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Helle C, Hillesund ER, Øverby NC. A qualitative study of public health nurses' perspectives and experiences on nutritional guidance for parents of infants and toddlers. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 2:e13546. [PMID: 37439563 PMCID: PMC10765362 DOI: 10.1111/mcn.13546] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/26/2023] [Accepted: 06/07/2023] [Indexed: 07/14/2023]
Abstract
In Norway, public health nurses (PHNs) are responsible for giving parents nutritional knowledge, but limited research describes how they perceive this task. This study explores PHNs' perceptions and experiences on nutritional guidance for parents of infants and toddlers. Semistructured interviews with six PHNs were conducted and transcribed verbatim. Data were subjected to thematic analysis. Five main themes were identified: (1) Dietary guidance for parents is central to the work; (2) PHNs perceive they have parents' trust, and parents are in general open to nutrition counselling; (3) food and meals must be seen in light of the family context; (4) The dialogue must be adapted to the individual family; and (5) PHNs have expertise on nutrition; however, updating knowledge is difficult. Nutritional guidance was perceived by PHNs as a core activity. They felt that they had parents' trust, and that parents were particularly open to nutritional guidance during the first 2 years. Counselling was generally well received, but conversations on overweight were perceived as difficult. PHNs strove to tailor their guidance to individual needs. However, providing guidance on a wide range of issues in different families and cultures could be challenging. They acknowledged a need for updating knowledge but the offer of courses was sparse. Our findings suggest a discrepancy between how nutrition is prioritized in the education of PHNs and what they encounter in clinical practice. In the future, this should be given more attention given the PHNs' unique position to promote healthy eating and long-term health.
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Affiliation(s)
- Christine Helle
- Department of Nutrition and Public Health, Faculty of Health and Sport SciencesUniversity of AgderKristiansanNorway
| | - Elisabet R. Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sport SciencesUniversity of AgderKristiansanNorway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport SciencesUniversity of AgderKristiansanNorway
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Mekhoa TM, Mooi NM, Baloyi OB. Knowledge, attitudes and practices of nurses regarding maternal nutrition in pregnant women at a large hospital and filter clinics, Lesotho. Health SA 2022; 27:1768. [PMID: 35281282 PMCID: PMC8905416 DOI: 10.4102/hsag.v27i0.1768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 12/08/2021] [Indexed: 11/08/2022] Open
Abstract
Background Adequate nutritional knowledge, positive attitudes, and good practices of nurses regarding maternal nutrition of women during pregnancy are fundamental for maternal and foetal well-being. Aim This study aimed to determine the knowledge, attitudes, and practices of nurses regarding maternal nutrition in pregnant women. Setting A large hospital and its filter clinics in Lesotho. Methods A descriptive cross-sectional research design was used for this study. The data were collected from 120 nurses working in the reproductive health department of a large hospital and filter clinics, using a self-administered questionnaire. The research was conducted in accordance with the Declaration of Helsinki. Results The nurses showed good knowledge and practices, and positive attitudes regarding maternal nutrition, 88.3%, 99.2% and 62.5%, respectively. There was a significant relationship between attitude and practice, with a correlation coefficient of r = 296, n = 120, and p = 0.001. Conclusion The results of this study show that nurses’ practices were associated with their attitudes regarding maternal nutrition, meaning their attitudes regarding maternal knowledge transcends their related knowledge. Contribution The study contributes to the body of literature about the knowledge, attitudes and practices of nurses related to maternal nutrition. It has the potential to lead to the betterment of nursing care, which in turn results in improved pregnancy outcomes in women.
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Affiliation(s)
- Tsiame M Mekhoa
- Department of Nursing, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Nomaxabiso M Mooi
- Department of Nursing, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Olivia B Baloyi
- Department of Nursing, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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3
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Holmberg Fagerlund B. Reflections on a complex intervention targeting healthy eating in young children. Public Health Nurs 2021; 39:313-319. [PMID: 34729811 DOI: 10.1111/phn.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/07/2021] [Accepted: 10/09/2021] [Indexed: 11/30/2022]
Abstract
In this article, the author offers her experiences of conducting a public health nursing intervention based on the use of the Medical Research Council framework for complex interventions. This article provides examples aimed at helping and inspiring others who might be interested in conducting a complex intervention study. The intervention focused on counseling about food and feeding practices provided by public health nurses in a sample of child health centers in Norway 2015-2018. Aspects of food and nutrition are central to public health nurses' counseling at the child health center, and they experience challenges when counseling on these themes. This article offers an approach to handling the complexity of public health nursing interventions on counseling among families. The topics presented on planning and performing an intervention and the related challenges might have relevance for public health nursing in several countries.
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Affiliation(s)
- Bettina Holmberg Fagerlund
- Faculty of Health Studies, VID Specialized University, Oslo, Norway.,Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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4
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Callaghan S, O'Brien E, Coughlan B, McAuliffe FM. Midwives' and obstetricians' level of knowledge of appropriate gestational weight gain recommendations for pregnancy: A systematic review. Birth 2020; 47:322-331. [PMID: 32253784 DOI: 10.1111/birt.12485] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Excessive gestational weight gain (GWG) is a modifiable risk factor associated with maternal and infant health, and pregnancy outcomes. However, several factors influence the provision of health promotion advice including professional knowledge. This review aims to summarize published evidence relating to midwives' and obstetricians' knowledge of GWG guidelines. METHODS Electronic database searches were carried out using EMBASE, CINAHL, PubMed, Web of Science, and Cochrane Database. English-language studies and quantitative results were included. Identified studies were screened by two authors independently. Disagreements were discussed with a third reviewer. A review protocol was submitted for registration with PROSPERO in May 2019. RESULTS From 10 960 records identified in preliminary searches, 12 studies reporting on 2652 midwives and obstetricians collectively were included. All studies were conducted in high-income countries. Synthesis of data was difficult as guidelines and methods for assessing knowledge varied. Midwives were mainly reported as the leading participant, with limited data available on obstetrician knowledge. Both groups demonstrated insufficient knowledge of GWG guidelines. Self-reported knowledge was significantly higher than those assessed by direct knowledge. CONCLUSIONS This review highlights a substantial gap in health care professionals' knowledge of GWG guideline content which needs to be addressed. Differences between professionals' direct knowledge and self-reported knowledge are important for clinical practice as it may inhibit the provision of evidence-based advice. It is important to accurately assess knowledge in this area to develop further training for midwives and obstetricians to improve health promotion during pregnancy.
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Affiliation(s)
- Shauna Callaghan
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Eileen O'Brien
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Barbara Coughlan
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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Bak MAR, Hoyle LP, Mahoney C, Kyle RG. Strategies to promote nurses' health: A qualitative study with student nurses. Nurse Educ Pract 2020; 48:102860. [PMID: 32890934 DOI: 10.1016/j.nepr.2020.102860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 07/21/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
Developing strategies to support student nurses' health is a global priority for healthcare organisations and governments. This is because emerging international evidence indicates that improvements in student nurses' health are required to increase the longevity of careers and reduce the loss of time, skill and financial cost of sickness absence and workforce exit. However, we do not know what intervention strategies student nurses think would support their health. The study aim was to explore student nurses' views on factors that influence health-related behaviours and strategies that could improve health. Data were collected through participatory activities during focus groups with student nurses in Scotland. Analysis was theoretically informed and involved mapping to the Behaviour Change Wheel framework. Students identified several factors that influenced health-related behaviours. Four were ranked most important: knowledge, culture, time constraints, and stress. Strategies student nurses thought should be prioritised to improve nurses' health-related behaviours were: stimulating a health-promoting environment by reviewing shift work, improving workplace support, increasing staffing levels, subsidising and role-modelling of healthy food and exercise; and creating applied health-promoting curricula by integrating time and stress management training and lifestyle advice into nursing education. Educational and environmental interventions are needed to support student nurses' health.
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Affiliation(s)
- Marieke A R Bak
- Section of Medical Ethics, Department of General Practice, Amsterdam UMC, University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, the Netherlands.
| | - Louise P Hoyle
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK.
| | - Catherine Mahoney
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK.
| | - Richard G Kyle
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK; Research and Evaluation Division, Public Health Wales, Cardiff, CF10 4BZ, UK.
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Holmberg Fagerlund B, Helseth S, Andersen LF, Småstuen MC, Glavin K. The use of a communication tool about diet at the child health centre: A cluster randomized controlled trial. Nurs Open 2020; 7:1217-1232. [PMID: 32587742 PMCID: PMC7308697 DOI: 10.1002/nop2.498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 03/17/2020] [Indexed: 02/01/2023] Open
Abstract
Aim To investigate the effect of a communication tool about diet used in public health nurse consultations with parents compared with standard consultations concerning the 2-year-old child's diet. Design A cluster randomized controlled trial. Methods Ten municipalities were selected randomly and matched in pairs. In each pair, the control or intervention group was randomly allocated. Parents were recruited to participate from January 2015 to January 2017. In intervention clusters, a communication tool about diet was used to help the parents (N = 140) to focus on a healthy diet for their child. In the control clusters, parents (N = 110) attended standard consultations. The participants completed semi-quantitative food frequency questionnaires at baseline and end point. Results No effect of the intervention was seen on the child's daily intake of vegetables or saturated fat, or body mass index. Significantly fewer parents desired more information about food for toddlers in the intervention than in the control group.
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Affiliation(s)
- Bettina Holmberg Fagerlund
- Department of Nursing and Health PromotionFaculty of Health SciencesOsloMet – Oslo Metropolitan UniversityOsloNorway
| | - Sølvi Helseth
- Department of Nursing and Health PromotionFaculty of Health SciencesOsloMet – Oslo Metropolitan UniversityOsloNorway
| | - Lene F. Andersen
- Department of NutritionInstitute of Basic Medical SciencesFaculty of MedicineUniversity of OsloOsloNorway
| | - Milada C. Småstuen
- Department of Nursing and Health PromotionFaculty of Health SciencesOsloMet – Oslo Metropolitan UniversityOsloNorway
| | - Kari Glavin
- Department of HealthVID Specialized UniversityOsloNorway
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Baginska J, Rodakowska E, Kobus A, Kierklo A. The role of Polish school nurses in the oral health promotion for 7-19 year-old children and adolescents. Eur Arch Paediatr Dent 2020; 22:265-272. [PMID: 32583292 PMCID: PMC8021534 DOI: 10.1007/s40368-020-00546-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/07/2020] [Indexed: 11/07/2022]
Abstract
Purpose The assessment of the role of school nurses in the oral health education and counselling of children and adolescents aged 7–19 years. Methods A self-administered questionnaire was used to evaluate nurses’ practice in oral health education, previous training in caries prevention, collaboration with a dentist and self-assessment of knowledge. Data were analysed with the Chi square test. Results The study group consisted of 140 Polish school nurses. Respondents declared the following activities: dietary counselling (99.2%), oral hygiene education (92.8%), NHS-funded supervised fluoride prophylaxis (82.8%), and caries screenings (4.3%). 47.1% participated in training on caries prevention, 25.7% had a collaboration with a dentist. Nurses from schools located in towns less frequently provided oral hygiene education (p < 0.005) and dietary counselling, but more often had a collaboration with a dentist (p < 0.05). The youngest nurses were more confident about their knowledge (p < 0.05). There was an association between participation in training on caries prevention and positive opinion on a school-based fluoride prophylaxis (p < 0.01). Nurses who did not include dental topics in their practice worked mainly with pupils older than 15 years, had shorter experience (p < 0.05), secondary education, worked in urban areas and had no training on dental problems (p < 0.01). Conclusion Polish school nurses have potentially crucial roles in improving the oral health status in pupils through oral hygiene education, dietary counselling and fluoride prophylaxis included in their duties.
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Affiliation(s)
- J. Baginska
- Department of Dentistry Propaedeutics, Medical University of Bialystok, ul. Szpitalna 30, 15-295 Bialystok, Poland
| | - E. Rodakowska
- Depertment of Restorative Dentistry, Medical University of Bialystok, Bialystok, Poland
- Present Address: Department of Clinical Dentistry-Cariology, University of Bergen, Bergen, Norway
| | - A. Kobus
- Department of Dentistry Propaedeutics, Medical University of Bialystok, ul. Szpitalna 30, 15-295 Bialystok, Poland
| | - A. Kierklo
- Department of Dentistry Propaedeutics, Medical University of Bialystok, ul. Szpitalna 30, 15-295 Bialystok, Poland
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Othman SME, Steen M, Fleet JA, Jayasekara R. Healthy eating in pregnancy, education for midwives: A pre-post intervention study. Eur J Midwifery 2020; 4:20. [PMID: 33537622 PMCID: PMC7839119 DOI: 10.18332/ejm/120004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/25/2020] [Accepted: 04/01/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Midwives have an important role in providing education in healthy eating to pregnant women, which is essential for maternal and foetal health and wellbeing. Importantly, midwives require continual professional development to ensure they provide up-to-date education. METHODS A pre-post intervention study utilised a purpose-designed questionnaire to collect data at three time points. Forty-four midwives completed the pre education questionnaire, 29 of these midwives attended the education intervention (workshop/webinar) and completed the immediately after questionnaire. Nineteen midwives then completed a questionnaire at 6–8 weeks follow-up. The study aimed to evaluate midwives’ knowledge and level of confidence to discuss healthy eating in pregnancy. RESULTS Education in healthy eating improved midwives’ knowledge and level of confidence, which were maintained for six to eight weeks. The mean difference of total scores on knowledge and confidence between pre and immediately after education questionnaires showed a statistically significant improvement in nutrition knowledge (4.93 ± 1.62 vs 7.55 ± 1.55; p<0.001) and confidence level (22.05 ± 6.87 vs 31.48 ± 7.47; p<0.001). In terms of the mode of education, there was a significant increase in total knowledge scores for midwives who attended a workshop compared to a webinar. CONCLUSIONS Overall, healthy eating education improved midwives’ knowledge and confidence immediately after receiving education and also at 6–8 weeks follow-up. This study is unique as it evaluated midwives’ knowledge and level of confidence at 6–8 weeks post education. This study concludes that midwives benefited from receiving further knowledge on cultural food choices, eating behaviours, and dental care.
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Affiliation(s)
- Shwikar M E Othman
- Obstetrics and Gynaecology Nursing Department, Faculty of Nursing, South Valley University, Luxor, Egypt.,UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Mary Steen
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Julie-Anne Fleet
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Rasika Jayasekara
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
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Holmberg Fagerlund B, Helseth S, Glavin K. Parental experience of counselling about food and feeding practices at the child health centre: A qualitative study. J Clin Nurs 2019; 28:1653-1663. [PMID: 30618063 DOI: 10.1111/jocn.14771] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 11/13/2018] [Accepted: 12/18/2018] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To investigate how parents experience counselling about food and feeding practices and the use of a communication tool about diet at the child health centre. BACKGROUND Food-related counselling is a key element in parents' consultations with public health nurses at child health centres. Public health nurses possess limited strategies and tools for addressing nutritional issues, especially in the context of client diversity. DESIGN An interpretive description approach, fulfilling the COREQ checklist criteria. METHODS Individual interviews performed between January 2017-May 2017 among parents (n = 12) of children (mean age 28 months) who had been exposed to a communication tool about diet, in regular child health centre consultations with their child. These consultations were included in clinical trial (ClinicalTrials.gov.: Identifier: NCT02266953). RESULTS Counselling using the communication tool about diet was primarily based on the public health nurse presenting images of healthy food choices. After infancy, consultations sometimes became more time-pressured, inhibiting parents from asking questions related to the child's diet. The parents who had questions related to food allergy or breastfeeding of their child sometimes experienced limited support. Some parents felt overwhelmed with information about healthy food choices if their child's diet differed from the recommendations presented. CONCLUSIONS The parents' existing expectations and needs had an impact on their satisfaction in relation to their perceptions of nutritional counselling. The use of the communication tool about diet to promote a two-way dialogue instead of providing one-way dietary information might be particularly useful in consultations for parents who do not follow customary recommendations. RELEVANCE TO CLINICAL PRACTICE If the diet of the family differs from what is recommended, parents often experience limited support at the child health centre. Promoting a two-way dialogue in consultations using a communication tool about diet could help parents in their concerns related to feeding their child.
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Affiliation(s)
- Bettina Holmberg Fagerlund
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Kari Glavin
- Department of Health, VID Specialized University, Oslo, Norway
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10
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Perinatal nutrition impacts on the functional development of the visual tract in infants. Pediatr Res 2019; 85:72-78. [PMID: 30237571 DOI: 10.1038/s41390-018-0161-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 07/18/2018] [Accepted: 07/23/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVE We investigated the associations of maternal diet and serum fatty acids during pregnancy and in early infancy on infantile neurodevelopment. METHODS Pattern-reversal visual evoked potentials (pVEP) as depictors of central nervous system maturation were recorded from 56 children when they were 2 years old. Maternal nutrient intakes were calculated from food diaries and fish consumption from questionnaires collected during pregnancy. Serum phospholipid fatty acids were determined by gas chromatography in late pregnancy and from infants at 1 month of age. RESULTS The children of the women who consumed fish three or more times per week during the last trimester of pregnancy had a higher pVEP component P100 amplitude for 60' (mean 23.4, SD 8.1) and 30' (mean 20.4, SD 6.7) of arcminute check sizes compared to those who consumed fish 0-2 times per week (mean 15.0, SD 4.8, p = 0.023, adjusted for birth weight and gender p = 0.058 and mean 13.4, SD 2.0, respectively, p = 0.028, adjusted p = 0.072). Maternal and child serum phospholipid fatty acids correlated with child pVEP measurements. CONCLUSION The results of this small-scale study suggest that fish consumption during pregnancy and perinatal serum fatty acid status may associate with neurodevelopment within visual system during infancy.
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Holmberg Fagerlund B, Helseth S, Andersen LF, Småstuen MC, Glavin K. Parental concerns of allergy or hypersensitivity and the infant's diet. Nurs Open 2019; 6:136-143. [PMID: 30534403 PMCID: PMC6279714 DOI: 10.1002/nop2.195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/30/2018] [Accepted: 07/14/2018] [Indexed: 11/07/2022] Open
Abstract
AIM To investigate a possible association between children's current diet and parents' reported avoidance of appropriate foods in the child's diet at the age of 10 months, due to fears of allergic or hypersensitivity reactions. DESIGN A cross-sectional study. METHODS In 10 randomly selected municipalities willing to participate, 686 children represented by their parents visiting the child health centre were enrolled in the study. From January 2015-January 2017, 440 (64%) parents completed a semi-quantitative food frequency questionnaire concerning their child. RESULTS Thirty-four percent of parents reported that they avoided introducing some food items due to fears of allergy or hypersensitivity in their child. A statistically significant relationship emerged between this reporting and parents wanting more information about food for infants and toddlers. However, the reported fear was not associated with dietary restrictions regarding actual feeding of the child.
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Affiliation(s)
- Bettina Holmberg Fagerlund
- Department of Nursing and Health Promotion, Faculty of Health SciencesOsloMet – Oslo Metropolitan UniversityOsloNorway
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health SciencesOsloMet – Oslo Metropolitan UniversityOsloNorway
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Faculty of Health SciencesOsloMet – Oslo Metropolitan UniversityOsloNorway
| | - Kari Glavin
- Department of HealthVID Specialized UniversityOsloNorway
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"Practice What You Teach" Public Health Nurses Promoting Healthy Lifestyles (PHeeL-PHiNe): Program Evaluation. J Ambul Care Manage 2018; 41:171-180. [PMID: 29847404 DOI: 10.1097/jac.0000000000000243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Healthy lifestyle programs are essential for meeting the challenge of noncommunicable diseases. The Public Health Nurses Promoting Healthy Lifestyles (PHeeL-PHiNe) program engaged nurses from family health clinics in Jerusalem District and included physical activity, healthy nutrition, and motivational skills. Questionnaires were completed at baseline, postintervention, and at 18 months. Results showed a marked effect on health practices. The proportion of nurses consuming a balanced diet and the use of food labels significantly increased and were maintained over time. Short-term improvements in physical activity were also observed. Nurses who practiced a healthy lifestyle were significantly more likely to provide guidance and counseling to families on healthy behaviors.
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Lee A, Newton M, Radcliffe J, Belski R. Pregnancy nutrition knowledge and experiences of pregnant women and antenatal care clinicians: A mixed methods approach. Women Birth 2017; 31:269-277. [PMID: 29126796 DOI: 10.1016/j.wombi.2017.10.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 09/29/2017] [Accepted: 10/25/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dietary intake of pregnant women do not appear to meet the dietary recommendations. Nutrition knowledge and practices of pregnant women and their antenatal care clinicians are factors that may be influential on dietary intakes of pregnant women. AIM To assess and compare pregnancy nutrition recommendation knowledge and to explore how nutrition knowledge impacts on food choices in pregnant women and nutrition education practices of antenatal care providers. METHODS An explanatory sequential research mixed methods study design was applied. All participants were recruited from a metropolitan maternity hospital in Melbourne, Australia. The first phase assessed pregnancy nutrition knowledge and sources of nutrition information using a questionnaire (n=202) then followed semi-structured interviews with women and clinicians (n=31). FINDINGS The clinicians obtained significantly higher nutrition scores than compared to women, however, nutrition knowledge gaps were highlighted for both women and clinicians. Women reported receiving limited nutrition advice, a reflection of the clinicians reporting they provided limited nutrition advice. CONCLUSION A key challenge for women adhering to dietary recommendations was having inadequate knowledge of the dietary recommendations and receiving limited information from their care providers. Similarly, as well as time constraints, limited nutrition knowledge and a lack of nutrition training impacted on the capacity of clinicians to provide adequate nutrition education.
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Affiliation(s)
- Amelia Lee
- Nutrition Department, Royal Women's Hospital, Parkville, Victoria 3052, Australia; School of Allied Health, La Trobe University, Bundoora, Victoria 3086, Australia.
| | - Michelle Newton
- School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086, Australia
| | - Jessica Radcliffe
- School of Allied Health, La Trobe University, Bundoora, Victoria 3086, Australia
| | - Regina Belski
- School of Allied Health, La Trobe University, Bundoora, Victoria 3086, Australia
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Gaps in international nutrition and child feeding guidelines: a look at the nutrition and young child feeding education of Ghanaian nurses. Public Health Nutr 2017; 20:2215-2224. [PMID: 28535828 DOI: 10.1017/s1368980017000908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To examine the nutrition and young child feeding (YCF) education and training of nurses in public health clinics of Ghana's Komenda-Edina-Eguafo-Abrem region (KEEA) in relation to global health guidelines, and how nurses served as educators for caregivers with children aged 0-5 years. DESIGN A qualitative study of semi-structured one-on-one and group interviews (n 21) following a questionnaire of closed- and open-ended questions addressing child feeding, nutrition and global health recommendations. Interviews were conducted in English, audio-recorded, transcribed and coded. Descriptive data were tabulated. Content analysis identified themes from open-ended questions. SETTING KEEA public health clinics (n 12). SUBJECTS Nurses (n 41) purposefully recruited from KEEA clinics. RESULTS A model capturing nurses' nutrition and YCF education emerged with five major themes: (i) adequacy of nurses' basic knowledge in breast-feeding, complementary feeding, iron-deficiency anaemia, YCF and hygiene; (ii) nurses' delivery of nutrition and YCF information; (iii) nurses' evaluation of children's health status to measure education effectiveness; (iv) nurses' perceived barriers of caregivers' ability to implement nutrition and YCF education; and (v) a gap in global health recommendations on YCF practices for children aged 2-5 years. CONCLUSIONS Nurses demonstrated adequate nutrition and YCF knowledge, but reported a lack of in-depth nutrition knowledge and YCF education for children 2-5 years of age, specifically education and knowledge of YCF beyond complementary feeding. To optimize child health outcomes, a greater depth of nutrition and YCF education is needed in international health guidelines.
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Mokkala K, Röytiö H, Ekblad U, Laitinen K. Opportunities for probiotics and polyunsaturated fatty acids to improve metabolic health of overweight pregnant women. Benef Microbes 2017; 8:3-15. [DOI: 10.3920/bm2016.0068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Overweight during pregnancy predisposes both the mother and foetus to health complications. Maternal complications include gestational diabetes, obstetric problems and type 2 diabetes later in life. Complications for the offspring are not only restricted to the foetal period or birth, such as prematurity and foetal macrosomia, but may also have long-term metabolic health implications through the mechanism of early nutrition programming. One of the key metabolic components characterising overweight in the non-pregnant state is low-grade inflammation manifested by elevated levels of circulatory pro-inflammatory cytokines. In pregnancy, in addition to adipose tissue and placenta, inflammatory response may originate from the gut. The extent to which overweight induces metabolic maladaptation during pregnancy and further compromises maternal and child health is currently poorly understood. In this review, we evaluate recent scientific literature and describe the suggested links between overweight, gut and low-grade inflammation associated metabolic disorders. We focus on overweight pregnant women and gestational diabetes, and discuss how specific dietary factors, probiotics and long-chain polyunsaturated fatty acids (fish oil), might confer health benefits in combatting against metabolic risk factors.
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Affiliation(s)
- K. Mokkala
- Institute of Biomedicine, Department of Medical Microbiology and Immunology, and Functional Foods Forum, University of Turku, 20014 University of Turku, Finland
| | - H. Röytiö
- Institute of Biomedicine and Functional Foods Forum, University of Turku, 20014 University of Turku, Finland
| | - U. Ekblad
- Department of Obstetrics and Gynaecology, University of Turku, 20014 University of Turku, Finland
- Turku University Central Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - K. Laitinen
- Institute of Biomedicine and Functional Foods Forum, University of Turku, 20014 University of Turku, Finland
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Rouen PA, Wallace BR. The 2015-2020 Dietary Guidelines: Overview and Implications for Nursing Practice. Home Healthc Now 2017; 35:72-82. [PMID: 28157773 DOI: 10.1097/nhh.0000000000000503] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This article reviews the 2015-2020 Dietary Guidelines for Americans released in 2016. Key recommendations are summarized and significant changes in the guidelines are highlighted. Implications for nursing practice to promote nutrition health are identified and resources to support implementation are included.
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Affiliation(s)
- Patricia A Rouen
- Patricia A. Rouen, PhD, FNP-BC, is an Associate Professor at McAuley School of Nursing, University of Detroit Mercy, Detroit, Michigan. Brenna R. Wallace is a Senior Dietetics student at Michigan State University, East Lansing, Michigan
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Simple dietary criteria to improve serum n-3 fatty acid levels of mothers and their infants. Public Health Nutr 2016; 20:534-541. [PMID: 27692015 DOI: 10.1017/s136898001600238x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Sufficient maternal dietary intake of n-3 fatty acids (FA) supports offspring development. We aimed to construct simple criteria for dietary counselling to improve intake of n-3 FA. DESIGN Serum phospholipid FA from mothers and infants were analysed by GC one month after delivery. Dietary intake of foods during pregnancy and one month after delivery were recorded using 3 d food diaries and an index for healthy eating was calculated. Fish consumption was established by questionnaires. Dietary consumption of foods resulting in an increase in serum n-3 FA was defined. SETTING A mother-child follow-up study in Southwest Finland. SUBJECTS Mothers (n 90) and 1-month-old infants (n 63). RESULTS After delivery, the mother's consumption of fish at least three times per week resulted in an increase in total serum n-3 FA (mean difference (95 % CI): 1·7 (0·7, 2·8) % of total FA, P<0·001) and DHA (1·1 (0·5, 1·8) % of total FA, P<0·001) compared with non-consumers. Persistent fish intake once weekly throughout pregnancy increased total serum n-3 FA (P=0·001) and DHA (P<0·001). Overall, a healthy diet (middle and highest tertiles of healthy eating index score v. the lowest tertile) resulted in higher total serum n-3 FA (P=0·004) and DHA (P=0·008). Mother's diet along with higher serum levels of n-3 FA were related to serum FA levels in 1-month-old infants. CONCLUSIONS An overall healthy diet and persistent consumption of fish at least once weekly throughout pregnancy or more frequent fish intake three times per week increases n-3 FA in serum phospholipids of both mothers and their infants.
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Tuominen M, Kaljonen A, Ahonen P, Mäkinen J, Rautava P. A Comparison of Medical Birth Register Outcomes between Maternity Health Clinics and Integrated Maternity and Child Health Clinics in Southwest Finland. Int J Integr Care 2016; 16:1. [PMID: 27761106 PMCID: PMC5056594 DOI: 10.5334/ijic.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 06/22/2016] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. METHODS A comparative, register-based cross-sectional design was used. The data of women (N = 2741) who had given birth in the Turku University Hospital area between 1 January 2009 and 31 December 2009 were collected from the Finnish Medical Birth Register. Comparisons were made between the women who were clients of the maternity health clinics and integrated maternity and child health clinics. RESULTS There were no clinically significant differences between the clients of maternity health clinics and integrated maternity and child health clinics regarding the utilisation of maternity care services or the explored health outcomes. CONCLUSIONS The organisational model of the maternity health clinic does not impact the utilisation of maternity care services or maternal and perinatal health outcomes. Primary maternity care could be provided effectively when integrated with child health services.
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Affiliation(s)
- Miia Tuominen
- PhD Student, Department of Clinical Medicine, Public Health, University of Turku and Institute for Child and Youth Research, University of Turku, FI-20014 Turun yliopisto, Turku, Finland
| | - Anne Kaljonen
- Statistician, Institute for Child and Youth Research, University of Turku, FI-20014 Turun yliopisto, Turku, Finland
| | - Pia Ahonen
- Head of Education and Research, Faculty of Health and Well-being, Turku University of Applied Sciences, Ruiskatu 8, 20760 Turku, Finland
| | - Juha Mäkinen
- Professor, Chief physician, Department of Obstetrics and Gynaecology, University of Turku and Department of Obstetrics and Gynaecology, Turku University Hospital, PO Box 52, 20521 Turku, Finland
| | - Päivi Rautava
- Professor, Chief physician of research, Public Health Department, University of Turku and Turku Clinical Research Centre, Turku University Hospital, PO Box 52, 20521 Turku, Finland
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Holmberg Fagerlund B, Pettersen KS, Terragni L, Glavin K. Counseling Immigrant Parents about Food and Feeding Practices: Public Health Nurses' Experiences. Public Health Nurs 2016; 33:343-50. [DOI: 10.1111/phn.12248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Bettina Holmberg Fagerlund
- Department of Nursing and Health Promotion; Faculty of Health Sciences; Oslo and Akershus University College of Applied Sciences; Oslo Norway
| | - Kjell Sverre Pettersen
- Department of Nursing and Health Promotion; Faculty of Health Sciences; Oslo and Akershus University College of Applied Sciences; Oslo Norway
| | - Laura Terragni
- Department of Nursing and Health Promotion; Faculty of Health Sciences; Oslo and Akershus University College of Applied Sciences; Oslo Norway
| | - Kari Glavin
- Department of Nursing and Health Promotion; Faculty of Health Sciences; Oslo and Akershus University College of Applied Sciences; Oslo Norway
- Department of Nursing; Diakonova University College; Oslo Norway
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Development and evaluation of a stand-alone index for the assessment of small children’s diet quality. Public Health Nutr 2015; 18:1941-9. [DOI: 10.1017/s1368980014002535] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
AbstractObjectiveTo construct and evaluate an independent Children’s Index of Diet Quality (CIDQ).DesignA food consumption questionnaire, which contained twenty-five multiple-item questions on eating and food intake, was formulated and evaluated against 7 d food records. Key questions that best reflected a healthy diet, defined in criteria set by the nutrient recommendations, were searched and validated by correlation and analyses of receiver-operating characteristic curves.SettingsA cohort of a young population of South-West Finland.SubjectsParticipants (n 400) were 2–6-year-old children.ResultsFifteen questions were identified to best depict the children’s diet quality in reference to the recommendations. These questions were scored, summarized and further constructed into a three-class index (good, moderate and poor dietary quality) where higher scores depicted better diet quality. The CIDQ cut-off score of 14 points for good dietary quality had a sensitivity of 0·59 and a specificity of 0·82 and the cut-off score of 10 points, for at least moderate dietary quality, had a sensitivity of 0·77 and a specificity of 0·69. Higher index scores were related to higher dietary intakes of several vitamins, lower dietary intakes of SFA and cholesterol, and further with lower serum cholesterol and higher serum vitamin C concentrations.ConclusionsThe three-class food index was found to represent diet quality as defined in recommendations and evaluated against nutrient intakes from food diaries and biochemical markers. This self-standing index could provide an effective and low-burden method to obtain information about diet quality and guide future recommendations.
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de Oliveira SC, Lopes MVDO, Fernandes AFC. Development and validation of an educational booklet for healthy eating during pregnancy. Rev Lat Am Enfermagem 2014; 22:611-20. [PMID: 25296145 PMCID: PMC4292660 DOI: 10.1590/0104-1169.3313.2459] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 05/06/2014] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE to describe the validation process of an educational booklet for healthy eating in pregnancy using local and regional food. METHODS methodological study, developed in three steps: construction of the educational booklet, validation of the educational material by judges, and by pregnant women. The validation process was conducted by 22 judges and 20 pregnant women, by convenience selection. We considered a p-value<0.85 to validate the booklet compliance and relevance, according to the six items of the instrument. As for content validation, the item-level Content Validity Index (I-CVI) was considered when a minimum score of at least 0.80 was obtained. RESULTS five items were considered relevant by the judges. The mean I-CVI was 0.91. The pregnant women evaluated positively the booklet. The suggestions were accepted and included in the final version of the material. CONCLUSION the booklet was validated in terms of content and relevance, and should be used by nurses for advice on healthy eating during pregnancy.
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Affiliation(s)
- Sheyla Costa de Oliveira
- Adjunct Professor, Departamento de Enfermagem, Centro de Ciências da
Saúde, Universidade Federal de Pernambuco, Recife, PE, Brazil
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Jaakkola J, Isolauri E, Poussa T, Laitinen K. Benefits of repeated individual dietary counselling in long-term weight control in women after delivery. MATERNAL AND CHILD NUTRITION 2014; 11:1041-8. [PMID: 24521459 DOI: 10.1111/mcn.12115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
As pregnancy may trigger overweight in women, new means for its prevention are being sought. The aim here was to investigate the effect of individual dietary counselling during and after pregnancy on post-partum weight and waist circumference up to 4 years post-partum. A cohort of women (n = 256) were randomized to receive repeated individual dietary counselling by a nutritionist during and after pregnancy, or as controls not receiving dietary counselling, from the first trimester of pregnancy until 6 months after delivery. Counselling aimed to bring dietary intake into line with recommendations, with particular focus on the increase in the intake of unsaturated fatty acids instead of saturated. Pre-pregnancy weight was taken from welfare clinic records. Weight and waist circumference were measured at 4 years after delivery. The proportion of overweight women increased from 26% prior to pregnancy to 30% at 4 years after delivery among women receiving dietary counselling, as against considerably more, from 32% to 57%, among controls. The prevalence of central adiposity was 31% in women receiving dietary counselling, 64% in controls. Likewise, both the risk of overweight (odds ratio: 0.23, 0.08-0.63, P = 0.005) and central adiposity (odds ratio: 0.18, 0.06-0.52, P = 0.002) were lower in women receiving dietary counselling compared with controls. Repeated dietary counselling initiated in early pregnancy can be beneficial in long-term weight control after delivery.
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Affiliation(s)
- Johanna Jaakkola
- Department of Clinical Sciences, University of Turku, Finland.,Functional Foods Forum, University of Turku, Finland
| | - Erika Isolauri
- Department of Clinical Sciences, University of Turku, Finland.,Department of Paediatrics, Turku University Hospital, Turku, Finland
| | | | - Kirsi Laitinen
- Functional Foods Forum, University of Turku, Finland.,Institute of Biomedicine, University of Turku, Finland
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