The nature of nutritional advice given by diploma nurses in primary health care centres in Jeddah, Saudi Arabia.
The introduction of Primary Health Care (PHC) in Saudi Arabia has given nurses
excellent opportunities and more responsibility to provide health education and
advice in health promotion activities. Provision of appropriate and affordable
dietary advice is an important role of the nurses in the Primary Health Care
Centres (PHCC). Maternal nutrition is an essential element for the health status of
the child, the family and the wider society. Many studies have suggested that
there is a relationship between good nutritional intake during pregnancy and the
successful outcome of the pregnancy.
The present study was conducted to explore the knowledge and understanding of
Saudi women and nurses in PHCC regarding nutritional intake during pregnancy.
The study also looked at the effect of a short education programme on the nurses'
nutritional knowledge and their subsequent practice. The aims of the study were
to identify the understanding of Saudi women of pregnancy and nutritional intake
during pregnancy, and to evaluate the effect of a short nutritional programme on
diploma nurses. To achieve the aims, data collection was carried out in three
phases. Phase one used semi-structured interview (tape recorded) on 10 pregnant
women, selected randomly, to elicit the general understanding pregnant women
had on pregnancy and pregnancy related areas. Phase two used a structured
interview schedule on 100 pregnant women attending PHCC, selected
systematically, to assess nutritional knowledge and their perception of nutritional
advice given by the nurses in PHCC. Phase three was divided into two stages.
The first stage used a self-administered questionnaire on 20 diploma nurses working
in antenatal clinics in PHCC to assess their nutritional knowledge in relation to
pregnancy. The questionnaire was used as both a pre-test and post-test instrument.
Thereafter, based on the findings from phase one and two, a 20-hour continuing
education (CE) programme was developed by the researcher on maternal nutrition
for the diploma nurses. The second stage was to implement the programme to the
nurses in five days. The effect of the programme was evaluated by an immediate post-test on nurses' knowledge and a follow-up post-test (after six months) to
assess any lasting changes. Data analysis was carried out using content analysis
for phase one. For the phase two and three, SPSS programme was used. Chi
square was used to look for any association between knowledge scores and personal
variables, paired Hest was used to assess the difference between pre-test and
post-test. The results from the study showed that the majority of women attending
the PHCC were illiterate or had little formal education, had a high pregnancy rate
and had poor nutritional knowledge in relation to pregnancy. They preferred
female health professional care and they preferred to have female doctors attending
their antenatal care rather than the nurses. There was no significant difference
between nurses' and women's nutritional knowledge. The results also showed a
significant correlation between poor nutritional knowledge scores of the women
and certain factors: the scores correlated positively with the level of education and
negatively with the number of pregnancies.
Regarding the programme, the results showed a significant increase in the nurses'
nutritional knowledge scores from pre-test to post-test at p< 0.05, indicating that
participants demonstrated increased nutritional knowledge as a result of participation
in the programme. There was no significant difference between the initial post-test
and the six-month follow-up. No significant relationships were identified between
the nurses' scores and their age and years of experiences. The study also indicated
that nurses in PHCC were not giving adequate nutritional advice to pregnant
women in the views of these women and in my own observation. The findings
suggest that frequent continuing education is essential for nurses in PHCC in
Saudi Arabia to improve their skills and nutritional knowledge to be able to
provide better care for women.