Impact of nutrition education on diabetes knowledge and attitudes of adults with type 2 diabetes living in a resource-limited setting in South Africa: a randomised controlled trial

Objective: To evaluate the effect of a nutrition education (NE) programme on diabetes knowledge and attitudes of adults with type 2 diabetes mellitus (T2DM).Methods: Eighty-two adults (40–70 years) with poorly controlled T2DM (HbA1c ≥ 8%) and attending two community health centres in Moretele, North West Province (South Africa) participated in a one-year randomised controlled trial. Participants were randomised to the intervention group (n = 41; 8 weekly group education (2 2.5 hours); follow-up meetings and education materials) or control group (education materials only). Diabetes Knowledge Form B assessed knowledge about diabetes. Diabetes Attitudes Scale-III assessed the attitudes towards diabetes and treatment. Assessments were done at 6 and 12 months. Analysis of co-variance compared the groups (baseline, age, gender and clinic adjustments). An intention to-treat analysis was employed.Results: The intervention group had higher mean diabetes knowledge scores + 0.95 (p = 0.033) and + 2.05 (p < 0.001) at 6 and 12 months respectively. However, the scores were below 50%. Patient autonomy for diabetes attitudes was the only score significantly higher in the intervention group + 0.27 (p = 0.028) at 12 months.Conclusion: NE significantly improved diabetes knowledge in the intervention group, though not satisfactorily, but had limited effects on the attitudes towards diabetes.Keywords: attitudes, diabetes knowledge, nutrition education, South Africa, type 2 diabete

Stakeholders’ perceptions of dietary and related self-management challenges and education programme preferences for type 2 diabetes adults

Objective: To inform the adaptation of an intervention from a primary healthcare setting to a tertiary setting, the dietary and related self-management challenges and education programme preferences of adults with type 2 diabetes (T2DM) were explored.Setting: A study was undertaken in a tertiary teaching hospital in Gauteng Province, South Africa.Methods: A qualitative approach was employed. Data were collected via focus-group discussions and open-ended selfadministered questionnaires from a convenient purposive sample of T2DM patients (n = 28; 40–70 years) and health professionals (n = 10) respectively. Data were analysed using a thematic framework method.Results: Participants revealed diabetes-related knowledge deficits and struggle with adhering to diet, exercise, medication and appointment keeping as problems affecting patients. They also perceived multiple barriers to effective self-management (financial constraints, unsupportive social and physical environments and personal factors). Patients perceived the challenges to greatly impact on their quality of life and consequently the motivation to self-care appropriately. Participants desired an education programme in the form of monthly group meetings with approaches to enhance learning (e.g. use of examples from peers and the provision of education materials). Strategies for motivating and sustaining programme participation (e.g. testimonials from successful participants) were perceived as necessary. Involving family was seen as a key support for positive behaviour change.Conclusion: In adapting the intervention, the participants’ preferences for education need to be considered and the unique challenges addressed. In particular, strategies for enhancing the patients’ motivation and the self-efficacy to effectively selfmanage are essential

Compulsory community service for dietitians - Monitoring and mentoring

[No abstract available]Editoria

Nutritional status, quality of life and CD4 cell count of adults living with HIV/AIDS in the Ga-Rankuwa area (South Africa)

Objective: To determine if there was a relationship between CD4 cell count, nutritional status and self-reported quality of life (QoL) in HIV-infected adults. Design: Descriptive study in the quantitative research domain. Setting: The out-patient antiretroviral (ARV) clinic at Dr George Mukhari Hospital (Ga-Rankuwa) (institutional). Subjects: The study group (n = 90) consisted of male (n = 34) and female patients (18-50 years) diagnosed with HIV/AIDS. Convenience sampling was used. Outcome measures: Anthropometry (weight, height, BMI, MUAC, TSF), dietary intake (habitual food intake recall) and QoL (WHOQoL-HIV questionnaire) were assessed. Data collection was done from January-April 2007. Results: Significant, but poor, positive correlation was found for the following anthropometrical parameters and the CD4 cell count: weight (r = 0.37; ρ = 0.00), BMI (r=0.39; ρ = 0.00), and MUAC (r = 0.36; ρ = 0.00). The study group had a poor dietary quality. Significant correlation with the CD4 cell count was found for the following domains of the QoL: physical activity (r = 0.27; ρ = 0.01), psychological (r = 0.27; ρ = 0.01), level of independence (r = 0.36; ρ = 0.00), and environmental (r = 0.27; ρ = 0.01). The overall QoL assessment was average, according to the WHOQoL-HIV questionnaire score. Conclusion: Significant positive relationships existed between specific anthropometry and the CD4 cell count, and also between certain QoL domains and the CD4 cell count. Strategies for increasing dietary diversity and QoL ought to be identified and implemented in communities. Recommendation: A longitudinal study would give better understanding of the relationship between nutritional status, the CD4 cell count and QoL.Articl