{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T12:27:23Z","timestamp":1784118443468,"version":"3.55.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005029","name":"Helse Vest Regionalt Helsef\u00f8retak","doi-asserted-by":"publisher","award":["912214"],"award-info":[{"award-number":["912214"]}],"id":[{"id":"10.13039\/501100005029","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016999","name":"H\u00f8gskulen p\u00e5 Vestlandet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016999","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005029","name":"Helse Vest Regionalt Helsef\u00f8retak","doi-asserted-by":"publisher","award":["HV1172"],"award-info":[{"award-number":["HV1172"]}],"id":[{"id":"10.13039\/501100005029","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Despite malnutrition being established as a well-known risk for postoperative complications, the lack of screening for nutritional risk remains a challenge. The aim of this study was to investigate whether self-screening for nutritional risk prior to surgery is feasible in a home setting and if it will increase number of patients screened for nutritional risk, and secondly, to compare their screening results with the \u201cin-hospital assessments\u201d conducted by healthcare professionals.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>This was a prospective study involving patients from six randomly selected surgical wards at two Norwegian hospitals as a part of the \u201cFeasibility study of implementing the surgical Patient Safety Checklist the (PASC)\u201d. This checklist included a self-reported screening tool based on the Nutritional Risk Screening tool (NRS 2002) to identify \u201cat risk of malnutrition\u201d in patients that will undergo surgery the next 3 months or less. The original screening tool (NRS 2002) was used as a standard routine to identify \u201cat risk of malnutrition\u201d by healthcare professionals at hospital. The interrater reliability between these results was investigated using Fleiss multi rater Kappa with overall agreement and reported with Landis and Koch\u2019s grading system (<jats:italic>poor<\/jats:italic>, <jats:italic>slight<\/jats:italic>, <jats:italic>fair<\/jats:italic>, <jats:italic>moderate<\/jats:italic>, <jats:italic>substantial<\/jats:italic>, and <jats:italic>almost perfect<\/jats:italic>).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Out of 215 surgical patients in the home setting, 164 (76.7%) patients completed the self-reported screening tool. A total of 123 (57.2%) patients were screened in-hospital, of whom 96 (44.7%) prior to surgery and 96 (44.7%) were screened both at hospital (pre- and post-surgery) and at home. Self-screening at home improved malnutrition screening participation by 71.9% compared to hospital screening prior to surgery (165 (76.7%) and 96 (44.7%), respectively) and by 34.1% compared to pre- and postoperative in-hospital screening, 165 (76.7%) and 123 (57.2%), respectively). The degree of agreement between patients identified to be \u201cat risk of malnutrition\u201d by the self-reported screening tool and healthcare professionals was <jats:italic>poor<\/jats:italic> (\u03ba = - 0.04 (95% CI: -0.24, 0.16), however, the degrees of agreement between the patients and healthcare professionals answers to the initial NRS 2002 questions \u201clow BMI\u201d, \u201cweight loss\u201d, and \u201creduced food intake\u201d were <jats:italic>almost perfect<\/jats:italic> (\u03ba = 1.00 (95% CI: 0,82, 1.18)), <jats:italic>moderate<\/jats:italic> (\u03ba = 0.55 (95% CI: 0.34, 0.75)), and <jats:italic>slight<\/jats:italic> (\u03ba = 0.08 (95% CI: - 0.10, 0.25) respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Three out of four patients completed the self-screening form and the preoperative screening rate improved with 70%. Preoperatively self-screening in a home setting may be a feasible method to increase the number of elective surgical patients screened for risk of malnutrition.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p>The trial is registered in ClinicalTrials.gov ID <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT03105713\" xlink:type=\"simple\">NCT03105713<\/jats:ext-link>. <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT03105713\" xlink:type=\"simple\">https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT03105713<\/jats:ext-link>.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0299305","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T17:36:18Z","timestamp":1713288978000},"page":"e0299305","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Is self-screening for 'at risk of malnutrition' feasible in a home setting?"],"prefix":"10.1371","volume":"19","author":[{"given":"Randi J.","family":"Tangvik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1421-2947","authenticated-orcid":true,"given":"Eli","family":"Skeie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvid Steinar","family":"Haugen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stig","family":"Harthug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"issue":"3","key":"pone.0299305.ref001","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.clnu.2017.02.013","article-title":"ESPEN guideline: Clinical nutrition in surgery","volume":"36","author":"A Weimann","year":"2017","journal-title":"Clin Nutr"},{"key":"pone.0299305.ref002","unstructured":"World Health Organization. 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