Pós-operatório de paciente oncológico em jejum prolongado: diagnósticos e intervenções de enfermagem / Post-operative oncological patients in prolonged fast: nursing diagnosis and interventions / Postoperatorio del paciente oncológico bajo ayuno prolongado: diagnósticos e intervenciones de enfermería

Objetivo: identificar os principais diagnósticos de enfermagem e suas respectivas intervenções em uma população de pacientes oncológicos submetidos a jejum prolongado no pós-operatório. Método: estudo descritivo, documental e transversal. O cenário do estudo foi um hospital federal de ensino no Rio de Janeiro, caracterizado como UNACON. Os dados foram coletados durante 60 dias em prontuários referentes aos anos de 2016 a 2018. Foram analisados 61 prontuários que atendiam aos critérios de inclusão e 208 complicações foram apresentadas pelos pacientes oncológicos. Resultados: Foram definidos oito diagnósticos de enfermagem, entre os quais os mais evidentes foram: Nutrição desequilibrada: menor que as necessidades corporais e Risco de glicemia instável. Onze intervenções de enfermagem foram definidas em consonância com a Taxonomia de NANDA-I e buscaram ser de fácil aplicação na prática assistencial de enfermagem. Conclusão: foi evidenciada uma ampla gama de diagnósticos e intervenções de enfermagem a qual se recomenda sua adoção no processo de enfermagem.

Objective: to identify the main nursing diagnoses and respective interventions in a population of cancer patients undergoing prolonged postoperative fasting. Method: descriptive, cross-sectional, documentary study. The study scenario was a federal teaching hospital in Rio de Janeiro, characterized as a high-complexity oncological facility. Data were collected for 60 days from medical records for the years 2016 to 2018. In the 61 medical records that met the inclusion criteria and were analyzed, cancer patients presented 208 complications. Results: eight diagnoses were established, the most in evidence being: nutrition imbalance: less than body requirements; and risk of unstable blood glucose level. Eleven nursing interventions, designed to be easily applied in nursing care practice, were specified in line with the NANDA-I Taxonomy. Conclusion: the wide range of nursing diagnoses and interventions evidenced are recommended for adoption in the nursing process.

Objetivo: identificar los principales diagnósticos de enfermería y sus respectivas intervenciones en una población de pacientes oncológicos sometidos a ayuno postoperatorio prolongado. Método: estudio descriptivo, transversal, documental. El escenario de estudio fue un hospital universitario federal en Río de Janeiro, caracterizado como una instalación oncológica de alta complejidad. Se recolectaron datos durante 60 días de las historias clínicas de los años 2016 a 2018. En las 61 historias clínicas que cumplieron con los criterios de inclusión y fueron analizadas, los pacientes con cáncer presentaron 208 complicaciones. Resultados: se establecieron ocho diagnósticos, siendo los más evidentes: desequilibrio nutricional: menor que los requerimientos corporales; y riesgo de niveles inestables de glucosa en sangre. Once intervenciones de enfermería, diseñadas para ser fácilmente aplicadas en la práctica del cuidado de enfermería, fueron especificadas de acuerdo con la Taxonomía NANDA-I. Conclusión: la amplia gama de diagnósticos e intervenciones de enfermería evidenciados se recomiendan para su adopción en el proceso de enfermería.

Nursing diagnoses and outcomes for children with nutritional anomalies: a descriptive study.

OBJECTIVES: to develop nursing diagnoses and outcomes for children with nutritional anomalies based on terms found in a children's clinical protocol and on the 2017 International Classification for Nursing Practice. METHODS: exploratory-descriptive study, conducted with the validation of diagnoses/outcomes by six nurses of the children's clinic of the Federal District's teaching hospital. It was based on the cross-mapping between the terms of International Classification for Nursing Practice 2017 and the terms of a children's health care protocol. The list of nursing diagnosis/outcomes was developed, then submitted to the validation process using a Likert-type scale and considering statements with content validity index > 0.79 to be validated. RESULTS: a total of 51 diagnoses/outcomes were generated, and of those, 11 were contained in International Classification for Nursing Practice. Those that were not in it were evaluated for similarity and comprehensiveness in relation to International Classification for Nursing Practice. Thirty nursing diagnoses/outcomes were validated with CVI > 0.79 among the nurses in the validation process. CONCLUSIONS: this study will allow the formation of a terminological International Classification for Nursing Practice subset aimed at children's nutrition.

Nursing diagnoses and outcomes for children with nutritional anomalies: a descriptive study / Los diagnósticos y resultados de enfermería sobre niños con alteración nutricional: un estudio descriptivo / Diagnósticos e resultados de enfermagem à criança com alteração nutricional: estudo descritivo

ABSTRACT Objectives: to develop nursing diagnoses and outcomes for children with nutritional anomalies based on terms found in a children's clinical protocol and on the 2017 International Classification for Nursing Practice. Methods: exploratory-descriptive study, conducted with the validation of diagnoses/outcomes by six nurses of the children's clinic of the Federal District's teaching hospital. It was based on the cross-mapping between the terms of International Classification for Nursing Practice 2017 and the terms of a children's health care protocol. The list of nursing diagnosis/outcomes was developed, then submitted to the validation process using a Likert-type scale and considering statements with content validity index > 0.79 to be validated. Results: a total of 51 diagnoses/outcomes were generated, and of those, 11 were contained in International Classification for Nursing Practice. Those that were not in it were evaluated for similarity and comprehensiveness in relation to International Classification for Nursing Practice. Thirty nursing diagnoses/outcomes were validated with CVI > 0.79 among the nurses in the validation process. Conclusions: this study will allow the formation of a terminological International Classification for Nursing Practice subset aimed at children's nutrition.

RESUMEN Objetivos: elaborar enunciados diagnósticos y resultados de enfermería sobre el niño con alteración nutricional a partir de términos encontrados en el protocolo clínico pediátrico y en la Clasificación Internacional para la Práctica de Enfermería 2017. Métodos: estudio exploratorio-descriptivo, con la validación de diagnósticos/resultados realizada por seis enfermeras de una Clínica pediátrica del Hospital-Escuela del Distrito Federal (Brasil). Se realizó un mapeo cruzado entre los términos de la Clasificación Internacional para la Práctica de Enfermería 2017 y los términos del Protocolo de Atención Sanitaria del Niño. Se elaboró una lista de diagnósticos/resultados de enfermería, a la cual se sometió al proceso de validación, que utilizó la escala tipo Likert por medio del índice de validez de contenido, que considera válido el enunciado que posee IVC > 0,79. Resultados: de los 51 enunciados diagnósticos/resultados obtenidos, 11 estaban presentes en la Clasificación Internacional para la Práctica de Enfermería. Los diagnósticos no presentes se evaluaron mediante la similitud y el alcance de la Clasificación Internacional para la Práctica de Enfermería. Treinta enunciados diagnósticos/resultados de enfermería con ICV > 0,79 fueron validados por los enfermeros en el proceso. Conclusiones: este estudio puede permitir la formación de un subconjunto terminológico Clasificación Internacional para la Práctica de Enfermería en torno a la nutrición del niño.

RESUMO Objetivos: elaborar enunciados diagnósticos e resultados de enfermagem à criança com alteração nutricional a partir de termos encontrados em protocolo clínico pediátrico e a Classificação Internacional para a Prática de Enfermagem 2017. Métodos: estudo exploratório-descritivo, realizado com validação de diagnósticos/resultados por seis enfermeiras da clínica pediátrica do hospital-escola do Distrito Federal. Realizou-se mapeamento cruzado entre os termos da Classificação Internacional para a Prática de Enfermagem 2017 com termos do protocolo de atenção à saúde da criança. Foram elaborados a lista de diagnósticos/resultados de enfermagem, essa lista foi submetida ao processo de validação com utilização da escala tipo Likert por meio do índice de validade de conteúdo, que considera validado o enunciado que possuir IVC > 0,79. Resultados: gerados 51 enunciados diagnósticos/resultados, dessas, 11 constantes na Classificação Internacional para a Prática de Enfermagem. Os diagnósticos não constantes foram avaliados conforme similaridade e abrangência à Classificação Internacional para a Prática de Enfermagem. 30 enunciados diagnósticos/resultados de enfermagem foram validados, possuindo ICV > 0,79 entre os enfermeiros, no processo de validação. Conclusão: este estudo possibilitará a formação de um subconjunto terminológico Classificação Internacional para a Prática de Enfermagem voltado à nutrição da criança.

Combating Food Insecurity: Addressing Health Beyond an Empty Pantry.

Individuals and food-insecure households who rely on food banks have a higher likelihood of chronic health conditions. A study of the Action Family Program at a faith-based community center demonstrated how nurses can impact food bank recipients' health measures through health promotion interventions. Providing healthier food options with the weekly food distribution box, cooking demonstrations, health screenings, and health education resulted in reduced weight, and decreased systolic and diastolic blood pressure measurements.

Diagnósticos enfermeros prevalentes en personas mayores no institucionalizadas / Prevalent nursing diagnoses in non-institutionalized older people

Objetivos: Identificar posibles deficiencias nutricionales y establecer los diagnósticos enfermeros más prevalentes en personas mayores no institucionalizadas. Material y métodos: Proyecto piloto en el que se ha utilizado la herramienta Mini Nutritional Assessment a personas de nuestro entorno, mayores de 65 años, que viven en su domicilio y aparentemente en buen estado de salud. Resultados: Se han realizado 24 encuestas a personas mayores, con una media de edad de 82 años y un rango entre los 68 y los 90 años. Todos presentaban riesgo nutricional, siendo alto en 19 de ellas. Se han identificado cuatro diagnósticos enfermeros que, por orden de frecuencia son: "deterioro de la deglución", "Ingesta inferior a las necesidades", "Déficit de autocuidado: alimentación" y "gestión ineficaz de la propia salud". Sin embargo, en ningún caso, ni la familia ni la propia persona, habían considerado la posibilidad de consultar con su médico o enfermera por suponer las causas del riesgo como normales a consecuencia de la edad. Conclusiones: La valoración del riesgo nutricional mediante herramientas de cribado, es un requisito esencial en la atención de los adultos mayores no institucionalizados y con autonomía funcional, al tratarse de un segmento de población que, aunque no suelen presentar problemas de malnutrición, si pueden estar en situación de riesgo, que puede pasar desapercibido por su autonomía o por su aparente buen estado de salud

Objetives: Identify possible nutritional deficiencies and establish the most prevalent nursing diagnoses in non-institutionalized older people. Material and methods: It has been carried out an exercise in which students have applied the Mini Nutritional Assessment tool to people over 65 years old of our environment who live in their own homes and apparently in good health condition. Results: 24 surveys have been carried out to old people with an average age of 82 and an age range of 68 to 90. All of them had nutrition risk and it was high in 19 of them. Four nursing diagnoses have been identified (by order of frequency): "Impaired swallowing", "Imbalanced nutrition: less than body", "Feeding self-care deficit", "Ineffective health management". However, neither the family nor the tested person had considered the possibility of consulting their general practitioner or community nurse because they assumed this risk was part of normal aging process Conclusions: The assessment of nutritional risk by screening tools is an essential requirement in the care of noninstitutionalized elderly people with functional autonomy. Despite the fact that they do not usually suffer malnutrition problems, this segment of population may be in an unnoticed risk situation because of their autonomy and their apparent good health status

Evaluación nutricional por el Mini Nutritional Assessment: una herramienta para las enfermeras / Avaliação nutricional pela Mini avaliação Nutricional: uma ferramenta para o enfermeiro / Nutritional assessment by the Mini-Nutritional Assessment: a tool for the nurse

Objetivo: Caracterizar el estado nutricional de los ancianos institucionalizados según el test Mini Nutritional Assessment (MNA(R)). Métodos: Estudio transversal, basado en la población, con enfoque cuantitativo, realizado con 321 ancianos residentes en centros de atención a largo plazo de João Pessoa/PB. Fue aprobado por el Comité de Ética en Investigación del CCS/UFPB, CAEE: 02043712.4.0000.5188. Resultados: La edad media de los participantes era de 81,09 años y la mayoría eran mujeres (75,7%). En primer lugar, los ancianos fueron evaluados por una triaje, en los que 86 (26,8%) tenían un estado nutricional adecuado y 235 (73,2%) pasaron a la evaluación general; 7 (3,0%) de estos tuvieron un estado nutricional adecuado. Por lo tanto, de acuerdo con el test MNA(R), el total fue de 93 (29,0%) ancianos con estado nutricional adecuado; 127 (39,6%) estaban en riesgo de desnutrición y 101 (31,5%) estaban desnutridos. Conclusión: Es indispensable establecer programas de prevención en las instituciones a largo plazo que apoyen las actividades del equipo de salud multidisciplinar, con el fin de controlar los factores de riesgo, incluyendo parámetros nutricionales

Objetivo: Caracterizar o estado nutricional de idosos institucionalizados segundo a Miniavaliação Nutricional (MAN(R)). Método: Estudo transversal, de base populacional e abordagem quantitativa, realizado com 321 idosos residentes em instituições de longa permanência para idosos de João Pessoa/PB. Foi aprovado pelo Comitê de Ética em Pesquisa do CCS/UFPB, CAEE: 02043712.4.0000.5188. Resultados: A idade média dos participantes foi de 81,09 anos, e a maioria era do sexo feminino (75,7%). Na primeira fase da MAN(R), a triagem, 86 (26%) dos idosos avaliados apresentaram estado nutricional adequado e 235 (73,2%) passaram para a avaliação global; desses, sete (3,0%) estavam com estado nutricional adequado. Portanto, concluída a avaliação, 93 (29,0%) idosos estavam com estado nutricional adequado; 127 (39,6%) apresentaram risco de desnutrição, e 101 (31,5%) estavam desnutridos. Conclusão: É fundamental estabelecer programas de prevenção em instituições de longa permanência que subsidiem as intervenções da equipe multidisciplinar de saúde, a fim de controlar os fatores de risco, incluindo-se os parâmetros nutricionais

Objective: To characterize the nutritional status of institutionalized aged individuals according to the Mini-Nutritional Assessment (MNA(R)). Method: Cross-sectional, population-based study of quantitative approach, performed with 321 elderly residents in long term care facilities of João Pessoa/PB. This study was approved by the Committee on Ethics in Research of CCS/UFPB, CAEE: 02043712.4.0000.5188. Results: The mean age of participants was 81.09 years old and the majority of them were female (75.7%). Firstly, the elderly were evaluated by a screening, in which 86 (26.8%) had adequate nutritional status and 235 (73.2%) passed to the overall assessment; seven (3.0%) of these had adequate nutritional status. Therefore, the total amount of elderly with adequate nutritional status, according to MNA(R), was 93 (29.0%); 127 (39.6%) of them were at risk of malnutrition and 101 (31.5%) were malnourished. Conclusion: It is essential to establish prevention programs in long-term institutions that subsidize the activities of the multidisciplinary health team, in order to control risk factors, including nutritional parameters

La anorexia nerviosa en adolescentes. A propósito de un caso / Anorexia nervosa. A propos of a case

La incidencia de los trastornos de la conducta alimentaria (TCA) es ahora más alta que nunca. La edad promedio de inicio de la anorexia nerviosa está en los 17 años. La prevalencia encontrada es preocupante. En las chicas escolarizadas de 12 a 21 años, parece que el 4-5 % padece algún TCA (diagnosticado por psiquiatra). En este trabajo se pretende reflejar, mediante un caso clínico, los cuidados de enfermería que se realizan en una unidad de psiquiatría infanto-juvenil a los usuarios que ingresan con diagnóstico de anorexia nerviosa. Se trata de una adolescente que ingresa en la unidad con diagnóstico de anorexia nerviosa. Inicialmente, se realiza una valoración mediante los patrones funcionales de Gordon, para posteriormente determinar las esferas sobre las que se va a actuar y enunciar los diagnósticos principales, con sus respectivos objetivos e intervenciones. La atención de enfermería en la Unidad de Psiquiatría Infanto-Juvenil es primordial. Las enfermeras son las que están en constante contacto con los pacientes y las que limitan las conductas de estos. También actúan como confesores y mantienen una relación estrecha con ellos (AU)

The incidence of eating disorder (ED) is now higher than ever. The average age of onset of anorexia nervosa is 17 years. The prevalence found is worrying. In the girls in school 12 to 21 years, it seems to suffer from a 4-5 % ED (diagnosed by a psychiatrist). This work intends to reflect, through a clinical case, the nursing care performed in a unit of child and adolescent psychiatry users admitted with diagnosis of anorexia nervosa. The teenager joined the unit with a diagnosis of anorexia nervosa. Initially, an evaluation is performed by the functional patterns of Gordon, later to identify areas on which it will act and state the principal diagnoses, with their respective objectives and interventions. The nursing care at the Adolescent Psychiatry Unit is paramount. Nurses are the ones that are in constant contact with patients and limiting these behaviors. They also act as confessors and maintain a close relationship with them (AU)

Identifying and managing malnutrition in the community.

Malnutrition affects more than 3 million people in the UK, most of whom live in the community. Malnutrition is both a cause and consequence of disease and can lead to increased mortality and morbidity, delayed recovery from illness and impaired body function which can make carrying out activities of daily living difficult. Managing malnutrition in the community involves identifying malnutrition using a universally validated screening tool and implementing appropriate care plans according to the degree of malnutrition. Regional and local guidance can be used to assist healthcare professionals to prescribe appropriate oral nutritional supplements and monitor nutritional aims and goals.

Nasogastric tube feeding: a safe option for patients?

This article will show that fine-bore nasogastric tube feeding can be facilitated for patients when long term percutaneous endoscopic gastrostomy (PEG) or radiologically inserted gastrostomy (RIG) options are not suitable. How the safe replacement of these tubes is facilitated, and what instructions the patient and the nursing home are given to support patient care and safety are also discussed. The decision to support this type of feeding must be completely individualised, considering home and external support agencies available to each patient. The risk assessment completed to facilitate this has been based on the patients' individual circumstances, and a nasogastric tube home passport developed to help in the assessment and decision-making process. For fine-bore nasogastric tube feeding to be safe, it does have to be supported once the patient is discharged from the hospital. A good knowledge of the home support and carer support agencies, and what is available, should be discussed. Multidisciplinary team support is essential in ensuring a safe discharge can be planned and managed. Good patient risk assessment and nursing considerations are discussed to show how the challenges that may prevent a patient discharge with this type of feed are managed. This article will show how two very different patients discharges were facilitated by safe fine-bore nasogastric tube feeding in the community. Patient assessment and nursing considerations are discussed, as well as the importance of a multidisciplinary approach to show how this was successfully achieved in a local district hospital.

Innovations to support hydration care across health and social care.

It is known that the primary cause of dehydration in elderly care is caused by a person not regularly drinking enough. Dehydration is a much-publicised national concern, associated with poor outcomes of care and acute hospital admissions. However, in November last year, NHS England stated that the scale of dehydration is not known; in comparison, it confirmed at least three million people are at risk of malnutrition. The stark comparison in information occurs because there is no nationally recognised screening tool to identify who is at risk of dehydration. An innovative nursing role, focused on finding solutions to reduce the risk of dehydration in the care of older and vulnerable persons, has led to the development of a simple dehydration screening tool called 'ROC to drink' (ROC stands for 'reliance on a carer'), which focuses on the level of support needed to drink. An innovative tea cup has been designed to help raise standards for monitoring drinks and raise awareness about intake.

[Principles of nutrition in patients with newly appointed stoma]. / Zasady zywienia chorych z wyloniowa stomia.

The treatment of intestinal stoma is often a difficult experience for patients and results in numerous problems in the physical, psychological and social aspects. Therefore, post-operative care of the patient with the newly appointed stoma should be taken by therapeutic team consisting of doctors, nurses, physiotherapists, dieticians, psychologists and social workers. Appropriate nutritional education of patients aims to improve their quality of life and to prevent from unpleasant ailments formed after the operation. The specific type of stoma may decide about certain dietary recommendations. The presented work provides a practical dietary recommendations for patients with newly appointed stoma.

Validation of Clinical Indicators of Imbalanced Nutrition: Less Than Body Requirements in Early Childhood.

This is a clinical validation study of the nursing diagnosis of imbalanced nutrition: less than body requirements based on the diagnostic accuracy measures. Measures of sensitivity and specificity were calculated based on the latent class analysis method using a random effects model in a sample of 123 children between 0 and 6 years old. The prevalence of the diagnosis was estimated to be 27.6% using the latent class model. Indicators that exhibited the best measures of diagnostic accuracy included insufficient interest in food and satiety immediately upon ingesting food. A total of seven clinical indicators were validated clinically.

Valoración del estado nutricional y consumo alimentario de los pacientes en terapia renal sustitutiva mediante hemodiálisis / Assessment of nutritional status and food intake of patients in renal replacement therapy with hemodialysis

Introducción: La malnutrición proteico-energética es un hecho frecuente entre los pacientes en tratamiento sustitutivo renal con hemodiálisis y a ello contribuye, además de la propia técnica dialítica, la dieta inadecuada. Objetivos: Valorar la evolución del estado nutricional y la ingesta alimentaria de los pacientes de 3 unidades de hemodiálisis extrahospitalaria, tras una intervención enfermera educativa. Pacientes y métodos: Hemos realizado un estudio transversal en 66 pacientes de 3 unidades extrahospitalarias (44 hombres y 23 mujeres) con dosis de diálisis medida por KT/V > 1,3 .Se hizo una determinación del estado nutricional por métodos convencionales y del consumo alimentario mediante encuesta dietética, determinándose mediante soporte informático el índice de alimentación saludable, identificando los déficits y/o excesos de nutrientes en cada paciente. Se llevaron a cabo intervenciones educativas personalizadas dirigidas a corregir los excesos o déficits de nutrientes detectados en los pacientes, y se volvieron a hacer las mismas valoraciones a los seis meses. Resultados: La prevalencia de desnutrición es leve en el 41% de hombres y 43% de las mujeres y moderada en el 34% de los hombres y 21% de las mujeres. El índice de alimentación saludable era inadecuado en el 37,31% de los pacientes en el análisis basal y postintervención educativa paso al 18,8%. La ingesta media energética es elevada (1398.86 Kcal/paciente/día) con alto consumo de colesterol y déficit de aminoácidos. Se detectó un alto consumo de hidratos de carbono simples (> 20%) y un elevado uso de proteínas de origen animal. El contenido mineral y vitamínico de la dieta es muy deficiente, destacando el bajo consumo de Vitamina D (1.45±2.55 ng) y elevado de fósforo (1052.28±356.23 m/día). Conclusion: Tras una intervención educativa sobre nuestros pacientes, corrigiendo hábitos dietéticos no saludables, hemos conseguido mejorar su estado nutricional, reduciendo la prevalencia de desnutrición en nuestras unidades (AU)

Introduction: Protein-energy malnutrition is a common occurrence among patients on renal replacement therapy with hemodialysis and this in addition to the dialysis technique itself, improper diet contributes. Objective: Assess the evolution of nutritional status and food intake of patients from 3 outpatient hemodialysis units, after an educational nurse intervention. Methods: We conducted a cross-sectional study in 66 outpatient units from 3 patients (44 men and 23 women) with dialysis dose measured by Kt / V> 1.3. It was made a determination of nutritional status by conventional methods and food consumption by a diet questionnaire, determining by computer support the healthy eating index, identifying deficits and / or excess nutrients in each patient.Customized educational interventions designed to correct the excesses or deficiencies of nutrients detected in patients were carried out. The same assessments were made at six months. Results: The prevalence of malnutrition was mild in 41% of men and 43% of women and moderate in 34% of men and 21% of women. The healthy eating index was inadequate in 37.31% of patients at baseline but after the educational intervention was 18.8%. The average energy intake was high (1398.86 Kcal / patient / day) with high intake of cholesterol and amino acid deficiency. A high intake of simple carbohydrates (> 20%) and a high use of animal protein were detected. The mineral and vitamin content of the diet was very poor, highlighting the low consumption of vitamin D (1.45 ± 2.55 ng) and high phosphorus (1052.28 ± 356.23 m / day). Conclusion: After an educational intervention on our patients, correcting unhealthy dietary habits, we managed to improve their nutritional status, reducing the prevalence of malnutrition in our units (AU)

Understanding healthy pregnancies: the perspective of Inuit midwives in northwestern Quebec.

INTRODUCTION: For 25 years, Inuit midwives have provided perinatal and newborn care for about 90% of the pregnancies in northwestern Quebec. Patients in this region continue to have high rates of preventable nutritional deficiencies. The objective of this study was to explore the perceptions of professional midwives and students about what makes a healthy pregnancy and a healthy newborn. METHODS: We convened, via teleconference, a semistructured focus group with the local midwives and students. The conversation focused on local understanding of a healthy pregnancy and a healthy newborn, and the role of midwives in the communities. RESULTS: Four midwives and 6 students took part in the focus group, representing 80% of local midwives and students. All of the participants were women, and their professional experience ranged from 3 to 25 years. Through inductive thematic analysis, it became apparent that personal experiences and professional training were important determinants of opinions. Midwives believed that the health of women and infants could be improved through better food selection, particularly reliance on traditional nutrient-rich food. They were aware that iron deficiency was a problem and that infants required vitamin D; however, they reported that supplement uptake was poor. CONCLUSION: Concern was expressed about a decline in traditional beliefs and about unhealthy behaviours. Participants advanced strategies to promote knowledge locally (e.g., visual aids, local radio) to attempt to reduce rates of nutritional deficiencies.

INTRODUCTION: Pendant 25 ans, les sages-femmes inuites ont prodigué les soins périnataux et néonataux requis pour environ 90 % des grossesses dans le Nord-Ouest du Québec. Les patientes de cette région continuent de présenter des taux élevés de carences nutritionnelles évitables. L'objectif de cette étude était d'explorer les perceptions des sages-femmes professionnelles et des étudiantes sur ce qu'elles considèrent comme une grossesse saine et un nouveau-né en bonne santé. MÉTHODES: Nous avons organisé un groupe de discussion semi-structuré par téléconférence avec des sages-femmes et des étudiantes locales. L'entrevue a porté sur leur conception d'une grossesse saine et d'un nouveau-né en bonne santé et sur le rôle des sages-femmes dans les communautés. RÉSULTATS: Quatre sages-femmes et 6 étudiantes ont participé au groupe de discussion, représentant 80 % des sages-femmes et étudiantes locales. Toutes les participantes étaient des femmes et leur expérience professionnelle variait de 3 à 25 ans. Une analyse thématique inductive a fait ressortir que les expériences personnelles et la formation professionnelle étaient d'importants déterminants des opinions formulées. Les sages-femmes se sont dites d'avis que la santé des femmes et des nouveau-nés pouvait être améliorée par de meilleurs choix alimentaires, particulièrement en ce qui concerne l'alimentation traditionnelle, riche en éléments nutritifs. Elles étaient conscientes du fait qu'une carence en fer constitue un problème et que les nourrissons ont besoin de vitamine D. Elles ont toutefois mentionné que dans les faits, les suppléments sont peu utilisés. CONCLUSION: Les participantes ont exprimé leur inquiétude face au déclin des connaissances traditionnelles et face aux comportements malsains. Elles ont proposé des stratégies pour promouvoir la transmission des connaissances à l'échelle locale (p. ex., aides visuelles, radio locale) pour tenter de remédier aux carences nutritionnelles.