Application of the current dietary guidelines for people with diabetes mellitus by dieticians and nurses
| dc.contributor.advisor | Slabber, M. | |
| dc.contributor.author | Taljaard, Hilana | |
| dc.date.accessioned | 2017-01-31T08:41:14Z | |
| dc.date.available | 2017-01-31T08:41:14Z | |
| dc.date.issued | 2004-04 | |
| dc.description.abstract | English: Intensive diabetes management resulting in control of blood glucose concentrations will delay the onset and significantly impede the progression of complications from diabetes. Healthcare professionals such as dieticians and nurses are increasingly challenged to help patients with diabetes achieve a desirable body weight, and maintain good metabolic control. Therefore, a clear understanding of current dietary goals and skills to implement these goals when counselling patients with diabetes, is needed. A Position Statement was compiled by an expert group of dieticians in South Africa in 1997 to encourage a uniform approach to the nutritional management of diabetes mellitus. However, application of these dietary recommendations by health professionals has not been established. The main aim of this study was to assess the current practice trends of dieticians and nurses regarding application of the goals of the Position Statement in the Free State province (FS) and the North West province (NW). To accomplish this aim, dieticians and nurses were asked open-ended questions regarding the dietary goals. The study was a comparative, multi-centre study. A total of 18 dieticians (n=8 from the FS and n=10 from the NW), registered as Private Practicing Dieticians (PPDs), as well as a randomized, stratified sample of 150 registered nurses (n=100 from the FS and n=50 from the NW) working in all primary health care clinics, were included in the study. The researcher obtained informed consent from each participant. After the researcher telephonically scheduled appointments with all participants who gave permission to take part in the study, structured personal and telephonic interviews were conducted with dieticians and nurses, respectively. A standardized questionnaire was used to gather the necessary information. Answers were evaluated by scores preset to each answer, classifying them from the most to the least acceptable answer. High scores (from 75% to 100%) gave an indication of good application of the dietary goals, while lower scores (from 65%-74%) indicated that the dietary goals were not properly applied. The lowest scores (below 65%) indicated poor application of the dietary goals. All dieticians that were included in the study, as well as 64 and 31 nurses in the FS and NW, respectively, received formal letters from the researcher, requesting a copy of nutrition education material (NEM). Total scores were also determined for each NEM. High scores (from 75%-100%) indicated that the information was comparable to the dietary goals, while lower scores (from 65%-74%) gave an indication that part of the information was outdated. The lowest scores (below 65%) indicated that the information was unacceptable or completely outdated. Eighty-eight percent of the FS PPDs and 70% of the NW PPDs, as well as 87% and 96% of the FS and NW nurses, respectively, gave permission to take part in the study. Although dieticians obtained higher scores than nurses in both the FS and NW, total scores obtained by all health professionals were below 65%. No statistically significant differences were found between the scores obtained by nurses in the FS (mean 28%) and nurses in the NW (mean 29%). Dieticians in the FS and NW obtained mean scores of 64% and 61%, respectively. Although scores obtained by the FS dieticians were 3% higher, no statistically significant differences were found between the scores of dieticians in the two provinces. Mean scores obtained by NEMs from all health professionals were below 65%. No statistically significant differences were found between the scores for NEM from dieticians (mean 35%) and scores for NEM from nurses (mean 33%). It can be concluded that dieticians and nurses in the FS and NW poorly apply the current dietary recommendations for people with diabetes. Furthermore, most of the NEMs used by both dieticians and nurses in their respective practice settings do not correlate with the 1997 dietary goals. These results indicate that there is a dire need to focus on better education of health professionals who counsel patients with diabetes. More research is needed to identify the possible barriers to effective application of current dietary recommendations by health professionals. | en_ZA |
| dc.description.abstract | Afrikaans: Die begin en voortsetting van diabetiese komplikasies kan met goeie kontrole van bloedglukose konsentrasies, dit wil sê, intensiewe diabetiese sorg merkbaar uitgestel word. Die uitdaging word dus al hoe groter vir gesondheisorgwerkers, soos dieetkundiges en verpleegkundiges, om pasiënte met diabetes te help om ‘n ideale liggaamsmasse te bereik en om goeie bloedglukose kontrole te handhaaf. Dit is dus belangrik dat gesondheidsorgwerkers die huidige dieetriglyne verstaan en oor die nodige vaardighede beskik om daardie riglyne te implementeer wanneer pasiënte met diabetes gekonsulteer word. Om ‘n eenvormige benadering tot die voedingbehandeling van diabetes te bewerkstellig, het ‘n groep deskundige dieetkundiges in Suid Afrika in 1997 ‘n stel dieetriglyne saamgestel. Daar is egter nog nie vasgestel of gesonheidsorgwerkers hierdie dieetriglyne wel implementeer en toepas nie. Die doel van hierdie studie was om te bepaal of die huidige dieetriglyne vir pasiënte met diabetes deur dieetkundiges en verpleegkundiges in die Vrystaat provinsie (V) en die Noordwes provinse (N) toegepas word. Om hierdie doel te verwesenlik, is oop-einde vrae oor die dieetriglyne aan dieetkundiges en verpleegkundiges gestel. Die studie was ‘n vergelykende, multi-sentrum studie. Agtien dieetkundiges (n=8 van die V en n=10 van die N) geregistreer as Privaat Praktiserende Dieetkundiges (PPDs), asook ‘n gerandomiseerde, gestratifiseerde steekproef wat bestaan uit 150 geregistreerde verpleegkundiges, was by die studie ingesluit. Elke deelnemer het toestemming verleen om aan die studie deel te neem. Die navorser het vervolgens telefoniese afsprake geskeduleer met elke deelnemer wat toestemming verleen het om aan die studie deel te neem. Gestruktureerde persoonlike en telefoniese onderhoude is met dieetkundiges en verpleegkundiges, respektiewelik, gevoer. ‘n Gestandardiseerde vraelys is gebruik om die nodige inligting in te samel. Antwoorde is geëvalueer deur middel van vooropgestelde punte-tellings wat aan elke moontlike antwoord toegeken is. Hierdie punte-telling het antwoorde geklassifiseer van die mees aanvaarbare tot die minste aanvaarbare antwoorde. Hoë punte-tellings (vanaf 75% tot 100%) was ‘n aanduiding van goeie toepassing van die dieetriglyne, terwyl laer punte-tellings (vanaf 65%-74%) aangedui het dat die dieetriglyne nie voldoende toegepas word nie. Die laagste punte-tellings (onder 65%) was ‘n aanduiding van swak toepassing van die dieetriglyne. Die navorser het formele briewe aan al die dieetkundiges wat aan die studie deelgeneem het, sowel as aan 64 en 31 verpleegkundiges van die V en N, respektiewelik, gestuur. Hierdie briewe het gesondheidsorgwerkers versoek om ‘n afskrif van die voeding onderrigmateriaal wat hulle gebruik, na die navorser te stuur. Die totale punte-telling is ook vir elke stuk voeding onderrigmateriaal bereken. Hoë punte-tellings (vanaf 75% tot 100%) was ‘n aanduiding dat die inligting vergelykbaar is met die dieetriglyne van 1997, terwyl laer punte-tellings (vanaf 65% tot 74%) aangedui het, dat die inligting verouderd is. Die laagste punte-tellings (onder 65%) het aangedui dat die inligting onaanvaarbaar of totaal verouderd is. Agt-en-tagtig persent van die V en 70% van die N PPDs, sowel as 87% en 96% van die verpleegkundiges in die V en N, respektiewelik, het toestemming verleen om aan die studie deel te neem. Hoewel die dieetkundiges hoër punte-tellings as die verpleegkundiges behaal het, was die totale punte-tellings van alle gesondheidsorgwerkers onder 65%. Geen statisties betekenisvolle verskille het voorgekom tussen die punte-tellings van verpleegkundiges in die V (gemiddeld van 28%) en van verpleegkundiges in die N (gemiddeld van 29%). Dieetkundiges in die V en N het ‘n gemiddeld van 64% en 61%, respektiewelik, behaal. Hoewel die punte-tellings van dieetkundiges in die V 3% hoër was, was daar geen betekenisvolle verskille tussen die punte-tellings van dieetkundiges in die twee provinsies nie. Die gemiddelde punte-tellings van die voeding onderrigmateriaal van beide dieetkundiges en verpleegkundiges, was onder 65%. Daar was geen statisties betekenisvolle verskille tussen die punte-tellings van voeding onderrigmateriaal van dieetkundiges (gemiddeld 35%) en voeding onderrigmateriaal van verpleegkundiges (gemiddeld 33%). Die gevolgtrekking kan gemaak word dat dieetkundiges en verpleegkundiges in die V en N die dieetriglyne vir pasiënte met diabetes swak toepas. Meeste van die voeding onderrigmateriaal wat deur beide dieetkundiges en verpleegkundiges gebruik word, stem nie ooreen met die 1997 dieetriglyne nie. Die resultate van hierdie studie dui aan dat daar ‘n dringende behoefte is om gesondheidsorgwerkers beter te onderrig ten opsigte van voedingriglyne vir pasiënte met diabetes. Verdere navorsing word benodig om moontlike hindernisse te identifiseer wat gesondheidsorgwerkers verhinder om die dieetriglyne wel toe te pas. | af |
| dc.identifier.uri | http://hdl.handle.net/11660/5463 | |
| dc.language.iso | en | en_ZA |
| dc.publisher | University of the Free State | en_ZA |
| dc.rights.holder | University of the Free State | en_ZA |
| dc.subject | Dissertation (M.Sc. Dietetics (Human Nutrition))--University of the Free State, 2004. | en_ZA |
| dc.subject | Diabetes -- Nutritional aspects | en_ZA |
| dc.subject | Diabetes -- Diet therapy | en_ZA |
| dc.title | Application of the current dietary guidelines for people with diabetes mellitus by dieticians and nurses | en_ZA |
| dc.type | Dissertation | en_ZA |