Health care workers’ nutritional care practices in Paediatric Oncology Units at Kamuzu and Queen Elizabeth Central Hospitals
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Date
2021-02-10
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Kamuzu University of Health Sciences
Abstract
Type of study: This is a cross sectional study
Study problem: Malnutrition, particularly undernutrition is a poor prognostic factor in children
with cancer. Over 50% of children admitted in Paediatric oncology units in Malawi are
malnourished and just like in many low and middle income countries(LMIC) where malnutrition
in childhood cancer is also significant, survival rate is low. An already high prevalence of primary
malnutrition has shown to exacerbate malnutrition in cancer in LMIC. Studies conducted across
the Globe have demonstrated that proper nutritional interventions improve a child’s nutritional
status and promotes survival in childhood cancer and that calls for a proper nutritional management
plan which most oncology units, especially in the western world are striving to achieve. In Malawi
however, there are no guidelines that specifically look at the management of malnutrition in cancer
children and the current nutritional care practices remain unclear.
Broad Objective: To evaluate health care workers’(HCW) nutritional care practices in paediatric
oncology units at Kamuzu and Queen Elizabeth Central Hospitals.
Specific Objectives
i. To examine the criteria, screening tools and assessments that HCW employ to identify
malnourished children at KCH and QECH Paediatric oncology units.
ii. To assess the nutritional support and treatment interventions that HCW provide to
malnourished children at KCH and QECH Paediatric oncology units.
iii. To assess the discharge criteria and follow up care of malnourished children at QECH and
KCH Paediatric oncology units.
iv. To explore HCW’s perceived barriers and facilitators to providing nutritional care
interventions to malnourished children at KCH and QECH Paediatric oncology units
Methodology: This is a qualitative study in which in-depth interviews will be conducted among
health care workers (Nurses, clinicians and Doctors) working in the pediatric oncology units at
both Kamuzu and Queen Elizabeth central hospitals using a semi-structured interview guide.
Purposive sampling will be used to select 30 most experienced health personnel in the units and
the interviews will be audiotaped. The collected data will then be transcribed, coded and themes
will be generated. The collected data shall also be stored in a secure location.
Constraints: Participating in an interview that lasts more than 30 minutes may be deemed as time
consuming and other health care workers may feel the need to rather attend to patients than spend
time being interviewed. Others may also feel the need to not be truthful so as to portray a good
picture of best practices on themselves which would affect the results of the study
Expected findings: This study expects to find inconsistencies in the provision of nutritional care
among individual health care workers as well as between the two facilities and also non-adherence
to the current National nutritional guidelines.
Dissemination of results: Copies of this study will be shared with both study sites as well as
COMREC. The results of this study shall be disseminated through VIVA at College of Medicine
and will also be presented at one KCH Paediatric Oncology Wednesday meetings, Global Hope
Nursing Echo seminars as well as at International Society of Paediatric Oncology (SIOP) 2022
conference. In addition, these findings are also intended to be published in a journal article.