Çocuklara Önerilen D Vitamini Desteğinde Annelerin Bilgi, Tutum ve Davranışları

Year 2020, Volume: 10 Issue: 2, 231 - 239, 15.06.2020

Gizem Kara Elitok , Lida Bülbül Burhan Turan , Taha Akın Sinan Uslu Ali Bülbül

https://doi.org/10.31832/smj.692741

Cited By: 2

Abstract

Amaç
Çocuklara D vitamini profilaksisinin verilmesinde önemli bir rolü olan annelerin, D vitamini desteğiyle ilgili bilgi, tutum ve davranışlarının belirlenmesi amaçlandı.
Gereç ve Yöntemler
Kesitsel ileriye dönük olan bu araştırma, 0-12 ay arası çocuğu olan annelerle Sağlam Çocuk Polikliniğinde yapıldı. Katılımcıların sosyodemografik özellikleri, D vitamini desteğiyle ilgili bilgi, tutum ve davranışlarını içeren yirmi beş sorudan oluşan anket uygulandı.
Bulgular
Çalışmaya 467 anne katıldı. Annelerin %83,7’sine (n 391) D vitamini desteği vermeleri gerektiği bilgisi verilmişti. Bu bilgiyi %69,8’ine doktor, %29,4’üne hemşire vermişti. Annelerin %75,2’si (n: 351) çocuklarına D vitamini desteği veriyordu. Çocuklara D vitamini ortalama 17,7±18,2 günde başlanmıştı. D vitamini desteği verenlerin; %83,9’unun 400 IU/gün, %8,2’sinin ≥600 IU/gün dozunda verdiği saptandı. D vitamini desteğini vermemelerinin ilk üç nedeni; %50,8 henüz ilacı başlama zamanı gelmemesi, %33,6 mamalarda yeteri kadar olduğunu düşünmeleri, % 20,7 bu konuda bilgi verilmemesiydi. Annelerin %47,3’ü gebelikte, %19,3’ü emzirirken D vitamini desteği almıştı. Çocuklara D vitamini desteğinin verilme nedenleri sorulduğunda ilk üç neden: %58,9 kemik gelişimi için, %21 diş gelişimi için, %18,6 bıngıldak kapanması idi.
Sonuç
Çalışmamızda annelerin çocuklara önerilen D vitamini destek programına uyduğunu, desteğin başlanma zamanının ve dozunun çoğunlukla uygun olduğunu tespit ettik. Düşük bir oranda annenin D vitaminini yüksek dozda verdiğini saptadık. Annelerin D vitaminiyle ilgili bilgi düzeylerinin yeterli olmadığını, gebelik ve emzirme döneminde D vitamini desteğini kullanım oranın düşük olduğunu belirledik. Annelere bu konuda eğitim programlarının düzenlenmesinin, çocuklara ve kendilerine önerilen D vitamini destek programlarına uyumu arttıracağını düşünmekteyiz.

Keywords

vitaminD, bilgi, tutum

Knowledge, Attitudes and Practices the Mothers Regarding Recommendation of Vitamin D Supplementation to Children

Abstract

Objective: We aimed to determine the mothers' knowledge, attitudes and practices about vitamin D supplementation
Methods: This cross-sectional prospective study was conducted with mothers whose child was between 0-12 months of age in Well Child Clinic. A questionnaire consisting of twenty-five questions including socio-demographic characteristics of the participants, knowledge, attitudes and practices about vitamin D supplementation was performed.
Results: 467 mothers participated in this study. 83.7%(n:391) of mothers were informed they should give vitamin D supplementation. This information was given to 69.8% by doctors and 29.4% by nurses. 75.2%(n:351) of mothers administered vitamin D supplementation to children. Vitamin D was started to children on average 17.7±18.2 days. 83.9% of mothers gave vitamin D supplementation dose at 400 IU/day and 8.2% at ≥600 IU/day. The first three reasons why they didn't give vitamin D;50.8% not starting time of drug,33.6% thought formula was enough,20.7% was not informed about this issue.47.3% of mothers received vitamin D during pregnancy, 19.3% while breastfeeding. When asked why children are given vitamin D, the first three reasons was:58.9% for bone development, 21% for tooth development, 18.6% for fontanel closure.
Conclusion: We found that the starting time and dose of vitamin D supplementation were mostly appropriate but a few number of mothers gave high doses of vitamin D. The level of knowledge of mothers about vitamin D was not sufficient, and the rate of received vitamin D supplementation during pregnancy and breastfeeding was low. We think that education programs for mothers will increase compliance with vitamin D supplementation.

Keywords

vitaminD, knowledge, attitude

References

• Referans 1. Charoenngam N, Shirvani A, Holick MF. Vitamin D for skeletal and non-skeletal health: What we should know. J Clin Orthop Trauma. 2019;10(6):1082-1093.
• Referans 2. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M; Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398-417.
• Referans 3. Pludowski P, Holick MF, Pilz S, Wagner CL, Hollis BW, Grant WB, et al. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence. Autoimmun Rev. 2013;12:976–989.
• Referans 4. Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017;18(2):153-165.
• Referans 5. Peroni DG, Trambusti I, Di Cicco ME, Nuzzi G. Vitamin D in pediatric health and disease. Pediatr Allergy Immunol. 2020;31 Suppl 24:54-57.
• Referans 6. Hatun Ş, Ozkan B, Bereket A. Vitamin D deficiency and prevention: Turkish experience. Acta Paediatr. 2011;100(9):1195-9.
• Referans 7. Gebelere D vitamini destek programı. T.C. Sağlık Bakanlığı Genelgesi. https://www.saglik.gov.tr/TR,11158/gebelere-d-vitamini-destek-programi.html (Erişim Tarihi: 15.02.2020)
• Referans 8. Çataklı T, Taşar S, Oğulluk M, Dallar Bilge Y. Bir hastaneye başvuran annelerin D vitamini hakkındaki bilgileri ve kullanma tutumları. Ege Journal of Medicine 2014;53(3):135-140.
• Referans 9. Dağhan Ş, Toraman AU, Yelten G, Taşkıran G, Savan F. Annelerin Bebek Sağlığında D Vitamini Kullanımına İlişkin Bilgi ve Uygulamaları. Güncel Pediatri 2019;17(1):58-70.
• Referans 10. Day RE, Krishnarao R, Sahota P, Christian MS. We still don't know that our children need vitamin D daily: a study of parents' understanding of vitamin D requirements in children aged 0-2 years. BMC Public Health. 2019 Aug 15;19(1):1119.
• Referans 11. Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol. 2017 Aug;13(8):466-479. Referans 12. Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab. 2016;101(2):394-415.
• Referans 13. Gallo S, Jean-Philippe S, Rodd C, Weiler HA. Vitamin D supplementation of Canadian infants: practices of Montreal mothers. Appl Physiol Nutr Metab. 2010;35(3):303-309.
• Referans 14. Alramdhan AM, El-Zubair AG. Poor vitamin D supplementation in infants. Cross-sectional study of maternal practices and awareness of vitamin D supplementation in infants in Al-Ahsa, Eastern Saudi Arabia. Saudi Med J. 2014;35(1):67-71.
• Referans 15. Drury R, Rehm A, Johal S, Nadler R. Vitamin D supplementation: we must not fail our children! Medicine (Baltimore). 2015 May;94(18):e817.
• Referans 16. Wagner CL, Greer FR; American Academy of Pediatrics Section on Breastfeeding; American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122(5):1142-52.
• Referans 17. Mrad SM, Gazdalli N, Gharsallah L, Bouyahia O, Barsaoui S, Boukthir S, et al. [Study of 116 mothers of the knowledge, behavior, and practices of vitamin D supplementation]. Tunis Med. 2009;87(4):273-278.
• Referans 18. Zadka K, Pałkowska-Goździk E, Rosołowska-Huszcz D. The State of Knowledge about Nutrition Sources of Vitamin D, Its Role in the Human Body, and Necessity of Supplementation among Parents in Central Poland. Int J Environ Res Public Health. 2018;14:15(7).
• Referans 19. Alshamsan FM, Bin-Abbas BS. Knowledge, awareness, attitudes and sources of vitamin D deficiency and sufficiency in Saudi children. Saudi Med J. 2016;37(5):579-583.
• Referans 20. Javaid MK, Crozier SR, Harvey NC, Gale CR, Dennison EM, Boucher BJ, et al.; Princess Anne Hospital Study Group. Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: a longitudinal study. Lancet. 2006;367(9504):36-43.