Abstract

Effectively responding to children’s nutritional status and eating behaviors in Mozambique requires a community-based care approach grounded in sound nursing research that is evidence-based. The Community Assessment, Intervention, and Empowerment Model (MAIEC) is a nursing theoretical model that is based upon clinical decision-making for community health nurses using communities as a unit of care. We used the MAIEC to identify a community-based nursing diagnosis to address children’s nutritional status and eating behaviors in Mozambique. Objectives: (1) to conduct a descriptive study of children’s nutritional status and eating behaviors in a school community in Mavalane, Mozambique, and (2) to identify a community-based nursing diagnosis using the MAIEC clinical decision-making matrix in the same school community. Method: a cross-sectional, quantitative study was conducted to assess the nutritional status of children using anthropometric data, including brachial perimeter and the tricipital skinfold, and standard deviation for the relation of weight–height, in a sample of 227 children. To assess community management of the problem and identify a community-based nursing diagnosis, we surveyed 176 parents/guardians and 49 education professionals, using a questionnaire based on the MAIEC clinical decision matrix as a reference. Results: malnutrition was identified in more than half of the children (51.3%). We also identified a community-based nursing diagnosis of impaired community management related to the promotion of child health and healthy eating evidenced by the lack of community leadership, participation, and processing among more than 70% of the community members (parents/guardians and education professionals). Conclusion: a nursing diagnosis and diagnostic criteria for nutritional status and community management were identified. The need to intervene using a multidisciplinary public health approach is imperative, with the school community as the unit of care. In addition, reliable anthropometric data were identified as important criteria to complement the nursing diagnosis and guide future public health interventions.

Highlights

  • Framing the community as a unit of care and promoting community empowerment as both process and outcomes are the forming principles of the Community Assessment, Intervention and Empowerment Model (MAIEC) [1,2,3]

  • For the evaluation of the community management focus for the promotion of healthy eating in children, a questionnaire was created, by a process of expert consensus with the project researchers, based on the MAIEC clinical decision matrix, and administered to the leaders and members of the affected community

  • We present the results related to nutritional status and community management, starting with the first one: 3.1

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Summary

Introduction

Framing the community as a unit of care (i.e., approaching the whole community as a client) and promoting community empowerment as both process and outcomes are the forming principles of the Community Assessment, Intervention and Empowerment Model (MAIEC) [1,2,3]. This nursing model has a clinical decision matrix that guides nurses’ decision-making in relation to the community as the nursing client, Figure 1: Empowerment Model (MAIEC) [1,2,3]. This focus has three dimensions of diagnosis, which are included in the ICNP: Community leadership—related to the community’s knowledge, beliefs, behaviors and volition in the context of the problem addressed; Community participation—related to communication, partnerships and the existence of organizational structures; Community process—related to community coping or experiences with the problem addressed

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