Health professionals need sufficient knowledge about dietary fibre to provide appropriate advice to the elderly who have greater risk of constipation(Reference Tarcea, Fazakas and Szucs1).
We assessed knowledge beliefs and practices of health professionals in primary healthcare, geriatric units and hospitals in Kuwait using an online survey.The University of Glasgow College of Medical, Veterinary and Life Sciences Ethics Committee (Number. 200200090) and The Ministry of Health- Kuwait (Number. 2214) approved this survey. Participants were recruited (July 2021-February 2022) by free online webinar, and relevant official Twitter/Instagram accounts. The first part of the survey assessed knowledge about recommendations, sources, and effects of dietary fibre. The second part considered beliefs and practices about the use of fibre to treat constipation, assessing fibre intake, use of laxatives, and provision of dietary advice. Participants were divided into physicians (n = 79) and dieticians/nutritionists (n = 80). Percentages and frequency for each group were compared by Chi square test using SPSS to detect associations between demographic characteristics and levels of knowledge beliefs and practices.
The survey was completed by 79 physicians (53% female) and 80 dieticians/nutritionists (86% female). Dieticians/nutritionists (77%) mostly worked in government hospitals, while 77% physicians worked in primary care centres. Only 4% of physicians and no dieticians worked in geriatric units. 43% of physicians and 83% of dieticians/nutritionists were Kuwaiti. 40% of physicians worked in general practice and 28% in family medicine. Most dieticians/nutritionists had a degree: BSc (49%), MSc (27%). The health professionals had moderate knowledge about fibre. When asked ‘What is dietary fibre?’, most physicians (88%) had poor knowledge and 60% did not know the recommendations for fibre intake for those over 60y. compared to only 40% of dietitians/nutritionists. 82% of physicians and 90% of dieticians/nutritionists were able to identify foods high in fibre; and knowledge about constipation diagnosis was high in both groups. However, 56% of physicians could not state the health benefits of dietary fibre. Dieticians/nutritionists (60%) were a little more likely to assess fibre intake in elderly constipated patients compared with 52% physicians although most did not state how. Physicians (57%) were more likely to recommend laxatives than dieticians (21%). Approximately 53% of physicians and 65% of dieticians/nutritionists educate their patients on how to reduce constipation. There were no significant associations between demographic characteristics and knowledge or beliefs and practices. When asked the best way to learn more about fibre, continuing medical education programmes were the first choice among physicians (77%) and dieticians/nutritionists (84%), followed by contact with professional nutritionists asked for by 20% physicians and 9% of dieticians/nutritionists.
In conclusion, knowledge about dietary fibre among health professionals working with older adults in Kuwait is patchy and more training is required to improve the appropriate use of fibre to prevent constipation in older people.
Acknowledgments
We like to acknowledge Dr Ali Alqattan for organising the live webinar.
