EDUCATING THE FAMILY AND THE PATIENT ABOUT NUTRITION

Nurses' knowledge about Berardinelli-Seip Congenital Lipodystrophy

Berardinelli-Seip Congenital Lipodystrophy (BSCL) is a rare autosomal recessive disease characterized by the almost complete absence of adipose tissue. Due to a strong founder effect that resulted in a higher prevalence of BSCL in Rio Grande do Norte (RN), a state in northeastern Brazil, it has been essential that health professionals develop knowledge about this disease. Nurses are often the first point of contact with patients during health care assistance. The purpose of this study was to investigate the knowledge of these professionals about BSCL in two main hospitals in RN state. A questionnaire was applied to 199 nurses working in the Hospital Regional Mariano Coelho—HRMC (Regional Hospital Mariano Coelho), in Currais Novos–RN, and in the Hospital Universitário Onofre Lopes—HUOL (University Hospital Onofre Lopes), in Natal–RN. This study showed that most nursing professionals do not know about the disease, although they have already received patients with BSCL in those hospitals. The nurses from HRMC and HUOL lacked knowledge of BSCL and the healthcare of these patients requires immediate improvement. Significant efforts are required to close the gap between current and needed practice patterns.

Focused Nutritional Intervention in the Home Care Setting

In order to determine whether more efficient diabetic management could be achieved by focused application of resources in a Hospital Based Home Care (HBHCJ program, a nonrandomized prospective intervention was made during 1995-1996 in the HBHC program of the New Orleans VA Medical Center. Greater flexibility in application of personnel resources appears to increase the benefits of the nutritional interventions. Even with focused interventions, it appeared that lack of compliance was often a barrier to improved diabetic control. Obstacles to improved diabetic management in this HBHC setting often were due not to lack of objective knowledge, but to patient and caregiver difficulties in accepting life-style changes. Nutritional intervention was particularly useful in improving patient skills at grocery shopping, and appears a useful strategy to motivate smoking cessation.