ABSTRACT
A growing interest has become increasing in the role of physicians as effective resources for the promotion of good nutritional practices, however, the factors that impede their nutritional counseling and management practice [NC and M] are not clearly understood in Saudi Arabia. The objectives of the study were to investigate physicians' practices concerning NC and M and to explore some determinants that predict such practices. Data of 266 physicians working in big hospitals in Riyadh showed that only 7.9% of the respondents reported that they were practicing all aspects of NC and M; including nutritional assessment, therapy, and education. Those who practiced any one of these aspects ranged between 13.9-40.2%, meanwhile, 28% frankly reported that they did not practice NC and M. In the last year, the mean percentage of patients placed on nutrition therapy was 24.15 +/- 27.78% and the mean percentage of clinic time dedicated to NC and M was 21.49 +/- 20.54%. Most of the respondents [72.9%] had poor nutritional knowledge score. Overall, 19.2% previously attended CME in nutrition. Only 1.5% and 28.6% self-assessed themselves as ''outstanding'' and ''good'' in NC and M skills and the mean total self-efficacy in NC and M was moderate. The majority [77.8%] perceived NC and M as highly or moderately relevant to their specialties. Physicians attitude and perceived efficacy towards NC and M was moderately high as the mean scores were greater than their midpoint. Their perceived barriers of NC and M were considerably moderate; as the mean total score was found to be near the midpoint of that scale. Among the seven independent variables entered the binary logistic regression of physicians practice of NC and M, only the knowledge, attitude, and self-efficacy scores were significantly associated with their NC and M practice. These three predictors contributed by 23.5% of the variation of physician practice of NC and M. Physicians knowledge, self-efficacy, attitudes and other factors should be stressed in any intervention warranted to improve their nutritional practices
Subject(s)
Humans , Female , Male , Physicians , Surveys and Questionnaires , CounselingABSTRACT
Malnutrition is an evident problem in 40-50% of patients with end-stage renal disease [ESRD]. The aim of the present study was to assess the nutritional status and dietary practices of maintenance hemodialysis patients at Prince Salman Center for Kidney Diseases in Riyadh [PSCKD]. A cross-sectional study was conducted in [PSCKD] for 120 hemodialysis patients who agreed to participate in the study. Malnutrition score was used to quantify the degree of malnutrition. Two parameters from anthropometric and clinical manifestation data were used. Dietary practice score was measured the data showed that 79.2% of cases had normal nutritional status, while only 6.7% had moderate malnutritional status. Only 18.3% of them had good dietary practices while 65% had fair level. In patients with normal nutritional status, the body mass index [BMI] [29.57 +/- 10.34 vs. 17.19 +/- 1.80], mean weight [70.38 +/- 15.98 vs. 48.04 +/- 9.66], dry weight [68.537 +/- 15.55 vs. 46.188 +/- 7.93], mean albumin [35.50 +/- 3.63 vs. 35.07 +/- 4.06] and low density cholesterol [1.94 +/- 1.10 vs 1.25 +/- 0.52] were significantly higher than in moderately malnourished patients. In patients with normal nutritional status, the mean body height [154.67 +/- 9.47vs. 162.63 +/- 9.87], mean urea level [64.16 +/- 18.65 vs. 67.14 +/- 22.90] and mean creatinine level [750.94 +/- 271 vs. 926.63 +/- 358.79] were significantly lower than in moderately malnourished patients. Patient age, marital status were significant predictors for nutritional status. Patients aged >/= 50 years had 8 times the chance to develop malnutrition compared to those < 50 years. Single patients had 11 times the chance of getting malnutrition compared to married. These differences were statistically significant. [OR=8.213, 11.158, P=0.014, 0.011] respectively. Patient and nutrition education must be employed to hemodialysis for recommended dietary needs and for follow up of biochemical parameters