Needs and preferences for nutrition education of type 2 diabetic adults in a resource-limited setting in South Africa

Diabetes self-management education is crucial in diabetes care. Education that is tailored to the needs of the patient is considered the most effective in improving health outcomes. Diet, a critical element of diabetes treatment, is reported as the most difficult to adhere to by both patients and health professionals. Tailored nutrition education (NE) could benefit diabetic individuals with low socio-economic status, who are amongst those noted to have poor health outcomes. This qualitative interpretive phenomenological study aimed to explore and describe the NE needs of adults with type 2 diabetes mellitus to guide development of a tailored NE programme for resource-poor settings. Participants were 31 non-insulin-dependent type 2 diabetic patients (convenience sample) and 10 health professionals. Focus group discussions using semi-structured questions were held with the diabetics, and open-ended self-administered questionnaires were used with the health professionals. Data analysis was done using Krueger’s framework approach. Disease-related knowledge deficits and inappropriate self-reported dietary practices, including intake of unbalanced meals, problems with food portion control and unsatisfactory intake of fruits and vegetables, were observed. Recommendations for the NE programme included topics related to the disease and others related to diet. Group education at the clinic, a competent educator and comprehensive education were indicated by the patients. Participation of family and provision of pamphlets were aspects recommended by patients and health professionals. Barriers that could impact the NE included financial constraints, food insecurity, conflict in family meal arrangements and access to appropriate foods. Support from family and health professionals and empowerment through education were identified as facilitators to following dietary recommendations by both groups of participants. Knowledge deficits, inappropriate dietary practices and barriers are issues that need addressing in an NE programme, whilst the suggestions for an NE programme and facilitators to dietary compliance need to be incorporated.Onderrig in die selfbestuur van diabetes is essensieel in diabetessorg. Onderrig wat spesifiek ooreenkomstig die behoeftes van die pasi nt aangepas is, word die mees doeltreffend in die verbetering van gesondheiduitkomste geag. Dieet, ’n kritiese element in diabetesbehandeling, word deur pasi nte en gesondheidpraktisyns as die moeilikste beskou om na te volg. Spesifiek beplande voedingonderrig kan tot voordeel van lae sosio-ekonomiese diabet