Thesis (MNutr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Objective
To develop and test a marketable, Continuing Professional Development (CPD)
accredited training manual focused on the role of medical nutrition therapy (MNT) for
healthcare professionals (HCP) of the multidisciplinary Type 1 and Type 2 Diabetes
Mellitus (DM) management team.
Methods
The study consisted of two components: (a) development of the MNT manual and (b)
testing of the MNT manual.
The development of the MNT manual consisted of seven steps: (1) needs assessment
and problem definition; (2) literature search; (3) draft one of the MNT manual; (4) peer
review; (5) draft two of the MNT manual; (6) evaluation by means of a survey; and (7)
the final MNT manual.
The testing of the MNT manual’s impact on knowledge had a test-retest design which
consisted of seven steps: (1) DM knowledge questionnaire development; (2) participant
recruitment; (3) questionnaire pilot; (4) initial knowledge testing; (5) self-study of MNT
manual; (6) retesting of knowledge; (7) statistical analysis.
Results
From the literature a total of 132 published documents were selected for inclusion in the
MNT manual after grading of the information. The first draft was compiled and sent for
peer review and language editing. Recommended changes were made and the second
draft was developed and sent to 79 registered dietitians (RDs) who volunteered to
complete a survey after reading the MNT manual. The survey indicated that the majority
were satisfied with the content, which in turn led to the final MNT manual.The questionnaire was compiled using the content of the MNT manual and creating 10
questions per section of the manual. The pilot was conducted using 10% (n = 7) of the
total sample. Minor changes were made.
For knowledge testing, participants included RDs between the ages of 23 and 60 years,
registered with the Health Professions Council of South Africa. A test-retest design was
used. Participants scored a mean of 57.5% on the initial knowledge questionnaire
(KQ1), ranging between 33.6% and 79.8%. They lacked knowledge on: management of
the hospitalised patient; diabetes and exercise; diabetes and religion; gestational
diabetes; supplements commonly used by diabetics; diabetes in prisons; diabetes in
children; the function, side-effects and contra-indications of metformin.
The mean score on the second knowledge questionnaire (KQ2) increased to 90.5%,
with the lowest score 50.4% and the highest 99.2%.There were two questions where
participants scored < 50% (mean of n = 79) which related to the type of insulin regime
most suitable during Ramadan and risk factors for Type 2 DM in children.
Data were also analyzed according to various socio-demographic variables, but only
one significant difference was found between groups.
Conclusions and implications
There is adequate research available to develop a comprehensive guide for HCP on the
nutritional management of DM. Such an MNT manual should be marketed for CPD
purposes to encourage HCP to improve their DM management skills, as seen by the
dramatic improvement in DM management knowledge of the RDs participating in this
research. Future studies may include knowledge testing of other HCP, as well as testing
to determine if the newly acquired information is put into practice to the benefit of DM
patients. / AFRIKAANSE OPSOMMING: Objektiewe
Die ontwikkeling en toets van 'n bemarkbare, Voortgesette Professionele Ontwikkeling
(VPO) geakkrediteerde handleiding oor die rol van mediese voedings terapie (MVT) vir
mediese personeel van die multi-dissiplinêre Tipe 1- en Tipe 2 Diabetes Mellitus (DM)
behandelings span.
Metodes
Die studie het bestaan uit 2 komponente: (a) die ontwikkeling van die MVT handleiding
en (b) die toets van die MVT handleiding.
Die ontwikkeling van die MVT handleiding het bestaan uit sewe stappe: (1) assesering
van benodighede en probleem definisie, (2) literatuursoektog; (3) aanvanklike konsep
van die MVT handleiding; (4) eweknie evaluasie; (5) volgende konsep weergawe van
die MVT handleiding; (6) evaluering deur ‘n meningsopname; en (7) die finale MVT
handleiding.
Die toets van die MVT handleiding se impak op die kennis het 'n toets-hertoets ontwerp
gehad wat bestaan het uit sewe stappe: (1) DM kennis vraelys ontwikkeling; (2)
deelnemer werwing; (3) toets van vraelys; (4) toets van aanvanklike kennis; (5) selfstudie
van die MVT handleiding; (6) hertoetsing van kennis; en (7) statistiese analise.
Resultate
Uit die literatuur is 132 gepubliseerde dokumente gekies vir insluiting in die MVT
handleiding na gradering van die kwaliteit van die inligting. Die aanvanklike konsep is
ontwikkel, taalversorg en eweknie geevalueer. Aanbevole veranderinge is gemaak en
die tweede konsep is ontwikkel en gestuur aan 79 dieetkundiges wat vrywillig die MVT
handleiding gelees het en aan ‘n meningsopname deelgeneem het. Uit die
meningsopname was dit duidelik dat die meerderheid tevrede was met die inhoud, wat
gelei het tot die finale MVT handleiding.Die vraelys is opgestel met 10 vrae per afdeling van die MVT handleiding, en getoets
deur 10% (n = 7) van die totale aantal deelnemers, waarna geringe veranderinge
gemaak is.
Vir kennis toetsing, is dieetkundiges tussen die ouderdomme van 23 en 60 jaar, wat
geregistreer is by die Raad vir Gesondheidsberoepe van Suid-Afrika, ingesluit.
Deelnemers het 'n gemiddeld behaal van 57.5 % op die aanvanklike kennis vraelys, met
kennis wat gewissel het tussen 33.6% en 79.8%. Hulle het aanvanklik gebrekkige
kennis gehad oor: die behandeling van die hospitaal pasiënt; diabetes en oefening;
diabetes en godsdiens; swangerskaps diabetes; aanvullings gebruik deur diabete;
diabetes in gevangenisse; pediatriese diabetes; asook die funksie, newe-effekte en
kontra-indikasies van metformien.
Die gemiddelde telling op die tweede kennis vraelys het toegeneem tot 90.5%, met ‘n
laagste telling van 50.4% en hoogste van 99.2%. Daar was 2 vrae waar deelnemers <
50% (gemiddelde % van n = 79) behaal het. Hierdie vrae het verband gehou met die
mees geskikte insulien behandeling tydens Ramadan en risikofaktore vir Tipe 2 DM in
kinders.
Data is ontleed volgens verskeie sosio-demografiese veranderlikes, maar slegs een
beduidende verskil is tussen groepe gevind.
Gevolgtrekkings en implikasies
Daar is voldoende navorsing beskikbaar om ‘n omvattende handleiding vir mediese
personeel oor die rol van voeding in die behandeling van DM te ontwikkel. So 'n MVT
handleiding moet bemark word vir VPO doeleindes om mediese personeel aan te
moedig om hul DM bestuursvaardighede te verbeter, soos gesien deur die dramatiese
verbetering in DM bestuur kennis van die huidige deelnemers. Toekomstige navorsing
kan die bepaling van kennis verbetering van ander mediese professies insluit, en of
die verbeterde kennis in die praktyk DM pasiënte bevoordeel.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/86701 |
| Date | 04 1900 |
| Creators | Rausch, Ursula |
| Contributors | Lombard, Martani J., Labuschagne, Irene, Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Division of Human Nutrition. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | xvi, 207, [42] p. |
| Rights | Stellenbosch University |
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