1.Development of nutrition screening guideline content for use by healthcare staffs in older adults in health clinic setting: A scoping review
Siti Nur Amirah Sheikh Hishamuddin ; Aliza Haslinda Hamirudin ; Sakinah Harith ; Mohd Aznan Md Aris ; Karimah Hanim Abd Aziz ; Iman Nabihah Noor Azam ; Nurul Syaireen A Rashid
Malaysian Journal of Nutrition 2022;28(No.1):119-148
		                        		
		                        			
		                        			Introduction: Malnutrition, specifically undernutrition, in community-dwelling 
older adults reduces their well-being and predisposes to diseases. Therefore, timely 
malnutrition identification through nutrition screening is needed to identify at risk 
and malnourished patients. This study aimed to develop the content of nutrition 
screening guideline to facilitate healthcare staffs in health clinics to administer a 
validated nutrition screening tool specifically for older adults. Methods: A scoping 
review was conducted electronically using SCOPUS, PubMed, ProQuest Health & 
Medical Complete, and Cochrane databases. The systematic search was performed 
up to 31st December 2021. Search terms were created for identification of eligible 
and related articles. Inclusion and exclusion criteria were determined for the 
systematic search. The search was limited to English and Malay languages, and 
full text articles with no limitation of years. All data were extracted and analysed, 
guided by the PRISMA extension for scoping reviews (PRISMA-ScR). Results:
From 728 identified articles, 18 articles were included in the analysis. Identified 
information for the guideline content were: introduction, aims and objectives, 
definition of malnutrition, prevalence of malnutrition, implementation of nutrition 
screening, guidance on administering items in validated tools, and guidance on 
anthropometric measurements. Meanwhile, format and flow charts from established 
guidelines served as references for the guideline development process. Conclusion:
Appropriate content to develop a nutrition screening guideline has been identified 
based on this review. Development of a guideline based on this content can facilitate 
healthcare staffs to perform timely nutrition screening in older adults.
		                        		
		                        		
		                        		
		                        	
2.Development, Validation and Acceptability of a Newly Developed Nutrition Resource Kit for At-Risk and Malnourished Elderly in Health Clinics Setting
Iman Nabihah Noor Azam ; Aliza Haslinda Hamirudin ; Sakinah Harith ; Mohd Aznan Md Aris ; Karimah Hanim Abd Aziz ; Nurul Syaireen A Rashid
Malaysian Journal of Medicine and Health Sciences 2022;18(No.5):93-103
		                        		
		                        			
		                        			Introduction: The elderly population is highly vulnerable to malnutrition, including those in the community. The use 
of nutrition education as part of nutrition intervention is able to improve their nutritional status. Hence, provision of a 
nutrition resource kit addressing the needs of at-risk and malnourished elderly would be advantageous. This research 
aimed to develop, validate and evaluate the acceptance of a newly developed nutrition resource kit, which served 
as an educational material among at-risk and malnourished elderly in Malaysian health clinics. Methods: This study 
was conducted in three phases: Phase I comprised of qualitative needs assessment to identify the types of nutrition 
resource kit needed; Phase II was the development and validation of the nutrition resource kit; while Phase III was 
acceptance evaluation, which involved individual in-depth interview and triangulation. Results: An A5-sized booklet with incorporation of an educational video in a QR code was developed. Both printed material and educational 
video had excellent content and face validity. Suggestions by experts and elderly from validation were considered 
and revision was done accordingly. Acceptance evaluation revealed four themes: 1) positive acceptance, 2) elderly-friendly, 3) valuable, and 4) individual preference. Triangulation data revealed that all elderly positively evaluated 
both resources. Additional suggestions given by elderly were considered for improvement. Conclusion: This newly 
developed nutrition resource kit, both in the printed and electronic format, was well-accepted among the at-risk and 
malnourished elderly. It could be used as an important reference for the elderly, especially those attending health 
clinics, in treating and preventing malnutrition. 
		                        		
		                        		
		                        		
		                        	
3.Content identification for the development of a nutrition resource kit for malnourished and at-risk elderly: A review
Iman Nabihah Noor Azam ; Aliza Haslinda Hamirudin ; Sakinah Harith ; Mohd Aznan Md Aris ; Karimah Hanim Abd Aziz ; Siti Nur Amirah Sheikh Hishamuddin ;
Malaysian Journal of Nutrition 2021;27(No.3):373-396
		                        		
		                        			
		                        			Introduction: Elderly population is more likely to suffer from malnutrition, thereby
requiring appropriate nutrition education as part of nutrition intervention to
overcome this issue. This review aims to identify content suitable for developing a
nutrition resource kit that provides nutritional guidance to combat malnutrition
among malnourished and at-risk elderly in health clinics setting, particularly in
Malaysia. Methods: A literature search was conducted up to 15th December 2019
in four databases: PubMed, Scopus, COCHRANE, and ProQuest Health & Medical
Collection. Potential literature on nutrition education, suitable dietary guidelines
and existing educational materials for elderly in the community, in English and
Malay languages, were searched to identify suitable content for the nutrition
resource kit. All relevant documents were included based on inclusion and exclusion
criteria. Data were extracted and analysed according to the PRISMA-ScR guidelines.
Results: A total of 27 documents consisting of articles, printed materials and
guidelines were included for analysis. Suitable content included information related
to malnutrition such as definition, signs and symptoms, cause-consequences, and
nutrition management, which included food plate, serving size, menu suggestion,
examples of recipes, tips to increase energy and protein intakes through food or
drink, texture modification, a guide to using oral nutritional supplements, tips for
maintaining nutrient content in food and drink, tips to encourage to eat, and oral
health. Conclusion: A nutrition resource kit tailored for malnourished and at-risk
elderly would be a beneficial nutrition intervention. There is a need to incorporate
these information in the development of a nutrition resource kit to improve their
dietary intake.
		                        		
		                        		
		                        		
		                        	
4.Types of Nutrition Resource Kit Needed by Community Living Elderly in Malaysian Health Clinic Setting: A Qualitative Study
Iman Nabihah Noor Azam ; Aliza Haslinda Hamirudin ; Sakinah Harith ; Mohd Aznan Md Aris ; Karimah Hanim Abd Aziz ; Nurul Syaireen A Rashid
Malaysian Journal of Medicine and Health Sciences 2021;17(No.2):217-224
		                        		
		                        			
		                        			Introduction: Elderly population is at high-risk to suffer from malnutrition and nutritional inadequacy. The use of 
nutrition resource kit which provides nutritional guidance could be helpful to improve their dietary intake. There is 
no study performed previously on the type of nutrition resource kit that can be used to overcome and prevent malnutrition among Malaysian elderly. Therefore, this study aimed to identify the types of nutrition resource kit needed 
by community living elderly in Malaysian health clinic setting. Methods: Qualitative study was conducted to explore 
the types of nutrition resource kit needed by community living elderly in health clinics. Recruitment for in-depth 
individual interview targeted elderly aged ≥60 years old who met the inclusion and exclusion criteria and received 
primary healthcare services in four health clinics in Kuantan, Pahang. Interview questions addressed the knowledge 
on existing nutrition educational materials, preference for types of nutrition resource kit and opinion on technology-based materials. Data were audiotaped, transcribed verbatim and thematically analyzed using NVivo software 
version 12. Results: 21 participants involved in this study (mean age=67.24 ±6.98 years). Five key themes identified 
from the data: provision of nutrition resource kit; preference for printed version; eye-friendly; facilitate understanding 
with diagram; and support for technology-based materials. This study also found that majority of elderly preferred for 
A5-sized booklet for nutrition resource kit. Conclusion: Future development of nutrition resource kit tailored to the 
need of elderly is needed to deliver nutritional guidance effectively and served as an important reference for them to 
overcome malnutrition. 
		                        		
		                        		
		                        		
		                        	
            

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