Browsing by Subject "ravitsemushoito"

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  • Weckman, Jaana (Helsingfors universitet, 2016)
    Hoivakotien ravitsemushoidolla ylläpidetään ja edistetään ikäihmisten terveyttä. Hoitajien positiiviset asenteet ravitsemushoitoa kohtaan ovat yhtä tärkeitä kuin hyvät hoitokäytännöt, jotta saavutetaan hyvä ravitsemushoito. Myös asukkaiden asenteet ravitsemukseen vaikuttavat asukkaiden ravitsemushoidon toteutumiseen. Pro gradu-tutkielman tavoitteena oli tutkia hoivakotien henkilökunnan ja asukkaiden asenteita ravitsemushoitoa kohtaan. Tutkimuksen aineisto kerättiin yksilöteemahaastatteluin. Tutkimuksessa haastateltiin kahtatoista hoitajaa ja kymmentä asukasta. Haastateltavista valtaosa oli naisia. Haastatteluissa käytiin läpi teemoja, jotka liittyivät ravitsemushoitoon esimerkiksi ravitsemustilan arviointiin, ravitsemushoitosuunnitelmaan, ravinnontarpeen määrittämiseen, ruokailutilanteeseen, ruoankäytön seurantaan ja ruokaan. Tutkimuksessa hoitajien ja asukkaiden asenteet olivat positiivisia ravitsemushoitoa kohtaan. Hoitajista ravitsemushoidolla oli tärkeä merkitys asukkaille muun saadun hoidon ohella. Myös asukkaat suhtautuivat positiivisesti ravitsemushoitoon ja heistä ruokailuilla oli hyvin tärkeä merkitys muun saadun hoidon ohella. Hoitajat suhtautuivat positiivisesti asukkaiden ravitsemustilan arviointiin sekä ruokien, ja juomien käytön seurantaan. Valtaosa hoitajista osoitti positiivisia asenteita asukkaiden ravitsemushoitosuunnitelmaa ja sen toteutumista kohtaan. Puolet hoitajista asennoitui positiivisesti asukkaiden ravinnontarpeen määrittämiseen ja piti tärkeänä, että asukkaiden ravinnontarve määritettiin. Asukkaat ja hoitajat asennoituivat positiivisesti tai melko positiivisesti ruokailuun ja ruokaan. Tutkimuksen tulosten perusteella voidaan todeta, että hoitajat ja asukkaat suhtautuivat positiivisesti hoivakodissa tapahtuvaa ravitsemushoitoa kohtaan. Hoitajien positiivinen asennoituminen ravitsemushoitoon ei aina näkynyt hoitajien hoitokäytännöissä.
  • Gothóni, Mia (Helsingin yliopisto, 2017)
    Introduction: The incidence of gestational diabetes (GDM) is rising in the Western world along with the increment in young women’s overweight and obesity rates. GDM poses short- and long-term threats to the health of both mother and child, which in turn might add to the economical burden and cause human suffering. Lifestyle counseling and nutritional management are key to managing adverse outcomes in both the woman with GDM and her unborn child. Objective: The aim of this thesis is to study whether the intake of energy, energy nutrients, and fiber change after the diagnosis of GDM. The changes in intakes of energy, energy nutrients, and fiber are compared between women with GDM and women with normal glucose tolerance. In addition, the changes in energy nutrients and fiber in different food sources are studied and compared between groups. Materials and methods: The study was conducted based on data from the control group in The Finnish gestational diabetes prevention study (RADIEL). RADIEL is a prospective, randomized, controlled intervention that was carried out in 2008–2014, and in which women at high risk of GDM pregnant in the first half of pregnancy or planning pregnancy were enrolled. The control group received usual care at antenatal clinics. The data was collected before the initiation of this thesis. Study participants with 3-day food record data from both the first and the third trimester of pregnancy were eligible for this study (n=111). GDM was diagnosed by a 75 g oral glucose tolerance test in 22 of the participants in 22–28 weeks of gestation. Of the participants, 89 remained healthy by their glucose metabolism. The differences between women with GDM and women with normal glucose tolerance were tested using a t-test for normally distributed variables, and Mann-Whitney U test, χ2 test or Fisher’s exact test for non-normally distributed variables. Analysis of covariance was used to test the differences in change in intake of energy, energy nutrients, and fiber between the first and third trimester. GDM, previous GDM, age, body mass index (BMI), education in years, and the intake of the nutrient at baseline (first trimester) were used as covariates. Results: The women with GDM had significantly lower prepregnancy BMI (p=0.025) and a history of GDM (p=0.011) was more common among them compared to women with normal glucose tolerance. Moreover, at baseline, their fasting insulin (p=0.033) and HOMA-IR (p=0.041) were lower and their HbA1c (p=0.038) higher than that of the women with normal glucose tolerance. The intake of energy, and energy nutrients and fiber in relation to energy did not differ between groups (p>0.05). However, as compaired to women with normal glucose tolerance, women with GDM reduced their intake of carbohydrates (adj. p=0.002) and sucrose (adj. p=0.002), and increased their intake of fat (adj. p=0.037) and fiber (adj. p=0.002) in relation to energy from the first trimester to the third. In food sources, the only difference between groups regarded the change of fiber (p=0.049) in relation to the total intake of fiber; this was seen in the food source of bread and flour, in which the proportion of fiber increased in women with GDM. Conclusions: The dietary intake changes significantly differently between women with GDM and women with normal glucose tolerance in regards of carbohydrate, fat, sucrose, and fiber. In women with GDM, the changes in beforementioned nutrients are in line with the Current Care Guidelines of GDM, with the exception of fiber that still changes towards the guidelines. The proportion of fiber changes differently between groups in the food source of bread and flour. Nutrition management of GDM should focus more on the importance of fiber and the composition of fatty acids in the diet, but it should also focus on increasing the proportion of protein to optimize the intake of carbohydrates and fat. The fact that women with GDM in this study had a relatively low energy intake from carbohydrates and a high energy intake from fat, raises the possible need to study how this affects the blood glucose and body composition of the child.
  • Toivola, Laura-Elina (Helsingfors universitet, 2014)
    Malnutrition is common among old people, particularly in the institutionalized elderly. Good nutritional status and ability to function could be maintaided by nutrition treatment that meets the requirements of the elderly. Nursing staff has an important role in nutrition treatment, but studies suggest that nutritional skills of nurses are not adequate, even though attitudes to nutrition treatment are often positive. The aim of the study was to examine the factors that may determine nurses’ nutrition treatment in Finnish elderly care and clear up what kind of attitudes and knowlegde may affect the nutrition treatment. 14 practical nurses (or equivalent) were inteviewed individually in an elderly service centre. Material was analyzed with content analysis. Four main themes were made up of the analysis. The themes were 1) formation of nutritional skills and skills assessment, 2) nutritional knwledge and attitudes, 3) environment of nutrition treatment and 4) nutrition treatment in practice. The nutritional skills of the nurses were of very varied backgrounds. Education, nutritional training in the service centre, nutritional atmosphere in the centre, working experience and personal life were highlighted varyingly. The nurses had wide knowledge of nutrition and its significance, but the views were not equal. Nutrition treatment was considered important and the nurses thought it was their responsibility, but alongside good nutritional status there were other rival values. Aged residents were the basis for the nutrition treatment. In addition, food services in the centre, multiprofessional co-operation and working atmosphere among the nurses were parts of the environment of the nutrition treatment. On one hand, food service practices eased the work of the nurses but on the other hand they decreased the feeling of the possibility to affect the work. Prerequisites for getting support in work were good but the roles among the professionals were partly unclear. Attitudes were varying among the nurses and bad working atmosphere might complicate the nutrition treatment. The nurses had a variety of methods to assess and maintain the nutritional status of the residents but there were lots of individual differences in the practices. In addition, for example lack of appetite and memory disorders were considered challenging when it came to nutrition treatment, and nurses’ problem-solving skills were not adequate in all of these cases. The results point out that nurses’ nutritional knowledge and skills don’t necessarily guarantee successful nutrition treatment. There is also a group of values and attitudes that may determine nutrition treatment. Besides it is important to be aware of where the knowledge, skills and attitudes come from and improve them through channels that are common to all nurses. Context of the treatment should be considered aswell. Without clear and logical practices, good working atmosphere and sufficient support in work it is difficult to utilize the potential that nurses have. More research is needed to develop nutrition treatment that meets the requirements of the elderly even better.