Translation and Reliability Of A Filipino Version Of The Validated Patient- Generated Subjective Global Assessment (PG-SGA) Short Form for Nutrition among Patients with Chronic Kidney Disease Not on Dialysis

 

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https://storage.unitedwebnetwork.com/files/1099/113225a0ac55942f52169ea82259926a.pdf
Translation and Reliability Of A Filipino Version Of The Validated Patient- Generated Subjective Global Assessment (PG-SGA) Short Form for Nutrition among Patients with Chronic Kidney Disease Not on Dialysis

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Lester John
Young
Lester John Young lesterjohnyoung10@gmail.com University of the Philippines- Philippine General Hospital Department of Medicine - Division of Adult Nephrology Manila City Philippines *
Abigail Marie Quiza abbymeq@gmail.com University of the Philippines- Philippine General Hospital Department of Medicine - Division of Adult Nephrology Manila City Philippines -
Marissa Elizabeth Lim marlim2006@yahoo.com University of the Philippines- Philippine General Hospital Department of Physiology, University of the Philippines - Philippine General Hospital Manila City Philippines -
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Malnutrition in Chronic Kidney Disease patients has already been a well-established risk factor for patient morbidity and mortality. As such, early detection with screening and early initiation of interventions are important.

In our setting currently, there is still no validated screening tool for Malnutrition in Chronic Kidney Disease patients translated into the Filipino language. In addition to that, translation can reduce bias, enable comparison, and ensure equivalence based on a study by Cruchinho et al. (2024). Moreover, The Patient-Generated Subjective Global Assessment (PG-SGA) Short Form can be filled up in a short period making it practical to use.

This is a cross-sectional study conducted on adult Chronic Kidney Disease patients not on dialysis, ages 19 years old and above with egfr <60ml/min based on CKD-EPI 2021 of at least 3 months or longer, based on at least 2 laboratory determinations of serum Creatinine at the Philippine General Hospital (PGH) Renal Outpatient Department that includes a systematic approach to the cultural adaptation of the Filipino version of Patient-Generated Subjective Global Assessment (PG-SGA) Short Form for Nutrition by means of translation and reliability testing.

The process of translation of the validated questionnaire is in accordance to the recommendation by a study of Cruchinho et.al. (2024): Stage I: Forward Translation, Stage II: Synthesis of Translations, Stage III: Back-translation, Stage IV: Expert Committee Review and Finalizing the Questionnaire, Stage V: Testing of the Prefinal Version of the Questionnaire

The translated questionnaire’s Stability-Reliability (Test-retest) will be measured using Intra-class Correlation Coefficient or Kappa. Anthropometric data including Body Mass Index (BMI) and triceps skin fold measurement will be measured for the benefit of the patients participating in the study.

The study included 59 participants with a mean age of 58.5 years. Most were in the old age group (60 years and above, 55.9%). Females comprised the majority (61.0%) of the participants. Most participants had a body mass index (BMI) greater than 18.5 kg/m² (93.2%) and all of the participants had triceps skinfold thickness above 5 mm. In terms of kidney function, majority of patients were classified under CKD stage 4 (37.2%), followed by stages 3b (27.1%), 5 (18.6%), and 3a (16.9%). Hypertension was the most common underlying etiology (N: 23), followed by diabetes mellitus (N: 21) others – to consider Chronic Tubulointerstitial Nephritis, to consider Cardiorenal Syndrome (N: 13), obstructive uropathy (N: 6).,and chronic glomerulonephritis (N: 4)

The test–retest analysis among 30 participants demonstrated generally high stability/reliability between the first and second assessments.

For the "weight and food intake" items, responses were consistent between the first and second assessments. About half of the participants reported no change in weight (53.3–56.7%), and most indicated their food intake was unchanged compared to normal (73.3% for both assessments), with perfect agreement (κ = 1.000). Nearly all continued to take normal food but in smaller amounts (86.7–90.0%), showing strong agreement (κ = 0.839).

For symptom-related items, the majority reported no problems eating (63.3–70.0%; κ = 0.851), while a few experienced nausea, vomiting, or pain, with kappa values ranging from 0.651 to 0.870, reflecting moderate to excellent agreement.

In terms of activities and function, around half to three-fifths of participants (50.0–60.0%) reported being able to perform normal activities with minimal limitations, showing good agreement between assessments (κ = 0.776).

Overall, the total score demonstrated excellent test–retest reliability, with an intraclass correlation coefficient (ICC) of 0.919, and mean total scores of 2.7 ± 1.8 at the first and 2.5 ± 1.8 at the second assessment.

Kewords