Nutrition Knowledge, Attitudes And Practices Among Healthcare Workers In Management Of Chronic Kidney Diseases In Selected Hospitals In Dar Es Salaam, Tanzania

ABSTRACT

Chronic kidney disease (CKD) is a permanent and progressive loss of kidney function, resulting in deterioration of renal function. The overall management of CKD focuses on medication, dialysis, transplant and nutrition. The importance of nutritional evaluation and diet therapy in the overall management of the patients with CKD is very important; its application is limited by lack of knowledge regarding the requirement for certain nutrients in health and the way in which these requirements are modified by chronic diseases. There is limited information on the nutrition knowledge on management of CKD and the factors affecting it among healthcare workers in the Dar es Salaam Tanzania. This study aimed to assess nutrition knowledge, attitudes and current practices of healthcare workers in management of patients with CKD in selected hospitals. A cross sectional descriptive study design was conducted amongst 133 healthcare workers in renal units at Muhimbili national hospital, Regency medical centre and the Aga Khan Hospitals. Hospitals were purposively selected based on the availability of renal care services in the facility. Study subjects were conveniently selected from the three hospitals. Nutrition knowledge was assessed using a standardized questionnaire. Data were analysed using SPSS computer software version 17. Descriptive statistics were used to summarize data. Chi-square was used to test the relationship between categorical variables. Results showed that the mean nutrition knowledge score was 9.8 (SD 3.12) with 18.8 % of respondents having good knowledge. There was a significant difference in the nutrition knowledge among different carders (p ≤ 0.001). It was also found that medical specialists had a higher mean score of nutrition knowledge (13.75) compared to medical doctors and nurses with mean score 12.05. Others (lab technicians, pharmacists, nutritionists and radiographers) had lower mean score of 8.65. Most of respondents (94%) had positive attitudes on the role of nutrition in preventing and treating diseases. However, their belief contradicted their practices. Most of respondents 92 % (n=122) did not use any nutrition guidelines. Nutrition management was discussed occasionally during ward rounds. Significant relationships between nutrition care practices and some demographic variables. Occupation (2= 12.9; df= 4; p= 0.014), work experience (2= 15.8;df= 3; p= 0.001). Nutrition knowledge among study participants was poor; though their attitude was positive they failed to practice due to poor knowledge. Inadequate nutrition training in medical school, lack of resources and motivation were identified as factors that influence nutrition management of CKD in the study area. Review of medical curriculum to incorporate clinical nutrition topics, continuous nutrition education programs for in-service healthcare workers and hiring dieticians in each hospital department would improve nutrition management of CKD patients in hospitals.