Food Insecurity Determinants, Coping Strategies, and Association With Nutritional Status Among Hemodialysis Patients in Pahang, Malaysia: Protocol for a Mixed Methods Study
Notice bibliographique
Résumé
BACKGROUND: Food insecurity involves the lack of physical and economic access to sufficient, safe, and nutritious food that meets an individual's dietary needs. Patients with end-stage renal disease (ESRD) undergoing hemodialysis have specific dietary needs, but food insecurity may hinder them from adhering to prescribed guidelines and preserving their nutritional status. However, no research has been conducted to elucidate food insecurity among patients undergoing hemodialysis in Malaysia. OBJECTIVE: This study aimed to assess the prevalence of food insecurity, its determinants, and its association with nutritional status and explore the coping strategies used among patients undergoing hemodialysis in Pahang, Malaysia. METHODS: This was a cross-sectional study that followed a mixed methods approach and was conducted with patients undergoing hemodialysis for ESRD at the Pahang Islamic Religious Council and Malay Customs (Majlis Ugama Islam dan Adat Resam Melayu Pahang [MUIP]) dialysis centers. The inclusion criteria were patients who were aged 18 years or older, were generally healthy, and had been undergoing hemodialysis regularly for at least 3 months. The food security status of the participants was determined using the Malay version of the Food Insecurity Experience Scale (M-FIES). The nutritional status included anthropometric measurements (height, weight, BMI, triceps skinfold [TSF] thickness, mid-upper arm circumference (MUAC), midarm muscle circumference (MAMC), and body fat percentage), biochemical parameters (serum urea, creatinine, albumin, phosphate, potassium, hemoglobin, and total iron-binding capacity [TIBC]), clinical assessments (Malnutrition Inflammation Score [MIS] and protein energy wasting [PEW]), and dietary intake (adherence to total calorie, protein, sodium, potassium, and phosphorus intake and diet monotony index [DMI]). The determinants were identified using logistic regression, while the association between food security status and nutritional status was analyzed using the chi-square or Fisher's exact test and the independent t test. Semistructured interviews involved participants who were categorized as mildly, moderately, or severely food insecure in order to explore the contributing factors of food insecurity and how they coped with it based on their lived experience. The interviews were carried out until the data reached saturation, and then the data were analyzed thematically. RESULTS: The study was funded by the Ministry of Higher Education Malaysia under the Fundamental Research Grant Scheme (FRGS/1/2023/SS10/UIAM/02/1) starting in September 2023. Data collection was conducted from December 2023 until August 2024, involving 287 participants, and data analysis has also been completed. As of January 2026, quantitative findings are under review and qualitative findings are being prepared. CONCLUSIONS: The implementation of this study protocol will provide new evidence to improve the understanding of food insecurity in this population. Elucidation of its key contributing factors, coping strategies, and potential connections to nutritional status in this population can help guide more informed policymaking and effective interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/84575.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,018 | 0,010 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,005 | 0,004 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,003 | 0,002 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,003 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,032 | 0,004 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».