Perbandingan Estimasi Visual Asupan Gizi Pasien Berdasarkan Metode Observasi Langsung dan Metode Foto Digital di RSUP Dr. Sardjito Yogyakarta

HERDAWAN INGGIT A, R. Dwi Budiningsari, SP, M.Kes., Ph.D. ; Fasty Arum Utami, S.Gz., M.Sc ; Yeni Prawiningdyah, SKM, M.Kes

2020 | Skripsi | S1 GIZI KESEHATAN

Latar Belakang: Pasien yang mengalami kekurangan energi dan protein akan mengalami penurunan status gizi pada saat dirawat di rumah sakit yang akan berpengaruh dalam upaya penyembuhan penyakit. Pemantauan asupan energi dan protein menjadi salah satu hal penting untuk mencegah hal tersebut. Comstock (observasi langsung) merupakan metode yang umum digunakan di rumah sakit. Foto digital merupakan metode yang memberikan banyak kelebihan dan dapat diterapkan di rumah sakit namun belum pernah diujikan di Indonesia. Tujuan Penelitian: Membandingkan metode Comstock (observasi langsung) dan foto digital (post meal dan pre post meal) dengan penimbangan sebagai gold standar dalam menilai asupan energi dan protein pasien di RSUP Dr. Sardjito. Metode: Pasien dewasa sebanyak 48 orang diambil set sisa makanannya pada saat makan pagi dan siang, sehingga diperoleh 96 sisa makanan pasien. Sisa makanan pasien yang berbeda diestimasi asupan gizinya (energi dan protein) oleh ahli gizi menggunakan metode Comstock dan foto digital (post meal dan pre-post meal), sedangkan metode penimbangan (gold standar) dilakukan oleh peneliti. Hasil: Analisis independent sample t-test menunjukkan tidak terdapat perbedaan hasil estimasi asupan gizi pasien antara metode foto digital dibandingkan dengan dengan Comstock dan penimbangan (penilaian energi berturut - turut p= 0,727 FW vs. C; p= 0,763 FW vs. PM; p= 0,829 FW vs. PPM; p= 0,966 C vs. PM; p= 0,894 C vs. PPM dan penilaian protein berturut - turut p= 0,865 FW vs. C; p= 0,848 FW vs. PM; p= 0,761 FW vs. PPM; p= 0,980 C vs. PM; p= 0,893 C vs. PPM). Limits of agreement dari Bland-Altman Plot antar metode dibandingkan dengan penimbangan pada energi adalah -46,21 hingga 32,22 (Comstock), -45,80 hingga 33,55 (post meal), dan -43,22 hingga 34,63 (pre post meal) sedangkan pada protein adalah -1,74 hingga 1,46 (Comstock), -1,79 hingga 1,47 (post meal), dan - 1,88 hingga 1,37 (pre-post meal). Kesimpulan: Metode foto digital (post meal) berpotensi untuk dapat digunakan dalam penilaian asupan gizi pasien di rumah sakit

Background: Patients who lack of energy and protein will experience a decrease in nutritional status when hospitalized. This will affect efforts to cure the disease. Monitoring energy and protein intake is one important thing to prevent it. Comstock (direct observation) is a method commonly used in hospitals. Digital photography is a method that has many advantages and can be applied in hospitals but has never been tested in Indonesia. Objective: To compare the Comstock method (direct observation) and digital photography (post meal and pre post meal) with weighing methods as a gold standard in assessing patient nutritional intake (energy and protein) in RSUP Dr. Sardjito. Methods: Forty-eight adult patient's plate of leftover food were taken in breakfast and lunch, the total is 96 plates of adult patients. Nutritional intake (energy and protein) of different patients was estimated by nutritionist using the Comstock method (direct observation) and digital photography (post meal and pre-post meal), while the weighing method (gold standard) was performed by the researcher. Results: The independent sample t-test analysis showed that there was no difference in the estimation results of the patient nutritional intake between the digital photography method compared with Comstock and weighing methods (energy assessments respectively p= 0,727 FW vs. C; p= 0,763 FW vs. PM; p= 0,829 FW vs. PPM; p= 0,966 C vs. PM; p= 0,894 C vs. PPM and protein assessment p= 0,865 FW vs. C; p= 0,848 FW vs. PM; p= 0,761 FW vs. PPM; p= 0,980 C vs. PM; p= 0,893 C vs. PPM). Limits of agreement from the Bland-Altman Plot between methods compared to weighing on assessing energy are -46,21 to 32,22 (Comstock), -45,80 to 33,55 (post meal), and -43,22 to 34,63 (pre-post meal) while on assessing protein are -1,74 to 1,46 (Comstock), -1,79 to 1,47 (post meal), and -1,88 to 1,37 (pre-post meal). Conclusion: Digital photography methods (post meal) have the potential to be applied for assessing patient nutritional intake in hospitals

Kata Kunci : Metode Comstock, metode foto digital, metode penimbangan, asupan gizi, energi, protein/ Comstock method, digital photography method, food weighing method, nutritional intake, energy, protein