 seconds / per meal) to estimate plate waste, compared to the control group (average of 57.2 seconds / per meal).

Conclusions. The study shows that VO provides reliable nutrition intake proportions data for dietitians, nursing staff, and supervisors. The timesaving and easy-to-use method can reduce mistakes due to memory errors of the staff and residents in nursing homes, and thus also alleviates the responsibility burden of these individuals.