慢病营养管理体系的构建及其信度、效度的分析研究  

Construction of nutrition management system for chronic noninfectious diseases and analysis of its reliability and validity

作　　者：刘钊[1] 刘航宽 张新胜[1] 李林杰 刘英华[1] LIU Zhao;LIU Hangkuan;ZHANG Xinsheng;LI Linjie;LIU Yinghua(The First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]解放军总医院第一医学中心,北京100853 [2]天津医科大学总医院,天津300052

出　　处：《实用预防医学》2025年第2期247-252,共6页Practical Preventive Medicine

基　　金：2022年度军保委保健专项重点项目(22BJZ20)。

摘　　要：目的构建Healthier for Me慢病营养管理软件,通过临床营养专家比较,验证其临床应用效果和一致性。方法选择440名慢性病患者为评价对象,并邀请44名临床营养专家。根据评价对象基本信息,分别采用Healthier for Me慢病营养管理软件和临床营养专家制定营养干预方案,包括营养素推荐量、膳食种类建议量及膳食医嘱等。比较Healthier for Me慢病营养管理软件和临床营养专家方案差异,采用组内相关系数(intraclass correlation coefficient,ICC)和Bland-Altman方法评价两者一致性。结果Healthier for Me慢病营养管理软件和专家两种评价方法,在推荐能量、三大营养素及膳食种类(除油脂类外)结果上差异均有统计学意义(P<0.05);Bland-Altman和ICC一致性分析发现:两者基础能量消耗(basal energy expenditure,BEE)一致性较好,能量、蛋白质一致性一般,其他一致性较差;不同专家间及专家均值和软件值间ICC在BEE、能量、脂肪、蛋白质、碳水化合物一致性较好,而在膳食种类方面一致性差异较大。结论Healthier for Me慢病营养管理软件与临床营养专家评价结果营养素推荐方面相对一致,而膳食种类推荐量上存在差异,但营养管理软件推荐值相对稳定,具有快捷和智能化等方面的优势。Objective To construct a Healthier for Me software about nutrition management system for chronic noninfectious diseases,and to verify its clinical application effect and consistency by a comparison of evaluation results from the Healthier for Me software about nutrition management system for chronic noninfectious diseases and clinical nutrition experts.Methods A total of 440 chronic noninfectious disease patients were selected as the evaluation subjects,and 44 clinical nutrition experts were invited.According to the evaluation subjects'general information,we conducted the evaluations based on the Healthier for Me software about nutrition management system for chronic noninfectious diseases and the nutrition intervention program designed by clinical nutrition experts,including the recommended amounts of nutrients and dietary types and the dietary prescription.We compared the differences in the evaluation results from Healthier for Me software about nutrition management system for chronic noninfectious diseases and the nutrition intervention program designed by clinical nutrition experts,and then assessed the consistency of the evaluation results from both by using the intraclass correlation coefficient(ICC)and Bland-Altman method.Results There were statistically significant differences in the results of recommended energy,three major nutrients and dietary types(except oils and fats)between the Healthier for Me software about nutrition management system for chronic noninfectious diseases and the nutrition intervention program designed by clinical nutrition experts(P<0.05).The consistency analysis based on Bland-Altman method and the ICC displayed that the consistency in basal energy expenditure(BEE)was good,the consistencies in energy and protein were general,and those in other items were poor.The evaluation based on the ICC showed good consistency in BEE,energy,fat,protein and carbohydrate among different experts as well as between expert mean and software values,but displayed great differences in dietary types.Co

关 键 词：慢性非传染性疾病 营养管理 软件系统 临床营养 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]