Knowledge attitudes and practices of perioperative nutrition management in gastrointestinal (GIT) surgery in South Africa

Abstract

Objective: To assess the knowledge, attitudes and practices (KAPs) of dietitians and surgeons regarding perioperative nutrition management in gastrointestinal surgery.
Design: Descriptive, cross-sectional study using an online questionnaire.
Setting: South Africa.
Subjects: Dietitians (n = 67) and surgeons (n = 35) in South Africa working with patients receiving gastrointestinal surgery.
Outcomes measured: An online questionnaire was developed to investigate the KAPs of dietitians and surgeons. The recommended surgical nutrition guidelines were the foundation for the knowledge questions. Open-ended questions were used for practices while attitudes were assessed via a 4-point Likert scale.
Results: Dietitians had a mean knowledge score of 57.6% (SD 1.68) with surgeons having a mean knowledge score of 64.4% (SD 1.27). Dietitians and surgeons typically fasted their patients from solids preoperatively at a mean of 7.5 hours (SD 4.33) and 6 hours (SD 0), respectively. Both groups delayed reinitiating nutrition postoperatively; dietitians by 8.3 hours (SD 11.6) and surgeons by 9 hours (SD 10.2). Regarding knowledge of reinitiating nutrition, a significant difference was found between knowledge and practice for dietitians (p = 0.007) and surgeons (p = 0.017). More than half (54.4%) of dietitians receive late referrals while 88.6% of surgeons operate on malnourished patients.
Conclusion: Although surgeons displayed a slightly higher level of knowledge, both healthcare professionals appear committed to ensuring effective nutritional practices, emphasising the vital role of nutrition in improving patient outcomes after surgery. Future efforts should focus on bridging the knowledge gap identified, enhancing training for healthcare
providers, and fostering team-based approaches to pre- and postoperative nutritional care.

Keywords: attitudes, dietitian, gastrointestinal, knowledge, nil per mouth, perioperative, practice, surgeon