BMI-based figure rating scale (FRS) as an adjunctive aid in nutritional screening and assessment in a resource-limited setting

Abstract

Objectives: Many existing malnutrition screening and diagnostic tools require body mass index (BMI) and quantification of weight change to detect malnutrition or risk thereof. This is often a challenge in South African public hospitals due to missing data, including patient records. This study investigated the extent to which hospitalised patients can gauge their current and usual body size from a validated BMI-based figure rating scale (FRS). It also ascertained whether a relationship exists between a change in clothing size and a change in perceived BMI, derived from the FRS.
Methods: A total of 196 adult patients participated in a cross-sectional study, in three Eastern Cape public hospitals. Data were collected by consulting medical files, patients and taking anthropometric measurements. Validated FRSs were used to determine patients’ accuracy of actual and usual BMI. Data were analysed with Statistica® and Microsoft Excel 2016.
Results: Some 66% (n = 131) of participants were accurate in selecting an image representative of their BMI, which was statistically significant (r² = 0.80; p < 0.001). Female participants were more likely to select the correct corresponding BMI image (p < 0.05; r² = 0.77 for males; r² = 0.82 for females). Altogether, 61% (n = 79) of participants with a known previous weight were accurate in selecting an accurate image representative of their usual BMI, also statistically significantly (r² = 0.71; p < 0.001).
Conclusion: An existing FRS may be a useful adjunctive aid in clinical practice to estimate certain anthropometric indices when not otherwise available. This may be especially relevant to nutritional screening practices conducted by frontline healthcare professionals, e.g. nurses and doctors not specifically trained in anthropometry. This in turn may improve malnutrition detection rates and facilitation of appropriate nutrition care pathways.