Finishing that plate of food …’ The role of the nurse caring for the patient with dysphagia
Dysphagia is a ‘hidden’ disorder that, if not efficiently and effectively managed, could present with food aversion, malnutrition, dehydration, aspiration pneumonia or death. Therefore, timeous intervention and team understanding of dysphagia is an advantage. While international studies have interrogated the role of the nurse in various aspects of dysphagia, such as screening, implementation of feeding strategies and reinforcement of speech language pathologist (SLP) recommendations for feeding, similar studies in developing contexts such as South Africa are lacking. In developing contexts specifically, there is a need for the speech-language therapist (SLT) to identify and intervene earlier with patients who have dysphagia, to prevent comorbidities, complications, increased medical expenses and increased length of hospital admission. However, the question of how remains. The nurse at the epicentre of service provision at hospitals, either as part of routine care or during medication dispensing, is the first professional to observe and identify eating and/or drinking difficulties, i.e. dysphagia in a patient, hence may be ideally positioned to fulfil this role via collaborations with the SLT and dietitian.
Breakfast and lunchboxes provided to foundation phase learners: do caregivers’ knowledge and attitude reflect their practices?
Children depend on their caregivers to provide them with food and cannot independently determine what they eat. It is therefore important to investigate the knowledge, attitudes and practices (KAP) of caregivers regarding food when addressing the eating patterns of children. Foundation phase learners are regarded as a nutritionally vulnerable group, because of the impact of nutrition on growth and development and nutrient needs. Periods of rapid growth can be challenging, especially as young children cannot provide for themselves. Inadequate nutrient intake is often the result of various socio-economic factors, the food choices children and their caregivers make, and not eating meals together as a family.
Nutritional status and psychomotor development in 12–18-month-old children in a post-intervention study
Globally in 2019, 144 million children aged under 5 years were stunted and 47 million were wasted, of whom 14.3 million were severely wasted. From 2000 to 2019 the global prevalence of stunting showed a steady decline, from 32.4% to 21.3%. Although the prevalence of stunting in the African region declined from 37.9% to 29.1%, it is the only region where the number of stunted children has increased over this time period, from 49.7 million in 2000 to 57.5 million in 2019,1 due to population growth. In South Africa, however, an increase in the prevalence of stunting has been reported. In 2016, 27% of children under five years were stunted, compared with 21.6% in 2012.3 This increase in the prevalence of stunting is a concern.
Mealtime challenges and food selectivity in children with autism spectrum disorder in South Africa
Caregivers continuously report on the difficulty in feeding their child with autism spectrum disorder (ASD) due to their restricted diets and the negative impact this has on their development as well as growth and nutrition. Previous research has highlighted that many children with ASD may present with associated feeding difficulties in comparison with typically developing children. Children with ASD will eat a small variety of foods, preferring certain types and textures. This results in a limited food repertoire and can have detrimental effects on the child’s health outcomes. Although research has highlighted the feeding difficulties prevalent in children with ASD, much of the literature has been unable to specify the distinct feeding problems, particular food items that are eaten and preferred, and potential factors that may be contributing to the feeding difficulties present as well as the family’s influence on feeding difficulties. In addition, there is a significant deficit in research that focuses on feeding in different social and environmental contexts, in particular in low- and middle-income countries such as South Africa.
Case study: nutritional considerations in the head and neck cancer patient
Globally, head and neck cancer (HNC) is the seventh leading cause of cancer. Up to 80% of these HNC patients are malnourished on presentation due to lifestyle and risk factors associated with the disease. These malignancies can involve a variety of sites and tissues in which they originate but the vast majority of these tumours arise from the mucosal squamous epithelium of the upper aero-digestive tract as head and neck squamous cell carcinoma (HNSCC). The risk factors for this cancer cohort include excessive smoking and alcohol abuse; the effect of these two substances on development of HNSCC is known to be synergistic.
Fostering healthy eating in children
Malnutrition has a negative effect on the health, development and educational achievement of children, highlighting the importance of fostering healthy eating behaviour and interventions that address both under- and over-nutrition in schoolaged children, particularly in low- and middle-income countries. Eating breakfast has positive effects on behaviour in the classroom, mainly in primary school age children, and academic performance. Skipping breakfast has been shown to be consistently associated with an increased risk of overweight/ obesity. Maintaining a healthy weight in childhood reduces the risks of overweight, obesity and cardiovascular disease later in life. South Africa’s Strategy for the Prevention and Control of Obesity 2015–2020 has a strong focus on preventing childhood obesity, aims to promote healthy eating, and enables access to healthy food choices in various settings, including schools.
Do lifestyle choices influence the development of overweight and obesity in the South African Air Force, Bloemfontein?
The prevalence of overweight and obesity has shown a steady upward trend in the global population during recent years. This trend has also been observed in numerous military communities around the world. The increase in the prevalence of overweight and obesity in these communities is concerning, as a high body mass index (BMI) has been associated with a decrease in force readiness, workforce maintenance and productivity.
Introducing a nutritional risk screening tool in a South African hospital
Childhood malnutrition impacts negatively on a child’s immunity and growth and development, making it the most important risk factor for the global burden of disease. The World Health Organization (WHO) recommends identifying acute malnutrition in children 6–59 months old by measuring weight-forlength/ height (WHZ), mid upper-arm circumference (MUAC), and assessing the presence of nutritional oedema. Length/ height-for-age (HAZ) is used to identify stunting, the most common form of malnutrition in South Africa (SA). Measurements are plotted on WHO growth standards charts, where scores correlate to a standard deviation of the international reference population.
Health Professions Council of South Africa
Attempts allowed: 2
70% pass rate
South African Journal of Clinical Nutrition - June 2022 - Vol 35 Issue 2