Knowledge, attitude and practice of dietary intake among pregnant mother in antenatal clinic, MHPP GROUP 3. Nutritional knowledge affects the quality of food intake and also healthy choices of purchased food. Women with higher knowledge of nutrition displayed healthier dietary behavior of fruit and vegetables intake.
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Knowledge, attitude and practice of dietary intake among pregnant mother in antenatal clinic, MHPP GROUP 3. Nutritional knowledge affects the quality of food intake and also healthy choices of purchased food. Women with higher knowledge of nutrition displayed healthier dietary behavior of fruit and vegetables intake.
Knowledge, attitude and practice of dietary intake among pregnant mother in antenatal clinic, MHPP GROUP 3. Nutritional knowledge affects the quality of food intake and also healthy choices of purchased food. Women with higher knowledge of nutrition displayed healthier dietary behavior of fruit and vegetables intake.
of dietary intake among pregnant mother in Antenatal Clinic, MHPP GROUP 3 NSM Jalilawani Binti Kamaruzaman NSM Rahayu Binti Ismail NSM Suhaida Binti Daud NSM Suhaila Binti Husain NSM Muliyemalar a/p Subramaniam CHAPTER 1 1.1 INTRODUCTION Background Adequate nutritional intake during pregnancy has been recognized as an important factor for healthy pregnancy and desired birth outcomes (Bawadia et al., 2010). It was found that deficiency of nutrients during gestation may cause the fetus to receive suboptimal micro and macro nutrients, causing inadequate intrauterine growth and development, inherited malformations, preterm deliveries, and pregnancy complications may occur. Thus, attention to appropriate dietary behavior and proper nutrient intake will supply adequate nourishment to achieve optimum health for both mother and child (Wen et al., 2010). Studies show that nutritional knowledge affects the quality of food intake and also healthy choices of purchased food (Verbeke, 2008). Advancement of individual nutrition knowledge (NK) provides new information which may stimulate changing of attitude and subsequently result in enhancement of dietary practices (De Vriendt et al., 2009). Healthy nutritional behavior and adequate dietary intake will provide required nutrients for both mother and her child and result in their optimum health during pregnancy. Studies show that nutritional knowledge has influence on the healthy selection of purchased or consumed food and quality of food intake. Improvement of personal nutrition knowledge (NK), by providing new information possibly influences on attitude and consequently results in alteration and enhancement of dietary practices It was found that women with higher knowledge of nutrition displayed healthier dietary behavior of fruit and vegetables intake. It was shown that, nutrition knowledge was predictive of change in dietary habits and health advices encouraged expectant women to advance their food intake. A number of studies have established that an improvement in nutrition knowledge is an important tool to stimulate dietary behavior that will promote healthy weight in all generations. It has also been shown that increasing ones knowledge in nutrition improves attitudes, beliefs, and self-efficacy towards the consumption of a healthy diet and a possible increase in physical activity. Therefore, it is important to examine the relationship between nutrition knowledge and the consumption of a healthy diet in order to improve the health status specifically among minority groups. Though some solutions, such as food assistance programs, have been proposed and implemented to ensure a healthy diet among low-income earners many of these solutions need to be localized in order to target specific populations. It is evident that solutions that may work for a particular group of people may not be helpful for others due to factors such as the level of education, cultural beliefs, financial status, and different ethnic food consumption. . Thus, to better tailor nutrition interventions to a specific group, it is important to understand the differences that exist between the two largest minority groups. 1.2 PROBLEM STATEMENT Malnutrition is inadequate intake of nourishing food or consumption of a particular type of food item that has little or no nutritional value (Jacinta A.Opara et.al 2011). Malnutrition is a condition where nutrition is defective in quantity or quality ( Sweet, D. 2006 cited in Jacinta A.Opara et.al 2011). Sometimes, a pregnant women does not know that she needs to eat a greater amount of quality food. For a healthy pregnancy, steady supplies of micro nutrients are essential both for mother and the growing baby. A mother who is underweight prior to becoming pregnant also puts her baby at higher risk for complications, mainly because of the association between underweight status and malnutrition (Ehrenberg et.al 2003 cited in Mustafa Kamal& Md Aynul Islam 2010)). Malnutrition maybe due to illness, food insecurity or others factor, and both the malnutrition and the underlying cause need to be address to maximize positive outcomes for both mother and baby. In some cases, underweight status before pregnancy and failure to gain appropriate weight during pregnancy may be a sign of either a preexisting eating disorder or one that has developed during pregnancy. Regardless of nutritional status, a BMI of less than 18.5 has been associated with a higher risk of preterm delivery (Hauger et.al,2008). In addition, one study found that women with eating disorders were significantly more likely than those without to be at risk for fetal growth restriction, preterm labor, anemia and labor induction (Bansil et.al,2008). In Penang, statistic from Pejabat Kesihatan Daerah Barat Daya, showed that the anemic cases among pregnant women has increased in the year 2013; 18 mothers were diagnosed in January and the number relatively increased to 29 in October as reported by the said department. Thus, it is interesting to examine the knowledge, attitude and practice related to nutrition of pregnant women 1.3 Significant of the research Mother Knowledge and practice of dietary intake can be improve so that to be able to perform a healthier dietary intakes and positive pregnancy outcomes. Midwife Help midwives make an early detection on mothers problem. Thus, midwives can give education to the mother according to their needs. Institution The research finding will help to establish better guidelines and policy to patient needs. Thus, quality of care is improve, morbidity and mortality rate will be reduced. Research Objectives General Objectives 1.4.1 To explore mothers knowledge, attitude and practice regarding dietary intake during pregnancy 1.4 Research Objectives 1.4.1 To describe sociodemographic characteristic of pregnant women. 1.4.2 To identify level of nutritional knowledge and attitude of dietary intake among pregnant women. 1.4.3 To determine the relationship between sociodemographic data and nutrition in knowledge, attitude and practice of dietary intake among pregnant women. 1.5 Research questions 1.5.1 What is sociodemographic characteristic of pregnant women 1.5.2 What level of nutritional knowledge, attitude and belief of dietary intake among pregnant women. 1.5.3 What is relationship between nutrition knowledge of pregnant women with their attitude and belief. Variable Independent variable Age Race Education level Household income Dependent variable Knowledge Attitude Practice 1.5 Definition of terms 1) Knowledge Facts, information, understanding and skills acquired by a person through experience or education. ( The American Heritage Medical dictionary fourth edition 2009 cited in www.thefreedictionary.com 2009 ) 2) Attitude The way a person views something or tends to behave towards it, often in an evaluation way. (Collins English dictionary 2003 cited in www.thefreedictionary.com 2003 ) 3) Practise To do or cause to do repeatedly in order to gain skill. (Collins English dictionary 2003 cited in www.thefreedictionary.com 2003) 1.7 Limitations of the Study There is some limitations to complete this study such as time constraints is the biggest problem. Due to constriction of time, the number of sample for this study might not be enough, so it will difficult to find significant relationships from the data. Due to time constriction, we had limited scope the study regarding antenatal dietary only knowledge and practice. In future, researchers suggest to explore more scope of antenatal dietary among pregnant women. Limitation of financial aid to conduct this study as it is a self sponsored research. This study will be only conducted in Antenatal Clinic MHPP as it is a near to Nursing College Penang due to cost of transportation. If the study can be expand to other hospital, sample will be larger and produce more significant result. LITERATURE REVIEW CHAPTER 2 2.1 Introduction In this chapter, the researcher will discussed more detail about theory and model which is relate with this research. Besides that, the researcher also refer to previous research whether in this country or outside this country. Researcher also provided summary from previous research. 2.3 Review of previous research Knowledge of antenatal nutrition Most physicians and their patients understand that proper nutrition during pregnancy is important, but many are not aware of specific recommendations and how to achieve these behaviors. In many cases, healthcare providers simply tell women to eat a healthy diet and gain appropriate weight during pregnancy. However, to achieve this, healthcare providers need to give women the tools and direction to do so properly (Vause, Martz, Richard, & Gralich,2006 cited in Jones, J. et.al 2010). 2.2 THEORITICAL GROUNDWORK According to Conkin Dale ,2005 the theoretical framework can be a conceptual model that is used as a guide for the study. Were focused on antenatal dietary and we selected based on food pyramid 2010. The food pyramid guidelines are summarized below: 4 to 8 servings of rice, noodles, breads, tubers, cereals and cereal products will provide energy/calories to mothers. 3 servings of vegetables and 2 servings of fruits (at least one rich in vitamin C and one in vitamin A) to provide fibre, vitamins and minerals to promote foetal development. 2 servings of milk or dairy products (cheese, yogurt) to provide calcium in building healthy foetal teeth, bones, heart, nerves and muscle. 1 serving offish, 1 serving meat/ poultry and 1 serving legumes. 6-8 glasses of water mainly plain water, and no more than a cup of soft drink or coffee or tea per day to limit caffeine intake. Knowledge of antenatal nutrition 2.3 REVIEW OF PREVIOUS RESEARCH Pregnant women have also expressed concern regarding their doctors level of nutritional knowledge and felt doctors did not have adequate time to discuss nutrition concerns. Many indicated materials they received at the doctors offices were not detailed enough to meet their needs. According to Begley, A. 2002 cited in Jones, J. et.al 2010, suggests there is a lack of consistent education on nutrition for pregnant women and there is a need to design and implement new more effective nutrition programs. Attitude of antenatal nutrition There are a number of reasons why pregnancy might be a suitable time for encouraging dietary change. First, women might change what they eat during pregnancy because of physical symptoms and would welcome any advice which will alleviate these; second, they are responsive to health advice at this time and third, they may actively seek health information. The antenatal care system provides an excellent opportunity to reach large numbers of healthy women and, thus, influence the health of the next generation. Research suggests that many factors including dietary knowledge, discomfort, and doctor interaction influence dietary behavior during pregnancy. Low and high levels of calorie consumption may be affected by discomfort (Dundas and Yarbro, 2000 cited in John, J.et.al 2010). Pregnant women have reported eating small amounts of food more frequently to counteract the feeling of fullness during their third trimester, and because many believed that their baby would be healthier if they ate more frequently. Furthermore, physical sensations associated with food deprivation changed during pregnancy making them feel hunger more often in some cases and less in others (Fairburn & Welch, 1989 cited in John, J et.al 2010) Research supports the idea that knowledge influences behavior. Increased nutritional knowledge has been shown to contribute to increase changes in healthy eating habits as well as healthier lifestyles (Fahlman, Dake, McCaughtry, & Martin, 2008). Petrini, Hamner, Flores, and Mulinare 2006 cited in Jones, J et.al 2010 was reported that women who were least likely to consume adequate amounts of folic acid were those who had the least knowledge about folic acid and its benefits for pregnancy, and Shanker 2004 cited in Jones, J et.al 2010, found that the second strongest indicator of females food choices was nutritional knowledge. RESEARCH METHODOLOGY CHAPTER 3 This chapter will discuss about setting of the study, the design of the study, research instrument that will be used by researchers, ethical consideration, reliability and validity of the study and how the collection io data will be performand analyze. 3.1 Study setting The study is conducted in Maternity Hospital Pulau Pinang (MHPP). Study will be done at A ward and B ward MHPP which is located in the state of Penang Island and is the public hospital in north Malaysia and it is the major referral centre. 3.2 Study design According to Polit & Beck (2007), research design is the overall plan for addressing a research question, including strategies for enhancing the studys integrity. To further the research, our study is designed as a quantitative, non experimental, descriptive design research proposal. 3.3 Population and sample Probability sampling was used in this research study. The target population comprised all the pregnant women on the Antenatal Clinic MHPP. A total of 30 pregnant women in Antenatal Clinic MHPP will be respondent. Questionnaire were sent to 30 pregnant women in this clinic. 3.4 Research instrument A structured questionnaire was developed by the researcher. Respondents were assured of their anonymity and freedom to decide whether to participate in this study or not. Clear instructions were given to the respondents regarding completion of specific items throughout the questionnaire. The questionnaire was divided into different section in order to facilitate the processing of the data. The questionnaire consisted of two section containing mostly closed-ended questions. Section A : Sociodemographic data questions consisting of age, race, education level, occupation and financial status. The aim of including this information was to identify whether there was relationship between the sociodemographic data of pregnant women and their intentions about dietary among pregnant women. Section B : Level of nutritional knowledge, attitude and practise of dietary intake among pregnant women question. There are 10 questions in these section. Research tools Research tools is refers to schedules or inventories on which data from a research project can be entered and stored for later analysis such of this tools are paper and electronic tools (Watson et,al.2008). Our research tool that will be used in this research project are papers, pen and the collected data will be entered into our computer before the data will be analysed. 3.5 Ethical consideration The study was conducted after approval permission from Maternity Hospital Pulau Pinang (MHPP). Letter requesting permission to conduct the study had been sent to them before starting this study. The study was only started after the researcher received written consent from them. Therefore all researches that will be involved in this research have been registered with National Medical Research Registry ( NMRR ). The researcher had asked for written consent from respondents at Antenatal Clinic MHPP. To answering the questionnaire, written consent from respondents was taken as a verification that they had agreed to participate in the study. The study procedure, including risk and benefit will be explained. Respondents were also informed that their involvement in this study was voluntary and they were allowed to refused to take part at anytime. All of the information gathered were strictly confidential and were only used for this study. 3.7 Reliability and Validity Validity is quality criteria that indicates the degree of accuracy of study conclusions (Polit & Beck, 2004). Validity is the ability of an instrument to measure what it is supposed to measure. 3.8 Collection of data Data was collected using self-administered questionnaires as to prevent any missing of the data collection. There will be no time limit given to them in completing the questionnaire. The questionnaires were collected right after they finished answering them. 3.9 ARRANGEMENT OF DATA Organizing data into the table and graphs can help make a data set more meaningful. However this not provides as much information as numerical measures. Hence a descriptive statistic may useful to measure numerical data. The collection data will be arranged into coding system using numerical code 3.10 Data analysis In our research, data entry and analysis were completed using Statistical Package For Social Science ( SPSS ) version 16.0. 4.0 Data Analysis PART A: Demographic data finding. Samples demographic data were analysed using descriptive statistics to obtain the mode, range and standard deviation 4.1 Introduction During the study period a total of 30 samples were collected to ascertain understanding, knowledge, attitude and dietary intake among women during pregnancy. From this sample we analysis that dietary intake among pregnant women need to be improve and able to perform a healthier dietary intakes and positive pregnancy outcomes. Table 4.2.1 Distribution respondent age Age Group Frequency Percent Valid Percent Cumulative Percent Valid 15-21 5 16.7 16.7 16.7 22-27 2 6.7 6.7 23.3 28-33 15 50.0 50.0 73.3 34-39 8 26.7 26.7 100.0 Total 30 100.0 100.0 Table 4.2.2 Distribution respondent race Race Frequency Percent Valid Percent Cumulative Percent Valid Malay 17 56.7 56.7 56.7 Chinese 4 13.3 13.3 70.0 Indian 9 30.0 30.0 100.0 Total 30 100.0 100.0 Table 4.2.3 Distribution respondent education Education Frequency Percent Valid Percent Cumulative Percent Valid Primary 3 10.0 10.0 10.0 PMR 3 10.0 10.0 20.0 SPM/ STPM 19 63.3 63.3 83.3 Diploma 4 13.3 13.3 96.7 Degree 1 3.3 3.3 100.0 Total 30 100.0 100.0 4.2.4 Respondent Household Income Income Frequency Percent Valid Percent Cumulative Percent Valid Below RM1000 6 20.0 20.0 20.0 RM 1001- RM2000 15 50.0 50.0 70.0 RM 2001- RM 3000 5 16.7 16.7 86.7 Above RM3001 4 13.3 13.3 100.0 Total 30 100.0 100.0 Table 4.2.5 Distribution respondent parity Parity Of category Frequency Percent Valid Percent Cumulative Percent Valid Primidgravida 7 23.3 23.3 23.3 Multiparous 15 50.0 50.0 73.3 Grand multiparous 8 26.7 26.7 100.0 Total 30 100.0 100.0 Table 4.2.6 Distribution respondent attending seminar or talk in dietary intake Attended any seminar or talk related to dietary intake Frequency Percent Valid Percent Cumulative Percent Valid Yes 17 56.7 56.7 56.7 No 13 43.3 43.3 100.0 Total 30 100.0 100.0 4.2.7 Respondent preference source of information about dietary intake Printed material Frequency Percent Valid Percent Cumulative Percent Valid 1 5 16.7 16.7 16.7 2 14 46.7 46.7 63.3 3 11 36.7 36.7 100.0 Total 30 100.0 100.0 4.2.7 Respondent preference source of information about dietary intake Electronics Frequency Percent Valid Percent Cumulative Percent Valid 1 10 33.3 33.3 33.3 2 10 33.3 33.3 66.7 3 10 33.3 33.3 100.0 Total 30 100.0 100.0 4.2.7 Respondent preference source of information about dietary intake Clinic, hospital Frequency Percent Valid Percent Cumulative Percent Valid 1 15 50.0 50.0 50.0 2 6 20.0 20.0 70.0 3 9 30.0 30.0 100.0 Total 30 100.0 100.0 DISCUSSION Our review is from aspects of age , race ,parity, level of education and house hold income of our samples . We also examine the women who exposed to source of information in pregnancy like health education by health worker, printed material or electronics . The most sample that has been taken is age range 28-33 years old. Malay is the highest race that has been taken. Multiparous is the highest sample that has been taken in MHPP. In A and B ward education in SPM / STPM is the highest in the sample. Most of samples that has been taken is income range RM1001-RM2000. The most of samples preferred to get information from health promoter via health education while antenatal visit.There about 15 samples (50%). Section B Knowledge, attitude and practice on food intake during pregnancy. The survey findings related to section B to measure the level of knowledge, attitude and practice on food intake during pregnancy who analyzed using descriptive statistics for the frequency and percentage of respondents. Section B RECOMMENDATION Training of Professionals midwives should offer every woman information and advice on importance of healthy dietary Provide information on the benefits of a healthy diet and practical advice on how to eat healthily throughout pregnancy. CONCLUSION There is relationship between sociodemographic data and knowledge , attitude and practice in dietary intake among pregnant women. These findings could help pregnant women to pay more attention to their food intake patterns. As we know health worker play importance roles in giving health education. REFERENCE Bawadia et all (2010).Gestational Nutrition Improves Outcomes of Vaginal Deliveries in Jordan: An Epideiologic Screening, Journal of Nutrition Research, 30(2): 110- 117. De Vriendt , T.,M atthys , C., Verbeke , W., Pynert,I.,& De Henauw,S.2009. Determinants of Nutrition Knowledge in Young and Middle Aged Belgian Women and The Association with their Dietary Behavior.Appetite , 52(3) : 788- 792. Polit. D.F., & Beck. C.T 2004. Essential of Nursing Research . London, England: Lippin Cot Williams & Wilkins. Wen , L.M.,Flood, V.M., Simpson, J.M., Rissel, C.,& Baur,L.A. 2010 .Dietary Behaviours During Pregnancy : Finding from First- Time Mothers in Southwest Sydney ,Australia. International Journal of Behaviour Nutrition and Physical Activity, 7: 1. Jennifer. J., Med. Jeff. H.,phD. Willis.M, phD . 2010. E xercise, Nutrition, and Weight Management During Pregnancy.American Journal of Health Studies: 25(3) 2010. Jacinta. A.O.,Helen E.A., Nkasiobi .S.O.,& Sodienye A.A. 2011, European School Science,Granada,Spain. Malnutrition During Pregnancy among Child Bearing Mothers In Mbaitolu Of South Eastern Nigeria.Advances in Biological Research 5(2) :111- 115, 2011 Thank you