Nutrition Assessment: Socio-Demography & History

• Theme 5 focuses on nutrition assessment, specifically socio-demography and medical history.
• The theme will be taught between March 17-21, 2025.
• Contact sessions are scheduled for Mondays (13:10-16:00) and Tuesdays (08:10-11:00) in Room 217 of the CR de Wet Bophelong Building.

Learning Outcomes

• Define socio-demographic background and its relevance to the Nutrition Care Process (NCP).
• Identify socio-demographic factors influencing nutritional status and dietary behaviors like age, sex, culture, education, and socioeconomic status.
• Define food security and its levels.
• Define medical history and its factors in the Nutrition Care Process (NCP).
• Describe how medications and food components interact.

Preparation and Activities

• Study uploaded material and attend face-to-face sessions.
• Complete sociodemographic and medical history sections from the Bluebook in pairs, followed by discussion.

Key Readings

• Rolfes, S.R., Pinna, K. & Whitney, E. 2021. Understanding Normal and Clinical Nutrition, 12th Ed. Cengage Learning: Boston, pp. 533–550.
• Nelms, M. & Sucher, K.P. 2020. Nutrition Therapy and Pathophysiology, 4th Ed. Cengage Learning: Boston, pp. 38 - 71.

Assessment

• Complete a practical assignment using a case study about socio-demography and medical history.

Case Study: Thabo Mokoena

• Thabo Mokoena, a 58-year-old Black South African man from Soweto, faces challenges due to kidney disease.
• He left school after Grade 7 to support his family and worked as a construction laborer.
• At 40, he was diagnosed with hypertension, which was poorly managed due to financial constraints and diet.
• At 55, he experienced fatigue, leg swelling, and headaches, leading to a chronic kidney disease (CKD) diagnosis.
• By 57, his condition progressed to end-stage renal disease (ESRD), requiring haemodialysis three times a week.
• Thabo is unemployed and relies on a government disability grant (SASSA), with his wife working as a domestic helper.
• The family lives in an RDP house in an informal settlement with no running water and limited electricity.
• Six family members survive on about R 2,500 per month, with R 2,000 available for food.
• Thabo's home language is Zulu, but he speaks some English.
• Thabo relies on affordable staples due to limited resources.
• He experiences electrolyte imbalances, fatigue, and constipation, the latter due to phosphate binders (Calcium Acetate 1334 mg with meals).

Treatment and Medications

• Thabo's treatment includes a combination of medications.
• Amlodipine (10mg daily) treats hypertension, with side effects of swelling in ankles (oedema).
• Calcium Acetate (1334mg with meals) acts as a phosphate binder for CKD, causing constipation.
• Erythropoietin (4000 IU injection weekly) treats anaemia due to CKD, causing joint pain.
• Iron supplement (1 tablet daily) prevents iron deficiency anaemia, causing stomach pain occasionally.
• Furosemide (40mg daily) controls fluid as a diuretic, with side effects of dizziness and dry mouth.
• IV Iron infusion treats iron deficiency anaemia, causing nausea, administered as per dialysis protocol.
• Heparin prevents blood clots during dialysis, causing bruising at the injection site, administered as per dialysis protocol.

Additional Information

• Side effects from medications make it hard for Thabo to maintain daily routines.
• A dietitian was consulted to improve Thabo’s nutrition with kidney-friendly foods, but financial limitations pose challenges.
• Thabo is seeking additional social support.

Rubric Criteria

• Completeness of Tables: Assesses if sections are completed with information from the case study.
  • Excellent: All sections thoroughly completed with detailed and relevant information.
  • Good: Most sections completed with relevant details; some minor information is missing.
  • Satisfactory: Sections are incomplete or lack detail, but the main ideas are present.
  • Needs improvement: Several sections missing or lack key details, making work unclear.
  • Poor: Responses have significant gaps; sections are incomplete or missing.
• Accuracy of Medical Information: Assesses medical and pharmacological details.
  • Excellent: Information is accurate and well-researched, with no medical errors.
  • Good: Minor errors, but these don't significantly affect understanding.
  • Satisfactory: Some errors, but general concepts are accurate.
  • Needs improvement: Several medical misinterpretations that affect understanding.
  • Poor: Major medical inaccuracies lead to misunderstanding.
• Interpretation of Socio-Demographic Factors: Assesses the impact of socio-demographic factors on health/nutrition.
  • Excellent: Strong understanding with insightful connections.
  • Good: Good understanding with some depth in explanation.
  • Satisfactory: Basic understanding, but lacks depth.
  • Needs improvement: Limited understanding with few connections.
  • Poor: Does not adequately address socio-demographic influences.
• Application of Critical Thinking: Assesses the analysis of the case study.
  • Excellent: Demonstrates excellent critical thinking in analysing.
  • Good: Good level of critical thinking.
  • Satisfactory: Some critical thinking, but mostly descriptive instead of analytical.
  • Needs improvement: Minimal critical thinking; responses are mostly surface-level.
  • Poor: No evidence of critical thinking; responses are purely descriptive.
• Clarity and Organisation: Assesses structure and language.
  • Excellent: Responses are well-structured, logical, and easy to follow. Professional language is used.
  • Good: Mostly well-organised, with minor lapses in clarity or structure.
  • Satisfactory: Some parts are unclear/disorganised, but the response is understandable.
  • Needs improvement: Responses lack organisation or have frequent clarity issues.
  • Poor: Disorganised, unclear, and difficult to understand; responses lack coherence.