{"id":"https://openalex.org/W7204453281","doi":"https://doi.org/10.64898/2026.08.25.26361293","title":"Nutritional screening in mental health and learning disability inpatient services: Dietitians\u2019 perspectives on practices, barriers and tool suitability","display_name":"Nutritional screening in mental health and learning disability inpatient services: Dietitians\u2019 perspectives on practices, barriers and tool suitability","publication_year":2026,"publication_date":"2026-08-27","ids":{"openalex":"https://openalex.org/W7204453281","doi":"https://doi.org/10.64898/2026.08.25.26361293"},"language":"en","primary_location":{"id":"doi:10.64898/2026.08.25.26361293","doi":"https://doi.org/10.64898/2026.08.25.26361293","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.25.26361293","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/08/27/2026.08.25.26361293.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/08/27/2026.08.25.26361293.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5102757236","display_name":"Stephanie Smith","orcid":"https://orcid.org/0000-0003-3133-564X","observed_orcids":["https://orcid.org/0000-0003-3133-564X","https://orcid.org/0000-0002-7203-5347"]},"institutions":[{"id":"https://openalex.org/I874055015","display_name":"Teesside University","ror":"https://ror.org/03z28gk75","country_code":"GB","type":"education","lineage":["https://openalex.org/I874055015"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"Steph Smith","raw_affiliation_strings":["Teesside University Tees, Esk and Wear Valley NHS Foundation Trust British Dietetic Association Mental Health Specialist Group"],"raw_orcid":"https://orcid.org/0000-0003-3133-564X","affiliations":[{"raw_affiliation_string":"Teesside University Tees, Esk and Wear Valley NHS Foundation Trust British Dietetic Association Mental Health Specialist Group","institution_ids":["https://openalex.org/I874055015"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5148425422","display_name":"April Leong","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1299864998","display_name":"North Tees and Hartlepool NHS Foundation Trust","ror":"https://ror.org/04zzrht05","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I1299864998"]},{"id":"https://openalex.org/I874055015","display_name":"Teesside University","ror":"https://ror.org/03z28gk75","country_code":"GB","type":"education","lineage":["https://openalex.org/I874055015"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"April Leong","raw_affiliation_strings":["Teesside University North Tees and Hartlepool NHS Foundation Trust"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Teesside University North Tees and Hartlepool NHS Foundation Trust","institution_ids":["https://openalex.org/I1299864998","https://openalex.org/I874055015"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5148425414","display_name":"Garreth Burke","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2802171185","display_name":"Oxford Health NHS Foundation Trust","ror":"https://ror.org/04c8bjx39","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2802171185"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Garreth Burke","raw_affiliation_strings":["Oxford Health NHS Foundation Trust British Dietetic Association Mental Health Specialist Group"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Oxford Health NHS Foundation Trust British Dietetic Association Mental Health Specialist Group","institution_ids":["https://openalex.org/I2802171185"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5148416384","display_name":"Rebecca Guerin","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I173538901","display_name":"British Dietetic Association","ror":"https://ror.org/023zt9146","country_code":"GB","type":"nonprofit","lineage":["https://openalex.org/I173538901"]},{"id":"https://openalex.org/I280385510","display_name":"Leeds and York Partnership NHS Foundation Trust","ror":"https://ror.org/00n635c12","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I280385510"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Rebecca Guerin","raw_affiliation_strings":["Leeds and York Partnership NHS Foundation Trust British Dietetic Association Mental Health Specialist Group"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Leeds and York Partnership NHS Foundation Trust British Dietetic Association Mental Health Specialist Group","institution_ids":["https://openalex.org/I173538901","https://openalex.org/I280385510"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":5,"corresponding_author_ids":["https://openalex.org/A5102757236"],"corresponding_institution_ids":["https://openalex.org/I874055015"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T13960","display_name":"Dietetics, Nutrition, and Education","score":0.9702000021934509,"subfield":{"id":"https://openalex.org/subfields/2916","display_name":"Nutrition and Dietetics"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T13960","display_name":"Dietetics, Nutrition, and Education","score":0.9702000021934509,"subfield":{"id":"https://openalex.org/subfields/2916","display_name":"Nutrition and Dietetics"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10397","display_name":"Nutrition and Health in Aging","score":0.013399999588727951,"subfield":{"id":"https://openalex.org/subfields/2737","display_name":"Physiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10858","display_name":"Clinical Nutrition and Gastroenterology","score":0.002899999963119626,"subfield":{"id":"https://openalex.org/subfields/2916","display_name":"Nutrition and Dietetics"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/nutritional-screening","display_name":"nutritional screening","score":0.9919999837875366},{"id":"https://openalex.org/keywords/dietitians-perspectives","display_name":"dietitians' perspectives","score":0.9480000138282776},{"id":"https://openalex.org/keywords/malnutrition-universal-screening-tool","display_name":"Malnutrition Universal Screening Tool","score":0.8190000057220459},{"id":"https://openalex.org/keywords/nutritional-risk","display_name":"nutritional risk","score":0.6000000238418579},{"id":"https://openalex.org/keywords/barriers-to-screening","display_name":"barriers to screening","score":0.921999990940094},{"id":"https://openalex.org/keywords/care-pathways","display_name":"care pathways","score":0.6349999904632568},{"id":"https://openalex.org/keywords/organizational-leadership","display_name":"organizational leadership","score":0.7580000162124634},{"id":"https://openalex.org/keywords/digital-technology-integration","display_name":"digital integration","score":0.6349999904632568},{"id":"https://openalex.org/keywords/severe-mental-illness","display_name":"severe mental illness","score":0.6000000238418579},{"id":"https://openalex.org/keywords/learning-disabilities","display_name":"learning disabilities","score":0.3630000054836273}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7512000203132629},{"id":"https://openalex.org/C74196892","wikidata":"https://www.wikidata.org/wiki/Q7781188","display_name":"Thematic analysis","level":3,"score":0.7009999752044678},{"id":"https://openalex.org/C134362201","wikidata":"https://www.wikidata.org/wiki/Q317309","display_name":"Mental health","level":2,"score":0.6233000159263611},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.5291000008583069},{"id":"https://openalex.org/C15107229","wikidata":"https://www.wikidata.org/wiki/Q860740","display_name":"Learning disability","level":2,"score":0.46389999985694885},{"id":"https://openalex.org/C551997983","wikidata":"https://www.wikidata.org/wiki/Q12167","display_name":"Malnutrition","level":2,"score":0.45010000467300415},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.42969998717308044},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.4124000072479248},{"id":"https://openalex.org/C87156501","wikidata":"https://www.wikidata.org/wiki/Q7268708","display_name":"Qualitative property","level":2,"score":0.3653999865055084},{"id":"https://openalex.org/C56995899","wikidata":"https://www.wikidata.org/wiki/Q1126687","display_name":"Focus group","level":2,"score":0.36169999837875366},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.35089999437332153},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.34380000829696655},{"id":"https://openalex.org/C2781390853","wikidata":"https://www.wikidata.org/wiki/Q4354389","display_name":"Challenging behaviour","level":3,"score":0.31310001015663147},{"id":"https://openalex.org/C133462117","wikidata":"https://www.wikidata.org/wiki/Q4929239","display_name":"Data collection","level":2,"score":0.2996000051498413},{"id":"https://openalex.org/C2776674806","wikidata":"https://www.wikidata.org/wiki/Q12135","display_name":"Mental illness","level":3,"score":0.29829999804496765},{"id":"https://openalex.org/C2778139618","wikidata":"https://www.wikidata.org/wiki/Q13440398","display_name":"Workforce","level":2,"score":0.29580000042915344},{"id":"https://openalex.org/C65067816","wikidata":"https://www.wikidata.org/wiki/Q2295139","display_name":"Computer-assisted web interviewing","level":2,"score":0.2784000039100647},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.27399998903274536},{"id":"https://openalex.org/C13200473","wikidata":"https://www.wikidata.org/wiki/Q2747831","display_name":"Reflexivity","level":2,"score":0.2700999975204468}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.08.25.26361293","doi":"https://doi.org/10.64898/2026.08.25.26361293","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.25.26361293","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/08/27/2026.08.25.26361293.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.08.25.26361293","doi":"https://doi.org/10.64898/2026.08.25.26361293","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.25.26361293","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/08/27/2026.08.25.26361293.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0},{"id":"https://metadata.un.org/sdg/10","display_name":"Reduced inequalities","score":0.7578999996185303}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204453281.pdf","grobid_xml":"https://content.openalex.org/works/W7204453281.grobid-xml"},"referenced_works_count":35,"referenced_works":["https://openalex.org/W1765464910","https://openalex.org/W1926162634","https://openalex.org/W2057327092","https://openalex.org/W2076248499","https://openalex.org/W2082447630","https://openalex.org/W2111961248","https://openalex.org/W2116643778","https://openalex.org/W2152129467","https://openalex.org/W2416606270","https://openalex.org/W2509846689","https://openalex.org/W2737518083","https://openalex.org/W2757112350","https://openalex.org/W2789060619","https://openalex.org/W2916672348","https://openalex.org/W3081718320","https://openalex.org/W3120671319","https://openalex.org/W3208760880","https://openalex.org/W3210786825","https://openalex.org/W3210801642","https://openalex.org/W4214929532","https://openalex.org/W4248648090","https://openalex.org/W4282835552","https://openalex.org/W4312186612","https://openalex.org/W4384126503","https://openalex.org/W4388041660","https://openalex.org/W4388075595","https://openalex.org/W4392353236","https://openalex.org/W4394613324","https://openalex.org/W4399182274","https://openalex.org/W4399602191","https://openalex.org/W4403849659","https://openalex.org/W4406239929","https://openalex.org/W4407089182","https://openalex.org/W4412933193","https://openalex.org/W4416736305"],"related_works":["https://openalex.org/W4403849659","https://openalex.org/W3210801642","https://openalex.org/W7156089669","https://openalex.org/W4407799696","https://openalex.org/W4384126503","https://openalex.org/W7171970945","https://openalex.org/W2749660995","https://openalex.org/W2320244105","https://openalex.org/W2290639658","https://openalex.org/W2043565525"],"abstract_inverted_index":{"Abstract":[0],"Introduction":[1],"People":[2],"with":[3,16,126,263,365],"severe":[4],"mental":[5,40,353,409],"illness":[6],"(SMI)":[7],"and":[8,23,34,43,60,100,110,141,145,173,181,294,330,338,355,375,394,405,436],"learning":[9,356],"disabilities":[10],"(LD)":[11],"experience":[12],"significant":[13],"health":[14,41,354],"inequalities,":[15],"diet-related":[17],"conditions":[18],"contributing":[19],"substantially":[20],"to":[21,51,160,211,237,243,311,333,343,372,385],"early":[22],"preventable":[24],"death.":[25],"Despite":[26],"high":[27],"levels":[28],"of":[29,36,66,133,164,176,253,271,402,432,440],"nutritional":[30,37,53,234,255,441],"risk,":[31],"the":[32,64,85,216,221,232,251,287,295,400,430],"presence":[33],"effectiveness":[35],"screening":[38,54,153,161,190,199,256,313,316,351,427,442],"in":[39,56,152,258,352],"(MH)":[42],"LD":[44,61],"settings":[45,260],"remains":[46],"under-researched.":[47],"This":[48],"study":[49,72],"aimed":[50],"investigate":[52],"practices":[55,137],"UK":[57],"inpatient":[58,358],"MH":[59,134,282],"services":[62,242,359],"from":[63,130],"perspectives":[65],"dietitians.":[67],"Methods":[68],"A":[69],"cross-sectional":[70],"mixed-methods":[71],"was":[73,82,97,115,200,277],"conducted":[74],"using":[75],"a":[76,131],"novel":[77],"22-question":[78],"online":[79],"survey.":[80],"Data":[81],"collected":[83],"via":[84],"British":[86],"Dietetic":[87],"Association":[88],"Mental":[89],"Health":[90],"Specialist":[91],"Group":[92],"(April-June":[93],"2025).":[94],"Quantitative":[95],"data":[96,102],"analysed":[98],"descriptively":[99],"qualitative":[101],"by":[103,117,143,204,325],"reflexive":[104],"thematic":[105],"analysis.":[106],"Findings":[107],"were":[108,138,184,208,227],"integrated":[109],"presented":[111],"thematically.":[112],"Ethical":[113],"approval":[114],"granted":[116],"Teesside":[118],"University":[119],"(2025Mar26544).":[120],"Results":[121],"Forty-seven":[122],"dietitians":[123],"participated,":[124],"most":[125,201],"substantial":[127],"dietetic":[128],"experience,":[129],"range":[132],"settings.":[135],"Screening":[136,224,291,379],"widely":[139],"established":[140],"supported":[142,324],"policy":[144],"audit.":[146],"However,":[147,266],"participants":[148],"reported":[149],"low":[150],"confidence":[151],"translating":[154],"into":[155],"meaningful":[156,340],"patient":[157,345,367],"care.":[158,346],"Barriers":[159],"included":[162],"appropriateness":[163],"available":[165],"tools,":[166,219],"time":[167],"constraints,":[168],"difficulty":[169],"engaging":[170,433],"distressed":[171],"patients":[172],"poor":[174],"prioritisation":[175],"physical":[177],"health.":[178],"Digital":[179],"integration":[180],"wider":[182],"infrastructure":[183],"also":[185],"important.":[186],"Dietitians":[187,417],"rarely":[188],"undertook":[189],"directly,":[191,428],"instead":[192],"holding":[193],"secondary":[194],"or":[195,411,421],"leadership":[196,422],"roles,":[197],"while":[198],"often":[202,209,361],"completed":[203],"nursing":[205,434],"staff":[206,435],"who":[207],"perceived":[210],"place":[212],"limited":[213,366],"importance":[214,431],"on":[215],"process.":[217],"Existing":[218],"particularly":[220],"Malnutrition":[222],"Universal":[223],"Tool":[225],"(MUST),":[226],"viewed":[228],"as":[229,286,363],"insufficiently":[230],"capturing":[231],"broader":[233],"risks":[235],"relevant":[236],"MH/LD":[238,259],"populations,":[239],"leading":[240],"some":[241],"adopt":[244],"bespoke,":[245],"unvalidated":[246,272],"tools.":[247,274],"Conclusion":[248],"Concerns":[249],"regarding":[250],"suitability":[252],"existing":[254],"tools":[257,284],"are":[261,397],"consistent":[262],"previous":[264],"literature.":[265],"we":[267],"suggest":[268],"cautious":[269],"use":[270,401],"bespoke":[273],"Whilst":[275],"there":[276],"no":[278],"clear":[279,321],"front":[280],"runner,":[281],"specific":[283],"such":[285],"St":[288],"Andrew\u2019s":[289],"Nutrition":[290],"Instrument":[292],"(SANSI)":[293],"NutriMental":[296],"Screener":[297],"warrant":[298],"further":[299],"evaluation.":[300],"Importantly,":[301],"findings":[302],"indicate":[303],"that":[304],"optimising":[305],"tool":[306,380],"choice":[307,381],"alone":[308,382],"is":[309,360,383],"unlikely":[310,384],"improve":[312,344,386],"effectiveness.":[314],"Nutritional":[315,350],"must":[317],"be":[318],"embedded":[319],"within":[320],"care":[322,373],"pathways,":[323],"organisational":[326],"leadership,":[327,389],"digital":[328,392],"infrastructure,":[329],"multiprofessional":[331,395,438],"engagement":[332,396],"move":[334],"beyond":[335],"procedural":[336,364],"completion":[337],"support":[339],"clinical":[341],"action":[342],"Practitioner":[347],"Points":[348],"-":[349,378,416],"disability":[357],"experienced":[362],"impact":[368,414],"unless":[369],"clearly":[370],"linked":[371],"pathways":[374],"follow-up":[376],"action.":[377],"practice.":[387],"Organisational":[388],"adequate":[390],"time,":[391],"integration,":[393],"critical,":[398],"alongside":[399],"reasonable":[403],"adjustments":[404],"pragmatic":[406],"approaches":[407],"where":[408],"state":[410],"communication":[412],"differences":[413],"screening.":[415],"typically":[418],"hold":[419],"advisory":[420],"roles":[423],"rather":[424],"than":[425],"completing":[426],"highlighting":[429],"supporting":[437],"ownership":[439],"processes.":[443]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-08-28T00:00:00"}
