Use of body composition for nutrition assessment in an IFU
Research type
Research Study
Full title
Patient perception on Using Body Composition for Nutritional Assessment in an Intestinal Failure Unit: A Qualitative Descriptive Study
IRAS ID
340113
Contact name
Simon Lal
Contact email
Sponsor organisation
Northern Care Alliance NHS Foundation Trust
Duration of Study in the UK
0 years, 4 months, 1 days
Research summary
Body composition is a term used by health professionals that refers to the quantities of fat, muscle and bone in your body and is used regularly to assess nutritional status. However, there are few publications that assess the acceptability of the body composition assessment use in Intestinal Failure (IF) by patients. This includes patients’ perceptions of having body composition measurements taken regularly and their perception of how the results reflect their nutritional status and predicted outcome as part of the pre-habilitation (preparation for surgery) pathway.
Body composition is assessed by measuring anthropometry (e.g. weight, height, BMI, arm muscle circumference, triceps skinfolds, calf circumference, body impedance analysis and grip strength). We would like to understand what the perceptions of this are including whether these values motivate them towards goals, what are the barriers, and get an overall idea of the value of the time spent to do these tests on patients.
Lay Summary of Results
Background:
Clinical guidelines recommend monitoring patients with IF (intestinal failure) on PN (parenteral Nutrition) at regular intervals and the anthropometry, body composition and hydration status be monitored at scheduled visits as part of providing nutrition support (1). Body composition and functional status can be assessed by measuring anthropometry (e.g., weight, height, Mid Upper Arm Muscle Circumference (MUAMC), Triceps Skinfolds (TSF), Calf Circumference, Body Mass Index (BMI), and Grip Strength (GS) . Body Impedance Analysis (BIA) can be used to objectively assess body composition, including fat free mass, fat mass, body cell mass and total body water (2). Although, assessment of body composition has been used among patients to assess nutritional status, there are few published publications to assess the acceptability of the body composition assessment use in clinical practice of IF, particularly the BIA.Aim:
This study aimed to examine the experience and acceptability of different methods of assessing body composition particularly the BIA in patients living with IF.Methods:
A single-site qualitative study was conducted at a national U.K. reference centre. Adults with IF were recruited until thematic saturation was reached. Nine participants took part in semi-structured interviews. Interviews were transcribed and analysed using Braun and Clarke’s inductive thematic analysis.Results:
Five key themes emerged around acceptability, understanding, communication, behaviour change and continuity of care. Participants consistently described the Bioelectrical Impedance Analysis (BIA) measurement as a highly acceptable and trustworthy component of their nutritional assessment. Many spoke about the BIA as revealing “hidden” aspects of their body composition, particularly fluid status, which they felt could not be captured through conventional home scales. For many, understanding the results was central to trusting the process. This sense of trust in the measurement appeared to underpin motivation and behaviour change. Across interviews, participants advocated for wider integration of BIA within the health system, often comparing it favourably to other assessment tools.Conclusions:
This is the first report to show that patients tolerate body composition measurements well and when results are personalised and clearly explained, they can be used to self-motivate and change behaviour to positively affect hydration and activity in IF patients. This new evidence shows the BIA’s value, and that it should routinely be built into IF care pathways to motivate patients, and support coordinated multidisciplinary care.REC name
Wales REC 7
REC reference
24/WA/0187
Date of REC Opinion
10 Jun 2024
REC opinion
Favourable Opinion