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Exploring the prevalence of multiple forms of malnutrition in children 6–18 years living in the Eastern Cape, South Africa 探讨生活在南非东开普省6-18岁儿童中多种形式营养不良的患病率
IF 1.1 Q3 Medicine Pub Date : 2022-05-07 DOI: 10.1080/16070658.2022.2061109
G. Moyo, A. Egal, W. Oldewage-Theron
Background: The existence of multiple forms of malnutrition is a growing problem in developing countries. Children living in the Eastern Cape have a relatively high prevalence of cardiovascular disease (CVD) risk factors and food insecurity, suggesting the possibility of the several coexisting forms of malnutrition. Due to the negative long-term consequences of undernutrition, overnutrition and, to a greater extent, a combination of both, it is important for this issue to be identified early in children and addressed. Aim: This study was undertaken to investigate the prevalence of the different forms of malnutrition in children living in the Eastern Cape province. Methods: Secondary analysis of a cross-sectional sample of 237 school-aged children, aged 6–18 years, in the Eastern Cape province of South Africa was conducted. The variables included in the analysis were the demographic data, anthropometric data and biochemical data, specifically blood profiles related to micronutrient deficiencies and CVD risk factors. Fisher’s exact test was used to compare the prevalence rates of several coexisting forms of malnutrition in the children. All data analysis was conducted in R version 4.0.3 and statistical significance was set at 0.05. Results: In children with overweight/obesity, 13.6% had a micronutrient deficiency, while 37.71% of the children within the normal weight range had coexisting micronutrient deficiencies and CVD risk factors. The prevalence of folate deficiency was 73.0%, iron deficiency 6.3%, and hyperglycaemia was at 10.6%. Fisher’s exact test was used to compare the prevalence rates between genders and no statistically significant differences were observed. Conclusion: Further research is needed to understand the relatively high prevalence of CVD risk factors in these children within the normal weight range and to investigate how dietary intake contributes to the overall double burden of malnutrition in children.
背景:多种形式的营养不良在发展中国家是一个日益严重的问题。生活在东开普省的儿童心血管疾病风险因素和粮食不安全的患病率相对较高,这表明可能存在几种共存形式的营养不良。由于营养不良、营养过剩以及在更大程度上两者结合的负面长期后果,在儿童中尽早发现并解决这一问题很重要。目的:本研究旨在调查东开普省儿童不同形式营养不良的患病率。方法:对南非东开普省237名6-18岁学龄儿童的横断面样本进行二次分析。分析中包括的变量包括人口统计数据、人体测量数据和生化数据,特别是与微量营养素缺乏和心血管疾病风险因素相关的血液特征。Fisher精确检验用于比较几种共存形式的儿童营养不良的患病率。所有数据分析均在R 4.0.3版本中进行,统计显著性设置为0.05。结果:在超重/肥胖儿童中,13.6%的儿童存在微量营养素缺乏症,而在正常体重范围内的儿童中,37.71%的儿童同时存在微量营养元素缺乏症和心血管疾病风险因素。叶酸缺乏症的患病率为73.0%,铁缺乏症为6.3%,高血糖症为10.6%。使用Fisher精确检验来比较性别之间的患病率,没有观察到统计学上的显著差异。结论:需要进一步研究,以了解这些儿童在正常体重范围内心血管疾病危险因素的相对较高患病率,并调查饮食摄入如何导致儿童营养不良的总体双重负担。
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引用次数: 1
Use and perceived effectiveness of complementary medicines for weight loss in adult women 成年妇女减肥补充药物的使用和疗效
IF 1.1 Q3 Medicine Pub Date : 2022-04-08 DOI: 10.1080/16070658.2022.2042923
J. Bussicott, R. Patel, J. Pellow, RK Razlog
Objectives: Complementary medicines (CMs) that are formulated to facilitate weight loss are a popular and widely available treatment option, particularly among women. There is limited research regarding their use in the South African context. The aim of this study was to gather information on the use and perceived effectiveness of CMs for weight loss among adult women. Design: A quantitative, descriptive survey design was used. Setting: Johannesburg, South Africa. Subjects: A purposive sample of women over the age of 18 years who had used CMs for weight loss within the past five years were recruited from health stores and a university campus healthcare centre. Outcome measures: Data were obtained through a self-administered 29-item, paper-and-pen questionnaire. Responses were descriptively analysed using cross-tabulation, multiple response analysis and frequency tables. Results: Data from 160 questionnaires were analysed and the results demonstrated that a wide variety of CM products are used for weight loss, with branded combination products, green tea, Garcinia cambogia and conjugated linoleic acid being the most popular. Most participants also adopted lifestyle interventions such as exercise and calorie restriction during their weight loss attempt. While minor side effects were experienced by over half of the participants, the majority were satisfied with their product choice as well as the amount of weight that they lost. Conclusion: Most participants perceived their CM weight loss product of choice to be effective. However, other concomitant weight-loss strategies that were employed may have been responsible for these results. Despite their popularity, there is only very limited research surrounding the safety and efficacy of these weight-loss products, with most studies being conducted on single constituents rather than whole formulations as sold on the market. Healthcare providers should encourage the disclosure of the use of CM weight-loss products to ensure safe and effective patient care and mitigate the potential risks associated with their inappropriate use.
目的:为促进减肥而配制的补充药物是一种流行且广泛可用的治疗选择,尤其是在女性中。关于它们在南非的使用研究有限。本研究的目的是收集有关成年女性使用CM减肥和感知效果的信息。设计:采用定量描述性调查设计。背景:南非约翰内斯堡。受试者:从健康商店和大学校园医疗中心招募了一名在过去五年内使用CM减肥的18岁以上女性。结果测量:数据是通过一份29项的纸笔问卷获得的。使用交叉表、多反应分析和频率表对反应进行描述性分析。结果:对160份问卷的数据进行了分析,结果表明,各种CM产品用于减肥,其中品牌组合产品、绿茶、藤黄和共轭亚油酸最受欢迎。大多数参与者在减肥过程中也采取了生活方式干预措施,如锻炼和限制热量。虽然超过一半的参与者经历了轻微的副作用,但大多数人对他们的产品选择以及体重减轻感到满意。结论:大多数参与者认为他们选择的CM减肥产品是有效的。然而,其他随之而来的减肥策略可能是造成这些结果的原因。尽管它们很受欢迎,但围绕这些减肥产品的安全性和有效性的研究非常有限,大多数研究都是针对单一成分进行的,而不是市场上销售的整个配方。医疗保健提供者应鼓励披露CM减肥产品的使用情况,以确保安全有效的患者护理,并减轻与不当使用相关的潜在风险。
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引用次数: 0
Case study: nutritional considerations in the head and neck cancer patient 案例研究:头颈癌患者的营养问题
IF 1.1 Q3 Medicine Pub Date : 2022-04-07 DOI: 10.1080/16070658.2022.2052424
N. van Wyk
Head and neck squamous cell cancer (HNSCC) involves cancer of the oral cavity, oropharynx, hypopharynx and larynx. By virtue of the tumour location, nutrition support in this patient cohort can be extremely challenging. A 48-year-old male presented with a two-month history of progressive dysphagia, significant loss of weight, shortness of breath and coughing secondary to a non-benign lesion in his throat. This debilitating condition led to severe malnutrition and due to the prevailing nutritional risk the patient was assessed as a very high risk for refeeding syndrome. Several investigations were done during the admission, which then confirmed the final diagnosis of a transglottic squamous cell cancer. Surgical optimisation, including preoperative nutritional optimisation, was discussed in a multidisciplinary meeting and a total laryngectomy was scheduled seven days later. Perioperative nutritional management required careful consideration of several factors but the involvement of dietetics services from the day of admission played a crucial role in the successful management of this patient.
头颈部鳞状细胞癌症(HNSCC)涉及口腔、口咽、下咽和喉部的癌症。由于肿瘤的位置,这一患者群体的营养支持可能极具挑战性。一名48岁男性,有两个月的进行性吞咽困难、体重显著减轻、呼吸急促和咳嗽病史,继发于喉咙的非良性病变。这种衰弱的情况导致了严重的营养不良,由于普遍存在营养风险,患者被评估为再喂养综合征的风险非常高。入院期间进行了几项调查,随后确认了跨声门鳞状细胞癌症的最终诊断。手术优化,包括术前营养优化,在一次多学科会议上进行了讨论,并计划在七天后进行全喉切除术。围手术期营养管理需要仔细考虑几个因素,但从入院当天起,饮食服务的参与对该患者的成功管理起到了至关重要的作用。
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引用次数: 0
Nutritional support practices at an intensive care unit in Johannesburg, South Africa 南非约翰内斯堡重症监护病房的营养支持实践
IF 1.1 Q3 Medicine Pub Date : 2022-04-04 DOI: 10.1080/16070658.2022.2052412
A. Laher, Jared McDowall, Mikayla van Welie, Domenic M Malinga, Alistair J Craythorne, B. J. van Aardt, Tasneem Dalvie, G. Richards
Objectives: Nutritional support is a fundamental component of holistic patient care in the intensive care unit (ICU). There is a paucity of local data pertaining to nutritional support practices at ICUs in South Africa. The aim of this study was to determine nutritional support practices at an academic hospital ICU in Johannesburg, South Africa. Methods: In this cross-sectional, descriptive and retrospective study, a simple random sampling method was utilised to select 50 data collection days from a three-month period (1 August–31 October 2018). Data relevant to the study were extracted from the ICU charts of patients who received formulae-based enteral and/or parenteral nutrition on the selected days. Charts were categorised into acute phase days (≤ 72 hours from ICU admission) and recovery phase days (> 72 hours from ICU admission). Results: A total of 387 ICU charts were included in the final sample, comprising 114 acute phase and 273 recovery phase days. Overall, enteral nutrition was prescribed on 296 (76.5%) chart days while parenteral nutrition was prescribed on 111 (28.7%) chart days. The median daily fluid balance was approximately 600 ml positive. Target protein and calorie intake was achieved on 67 (17.3%) and 110 (28.4%) chart days respectively. Conclusion: Although protein and calorie intake was suboptimal in comparison with the recommended targets, it is in keeping with general international trends. Regular audits, training of staff, attention to minimising feeding interruptions and encouraging the timely initiation of enteral nutrition are recommended interventions that may be useful in achieving nutritional targets.
目的:营养支持是重症监护室(ICU)患者整体护理的基本组成部分。关于南非icu营养支持做法的当地数据缺乏。本研究的目的是确定南非约翰内斯堡一家学术医院ICU的营养支持实践。方法:在这项横断面、描述性和回顾性研究中,采用简单随机抽样方法,从三个月期间(2018年8月1日至10月31日)中选择50个数据收集日。与研究相关的数据来自于在选定日期接受基于配方的肠内和/或肠外营养的患者的ICU图表。图表分为急性期天数(入院后≤72小时)和恢复期天数(入院后≤72小时)。结果:最终样本共纳入387张ICU图表,其中急性期114天,恢复期273天。总体而言,肠内营养在296(76.5%)个图表日开处方,肠外营养在111(28.7%)个图表日开处方。每日体液平衡中位数约为600毫升阳性。目标蛋白质和卡路里摄入量分别在67(17.3%)和110(28.4%)个图表日达到。结论:虽然与推荐目标相比,蛋白质和卡路里的摄入量是次优的,但这与国际总体趋势是一致的。建议的干预措施可能有助于实现营养目标,如定期审计、培训工作人员、注意尽量减少喂养中断和鼓励及时开始肠内营养。
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引用次数: 1
Key role-players’ perceptions of the current salt legislation in South Africa: opportunities and challenges 关键角色对南非现行盐立法的看法:机遇与挑战
IF 1.1 Q3 Medicine Pub Date : 2022-03-31 DOI: 10.1080/16070658.2022.2051381
M. van Loggerenberg, Bianca van der Westhuizen, N. Koen
Objective: A study was undertaken to determine the perceptions of key role-players regarding challenges and opportunities to move the South African salt-reduction strategy forward. Design: The study had a qualitative, exploratory design using in-depth, semi-structured interviews. Setting: South Africa. Subjects: A total of 12 participants from various fields within the salt-reduction strategy environment, including academia, government and policy-related institutions, research sector and non-governmental organisations, took part. Outcome measures: Consumer knowledge, consumer education programmes, multi-sectoral collaboration, research efforts and strategy recommendations were noted. Results: Overall perceptions of the current salt-reduction strategy in South Africa were positive. Most of the participants agreed that the current strategy is the best approach to reduce the salt intake of the South African population. Participants strongly believed, however, that the strategy is not currently reinforced and that the initial momentum is lost. Concerns were raised regarding the absence of consumer-awareness campaigns, the population’s lack of knowledge regarding salt intake and its relation to health, and the challenges around the monitoring of salt/sodium in processed foods. Participants also highlighted the lack of current studies in this field as well as existing data to be used for baseline studies. Conclusions: South Africa’s current salt-reduction strategy is the correct approach to decrease the population’s salt intake. The initial phase of implementing the strategy has been successful, but the current perception is that government is not following through with this strategy. Several key areas that are needed for this strategy to succeed are being neglected.
目标:进行了一项研究,以确定关键角色对推动南非减盐战略的挑战和机遇的看法。设计:该研究采用了定性的、探索性的设计,采用了深入的、半结构化的访谈。背景:南非。主题:共有12名参与者参加了减盐战略环境中的各个领域,包括学术界、政府和政策相关机构、研究部门和非政府组织。成果衡量标准:注意到消费者知识、消费者教育方案、多部门合作、研究工作和战略建议。结果:对南非目前减盐战略的总体看法是积极的。大多数与会者一致认为,目前的战略是减少南非人口盐摄入量的最佳方法。然而,与会者坚信,该战略目前没有得到加强,最初的势头已经丧失。有人对缺乏消费者意识运动、民众对盐摄入量及其与健康的关系缺乏了解以及对加工食品中盐/钠的监测面临的挑战表示关切。与会者还强调,目前缺乏这一领域的研究以及用于基线研究的现有数据。结论:南非目前的减盐战略是减少人口盐摄入量的正确方法。实施该战略的最初阶段是成功的,但目前的看法是政府没有贯彻执行这一战略。这一战略取得成功所需的几个关键领域被忽视了。
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引用次数: 1
Sociodemographic variables affecting caregivers’ attitudes towards the provision of healthy breakfast and lunchboxes to children in their care 影响照顾者对向其照顾的儿童提供健康早餐和午餐盒的态度的社会形态变量
IF 1.1 Q3 Medicine Pub Date : 2022-03-30 DOI: 10.1080/16070658.2022.2048444
Thea Hansen, E. du Toit, C. van Rooyen, R. Lategan-Potgieter
Objective: A study was undertaken to determine the sociodemographic variables (SDV) and caregivers’ attitudes that impact on healthy eating and the provision of healthy breakfast and school lunchboxes. Design: This was a cross-sectional, descriptive study using self-administered questionnaires. Setting: Participating Quintile 5 primary schools in Bloemfontein, South Africa (SA). Participants: Caregivers of learners, aged 6–12 years (N = 1 286). Main outcome measures: To determine associations between sociodemographic variables (SDV) and attitudes towards the provision of healthy breakfast and lunchbox foods. Analysis: Wilcoxon two-sample test for unpaired data or the chi-square test to compare groups. A p-value of <0.05 indicated statistical significance. Results: Caregivers with higher income and those living with a life partner were more likely to perceive healthy food as being more expensive than less healthy food (p < 0.01 and p < 0.01, respectively) and were of the opinion that preparing lunchboxes increased their workload (p < 0.01 and p < 0.01, respectively). Caregivers with lower income had a less positive attitude towards healthy eating habits (p < 0.01). Conclusions: Caregivers mostly had a positive attitude towards providing healthy breakfast and lunchbox foods. Discrepancies between caregivers’ perception of preparation time and cost of healthy food, and the provision of healthy food to learners, were observed.
目的:进行一项研究,以确定影响健康饮食以及提供健康早餐和学校午餐盒的社会人口统计学变量(SDV)和照顾者的态度。设计:这是一项横断面描述性研究,使用自填问卷。背景:南非布隆方丹的Quintile 5小学。参与者:6-12岁学习者的看护人(N = 1286)。主要结果指标:确定社会人口统计学变量(SDV)与对提供健康早餐和午餐盒食品的态度之间的关系。分析:对未配对数据进行Wilcoxon双样本检验或对各组进行卡方检验比较。p值<0.05表示具有统计学意义。结果:收入较高的护理人员和与生活伴侣一起生活的护理人员更有可能认为健康食品比不太健康的食品更贵(p < 0.01和p < 0.01),并且认为准备午餐盒增加了他们的工作量(p < 0.01和p < 分别为0.01)。收入较低的照顾者对健康饮食习惯的态度不那么积极(p < 结论:护理人员对提供健康的早餐和午餐食品大多持积极态度。观察到照顾者对健康食品的准备时间和成本的看法与向学习者提供健康食品的看法之间存在差异。
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引用次数: 1
The relationship of a weight-efficacy lifestyle with anthropometric indices among middle-aged Iranian women 伊朗中年妇女体重功效生活方式与人体测量指数的关系
IF 1.1 Q3 Medicine Pub Date : 2022-03-26 DOI: 10.1080/16070658.2022.2051305
Mahbobeh Kianfar, P. Afshari, P. Abedi, M. Haghighizadeh
Background: Overweight or obese middle-aged women are at a greater risk of chronic diseases. This study aimed to evaluate the relationship between a weight-efficacy lifestyle and anthropometric indices in middle-aged women. Methods: In this study, 500 middle-aged women were recruited randomly from ten public health centres in Ahvaz. A sociodemographic questionnaire and weight-efficacy lifestyle (WEL) questionnaire were used to collect the data. Anthropometric indices including weight, height, waist and hip circumference, waist–hip ratio, body fat percentage, and mid-upper arm circumference were measured. The Pearson correlation coefficient and logistic regression were used to analyse the data. Results: Women with higher negative emotions and those with a higher availability of food were 0.93 (OR 0.93, 95% CI 0.86–0.99, p = 0.03) and 0.89 (OR 0.89, 95% CI 0.82–0.96, p = 0.003) times more likely to have a higher BMI, respectively. Women with increased negative emotion (OR 0.92, 95% CI 0.85–0.99, p = 0.04), and lower positive activities (OR 1.15, CI 1.05–1.27, p = 0.003) were more likely to have a wider waist circumference. Conclusion: A weight-efficacy lifestyle was found to have a significant relationship with body mass index, waist circumference, hip circumference, waist–hip ratio, body fat percentage, and upper mid-arm circumference. Middle-aged women should be specifically educated regarding a weight-efficacy lifestyle.
背景:超重或肥胖的中年妇女患慢性病的风险更大。本研究旨在评估中年妇女体重效能生活方式与人体测量指标之间的关系。方法:在本研究中,从阿瓦士的10个公共卫生中心随机招募500名中年妇女。采用社会人口学问卷和体重-功效生活方式问卷收集数据。测量体重、身高、腰臀围、腰臀比、体脂率、中上臂围等人体测量指标。采用Pearson相关系数和logistic回归分析资料。结果:负面情绪较高的女性和食物可得性较高的女性的BMI值分别为0.93倍(OR 0.93, 95% CI 0.86-0.99, p = 0.03)和0.89倍(OR 0.89, 95% CI 0.82-0.96, p = 0.003)。负面情绪增加的女性(OR 0.92, 95% CI 0.85-0.99, p = 0.04)和积极活动减少的女性(OR 1.15, CI 1.05-1.27, p = 0.003)更有可能拥有更宽的腰围。结论:体重有效型生活方式与体重指数、腰围、臀围、腰臀比、体脂率、上臂中围有显著关系。中年妇女应该接受有关有效减肥生活方式的专门教育。
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引用次数: 0
Vitamin D status of the elderly in the Vaal region, South Africa 南非瓦尔地区老年人的维生素D状况
IF 1.1 Q3 Medicine Pub Date : 2022-03-22 DOI: 10.1080/16070658.2022.2041887
W. Oldewage-Theron, C. Grobler
Vitamin D status was determined in a sample of 79 elderly people and the results showed that 38% of the elderly had inadequate vitamin D status that was accompanied by various symptoms associated with vitamin D insufficiency/deficiency.
对79名老年人的样本进行了维生素D状况测定,结果显示,38%的老年人维生素D状况不足,并伴有与维生素D缺乏/缺乏相关的各种症状。
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引用次数: 0
When is the estimation of weight and height good enough? A life cycle view 对体重和身高的估计什么时候足够好?生命周期视图
IF 1.1 Q3 Medicine Pub Date : 2022-03-16 DOI: 10.1080/16070658.2022.2039353
F. Wenhold, Sanja Nel
Anthropometry – the measurement of body size and proportion – is an objective component of a comprehensive nutrition assessment. As such, it is intended to give a true (accurate and precise) reflection of the reality which one wants to observe. This applies to dietetic and clinical practice as well as the scientific study of growth and nutritional status throughout the life cycle. Measurements of weight and the height/length of the human body are the foundation of anthropometric assessment. True values for these parameters are obtained through measurement, using calibrated equipment and appropriate technique.
人体测量——测量身体大小和比例——是全面营养评估的客观组成部分。因此,它旨在真实(准确和精确)地反映一个人想要观察的现实。这适用于饮食和临床实践,以及对整个生命周期的生长和营养状况的科学研究。人体重量和身高/长度的测量是人体测量评估的基础。这些参数的真实值是通过测量、使用校准设备和适当的技术获得的。
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引用次数: 0
Nursing practices associated with diagnosis of malnutrition in children under 5 years in West Rand District primary healthcare facilities 西兰德区初级卫生保健设施中与5岁以下儿童营养不良诊断相关的护理做法
IF 1.1 Q3 Medicine Pub Date : 2022-02-24 DOI: 10.1080/16070658.2022.2035495
RP Dimo, TK Madiba, A. Bhayat
Background: Despite improvement in child health outcomes, undernutrition in children aged under five years continues to be a major public health problem, contributing to childhood morbidity and mortality. Objectives: The aim was to determine the knowledge and practice patterns used in the identification of malnutrition by nurses at PHC facilities. The attendance rates and the impact of in-house paediatric courses were also examined. Design: An observational, descriptive, cross-sectional study was undertaken from June to September 2018. Setting: The study was conducted at 36 primary healthcare clinics in the West Rand Health District Council Area, Gauteng, South Africa. Subjects: All nurses working with children aged under five years in the study clinics. Results: The response rate was 94% (49) with a mean age of 42.5 years (±9.7) with the majority (98%) being females. Nearly two-thirds (61%) of the participants had good knowledge, 33% had excellent knowledge and 6% had poor knowledge. The mean knowledge score was 20.3 (8–27, SD). The practice categories indicated that two-thirds of the participants (61%) displayed poor practices, and 21% had good practices whilst only 18% displayed best practices. The mean practice score was 4.5 (1.75, SD). There was no association between attendance at courses, knowledge scores and practice patterns. Conclusion: Most participants had good or excellent knowledge around issues of malnutrition. There was poor attendance on courses and there was no association between knowledge and attendance on the courses. More than 60% of the nurses had poor practice patterns and there was no association between knowledge, attendance on courses and practice patterns.
背景:尽管儿童健康状况有所改善,但五岁以下儿童营养不良仍然是一个主要的公共卫生问题,造成儿童发病率和死亡率。目的:目的是确定的知识和实践模式,用于鉴定营养不良的护士在初级保健设施。还审查了出勤率和内部儿科课程的影响。设计:2018年6月至9月进行了一项观察性、描述性、横断面研究。环境:研究在南非豪登省西兰德卫生区议会区的36个初级保健诊所进行。研究对象:所有在研究诊所与五岁以下儿童一起工作的护士。结果:有效率94%(49例),平均年龄42.5岁(±9.7岁),以女性居多(98%)。近三分之二(61%)的参与者知识良好,33%知识优秀,6%知识不佳。平均知识得分为20.3分(8-27,SD)。实践类别表明,三分之二的参与者(61%)表现出不良实践,21%的参与者表现出良好实践,而只有18%的参与者表现出最佳实践。平均练习得分为4.5 (1.75,SD)。课程出勤率、知识分数和练习模式之间没有关联。结论:大多数参与者对营养不良问题有很好的或很好的了解。课程出勤率很低,知识和课程出勤率之间没有联系。超过60%的护士实践模式较差,知识、课程出勤率与实践模式之间没有关联。
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引用次数: 0
期刊
South African Journal of Clinical Nutrition
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