Khdjchuan bang may tao ozone IHI khdng sd dung h6a chat nen nude thai ra khdng ed hod chat. Nudc thai da dupe khd khuan nen khPng gieo rac mam benh khi thai ra mdi trudng ndn phudng phap nay dupc coi Id than thien vdi mdi trudng.
A//iupb d l f ^ :
1^0 khuin bing DD Cidex OPA
Quy trinh khd khuan khdng khep kfn, nen ngudi sd dung luon tiep xdc true tiep vdi dung djeh. [7]. Dde tfnh cfla dung djch ed the gay ki'ch ^fch. Didu dd gdy ndn mot sd kfch dhg manh den cdc bd phdn nhay cam eda cd the nhu: nidm mae mat, mui, mieng, dudng tidu hda,.. Ngoai ra, dung dich bam dfnh ldn qudn ao, thidt bi * kem ONSM, khd tay rda. Vi vdy, yeu cdu ngudi sd dung phai ed cac phUdng tidn bao hd lao ddng nhu mu, ao choang, ki'nh. [2].
Tuy DD Cidex OPA cd kha ndng tai sd dung, nhung ve gid thanh tfnh tmng binh cao hdn so vdi phudng phap khd khuan bang may tao Ozone (Bang 3). Cd sU tieu tdn vd nhdn lUC vi can su phdi hpp, thao tae cda ngudi sd dung trong quy trinh khd khudn. DD Cidex OPA dupc coi Id mpt hda chdt khd khuan, cdn cd he thdng xd \p ridng dung djch khi thai ra ngodi mdi tnidng. [5].
Khdidiuin bing miy tao Ozone
Thdi gian khd khuan ONSM cda may tao ozone IHI la 14 phut. Tuy nhidn, de dam bao cho mpt quy tnnh hodn thanh ddng theo quy djnh cda Hang thi tmng binh mdt 20 phdt/ lan khd khuan keo ddi hdn so vdi phUdng phap rdia bang DD Cidex OPA chl mat 12 phdt (Bang 3).
Qua nghien cdu, didng tdi nhan thay de ddp dng Six vdi nhu cau ngudi benh npi soi hdng nam tai Viet Nam, can phat bang bj mpt he thdng may tao ozone IHl. Chi phf cho mot may tao ozone: - 20.000 USD.
Trong Mil dd, mdt cd sd npi soi tmng binh can khoang 05 may (~ lOO.OOO USD). Vi vdy, yeu cdu vdn ddu tU ban dau ldn. Tuy nhien, hieu qua tdng hpp cao khi sd dung lau ddi.
KETLUAN
Nghien cdu 90 cap mdu day ndi soi da day va 59 cdp mlu ddy npi soi dai trang trude va sau khi tidt trUvi
khuan bang may tao ozone IHI vd DD Cidex OPA, ohOng toi cd kdt ludn nhu sau:
Phudng phap khd khuan bang Dung djch khd khudn Cidex OPA vd may tao Ozone IHI deu cd kha ndng tidt trd vi khudn b ONSM da day va dai trang. Cht sd hidu qua can thidp eda phiAJno phdp khd khudn bdng ozone dat 94,6%, khd khudn Cidex OPA dat 85,1%.
Phudng phdp khd khuan bang Dung djch Cidex OPA giam dupc mdt dp vi khuan tmng binh Id 17,7 vi khudn thdp hdn so vdi phUdng phdp khd khudn bang mdy tao Ozone tHI Id 39,6 vi khuan.
Hd thdng khudn bang may tao Ozone IHI sd dung tdt cho sdfc khoe ngudi tofc tidp thuc hidn khd khudn, ddi hdi Cd sd y td phdi ed didn vd cdn cd kinh phf dau t u ban dau Idn nhung chi phf van hdnh re hdn so vdi phUdng phap khd khuan bang DDKK Cidex OPA.
T A I L I $ U THAM K H A O
1. Le Thj Kim Hoang (2007), "KhSo sat tinh trang nhiem khudn m6t sd dung cu dung dio benh nhdn cac khoa ldm sang vd budng ndi soi tai Benh vien Cap cUu Trung VUOng".
2. Npi soi tieu hod (2010), Nhd xuat t)an y hoc.
3. Alfa MJ, DeGagne P, Olson N, Fatima'l. (2010),
"EVOTECH endoscope cleaner and repracessor (ECR) simulated-use and clinical-use evaluation of cleaning efficacy". BMC Infect Dis, pp. 291-10.
4. Petersen BT, Chennat J, Cohen J, Cotton PB, Greenwald DA et al. (2011), "Multisociety guideline on reprocessing flexible Gl endoscopes". Infect Control Hosp Epidemiol, 32 (6), pp. 527-37.
5. Society of Gastroentemlogy Nurses and Associates, Inc. (2010), "SGNA Standards: standards of infection contml In reprocessing of flexible gastrointestinal endoscopes", Gastroenterol Nurs, 33 (1), pp. 70-80.
6. Spaun GO, Goere TA, Pierce RA, Cassera MA Scovil S, Swanstrom LL. (2010), "Use of flexible endoscopes for NOTES: sterilization or high-level disinfection?", Surg Endosc, 24(7), pp. 1581-8.
7. Kircheis U, Martiny H. (2007), "Comparison of the cleaning and disinfecting efficacy of four washer- disinfectors for flexible endoscopes", J Hosp Infect, 66(3), pp. 255-61.
THUC TRANG HIEU BIET VA THUC HANH DINH D U S N G CUA NGUiJl CHAM SDC BENH NHAN TRONG BENH VIEN
TOM TAT
N& dung bai bao li mdt phan trong nghiin cOu Thuc trang suy dinh dudng cQa binh nhin, hiiu biet.
thai dd vi thuc hinh cham sdc dinh dudng cOa ngudi chim sdc (ngudi nhi) binh nhin, cin bd y te tmng liinh win" tai binh viin da khoa tlnh Hii Duang.
Nghien cOu nhim xie dinh hiiu biit. thii do vi thuc hanh chim sdc dinh dudng cQa ngudi chim sdc benh nhin trong binh vien bing phong yin siu vi phong vin KAP birig bing hdi thiit ki sin. Thiet ke nghien
N G U Y I N V A N KHANG, NGUYEN D 5 HUY W ^ Dinh Dudng
citu cit ngang md ti trin 302 ngudi chim sdc benh nhan nhip viin tmng vong 48 gid tai t}enh vien da khoa tlnh Hii Duang td thing 3-6/2009. Kit qua cho thay tp li binh nhin dugc tu van dinh dudng tmng thdi gian nim vien ii rit thip (26.5%), tp li mua thitc in cOa eing tin binh vien dat 10.9%,. Cd tdi 90,7% thay sudn thiit cQa Khoa dinh dudng trong benh vien, neu cd Khoa Dinh dudng thi cd 40.4%, lua chgn thOC in eho binh nhin tdKhoa dinh dudng binh win.
YHOC THirC HANH (878) - S6 8/2013
Tdkhda: KAP. ngudi chim sdc b$nh nhin, chim sdc dinh dudng ngudi binh.
SUMMARY
The content of this article is part of the msults of mseamh title "Nutrition status of hospitalized patients and KAP status on nutrition ofcamgivers and medical staff at Haiduong hospital". The mseamh aimed to show the msults of KAP study on camgivers of hospitalized patients by in-depth inten/iews and stmctumd questionnaims Interviews. A cross se<^ional study was conducted with the involvement of 302 camgivers of hospitalized patients at Hai Duong province hospital fmm March to June, 2009. The msults show that the pementage of hospitalized patients who were advised on nutrition was very low (26.5%o). Only 10.9%, of hospitalized patients bought food at canteen of hospital. But the need of utilization of food and nutrition services of hospitalized patients In hospital was very high. Enthusiastic attitude of medical and nutrition staff was is the top concem of patient camgivers.
Keywords: KAP, hospitalized patients caregivers, nutrition sen/ices in hospital
DATVA'NOi
Hidn nay vdn dd suy dinh duQng trong bdnh vidn cdn ft dupc quan tdm, vide danh gid tinh trang dinh dudng cda bdnh nhdn trong benh vidn chua dupe tidn hdnh thudng xuyen. Suy dinh dudng la mpt hien tupng phd bidn cda benh nhan nam vien d i n ddn tdng bien chdng ddi vdi benh, keo ddi thdi gian nam vien, tdng tp Id tdvong, tdng chi phi y td^Viec xdc dinh niidng benh nhan ed nguy cd cao can hP trp dmh duPng tich cUe se lam giam dUdc nhdng van de tren [2],[3] [4] [5].
Hien nay vdn de dinh duPng trong benh vien vdn chua dupc quan tdm dung mdc. ThPng tin ve tinh hinh dinh dudng cda benh nhdn mdi nhap vien ndi ehung va theo tUng khoa phong ndi rieng cdn rat han che. Cho tdi thdi diem hien nay, chus ed mdt nghien cdu ndo danh gia viec viec sd dung cac djch vu chdm sdc dinh duPng cho benh nhan, nhu cau s d dung cdc djch vu chdm sdc dinh dUdng cho bdnh nhan trong bdnh vidn.
Do vay, trong nam 2009, chdng tdi lien hdnh nghien cdu ndy vdi muc tieu xdc dinh thue trang hidu biet vd thUc hdnh chdm sdc dinh dUPng eda ngUdi chdm sdc benh nhan trong benh vien, de dua ra nhdng du lidu giilp nang cao nhdn thdc eua epng ddng va xa hpi vd hoat dpng dinh dUdng trong benh vien.
PHUONG P H A P NGHlfeN COu 1. Ddi tupng nghien cUu.
- Benh nhan: tat ca cae benh nhdn mdi nhap vien trong vong 48 gid c6 tudi t d 16 den 85 tudi (triy benh nhdn mac cac benh cap tinh, cap edu).
- Ngudi chdm sdc bdnh nhan (ngudi nhd): tat ea nhdng nguPi td 16 tudi trd len, dang di cung chdm sdc ngudi benh, sdng vdi ngUdi benh it nhat 2 tuan trd lai, minh mdn, tlnh tao, tu nguyen tham gia phdng vdn.
2. Thiet ke nghien cdu; PhUdng phdp nghien edu tien cdu, tien hanh td thang 3 ddn thang 6 ndm 2009 tai benh vien da khoa tlnh Hai dUdng.
2.1. Cdmiu Udc lupng cho mdt tylf [4].
Z\p.(\-p)
Z:1,96,e:5%
p: tide tfnh tp Id ngudi chdm sdc bdnh nhan ed quan tdm vd dinh dUSrig cho ngUdi benh trong bdnh vien:
75%
Cd mdu edn thidt cho nghien cdu Id 272, them 10%
duphdng,n = 300
2.2. Cich chgn mSu: Ldy cdc bdnh nhan va ngUdi chdm sdc cd Sii tidu c h u i n lidn tidp ddn khi dd cd mlu.
3. PhUdng phdp nghidn cdu va kp thuat thu thap so' lifU.
' Vdl ngudi nhd bdnh nhdn: Phdng vdn sdu, phdng vdn ngudi chdm sdc bdnh nhdn l)ang t>cing hoi thiet ke sSn vd kidn thdc, thai dd vd thue hanh (KAP) chdm soc ngudi bdnh vd dinh dudng. Cae bang hdi, phdng van sdu cho ngUdi nhd bdnh nhdn dUdc thidt kd dda trdn cde nghidn cdU tnidc, dupc danh gid thd nghiem, dudc gdp •) ciia dc chuydn gia tnfdc khi tidn hanh nghien cdu trdn thuc dia [4],[5].
Phdn tfch thdng kd: Sd lidu dupc nhdp vdo mdy tinh bang ehudng trinh EPI DATA. Sd lieu dudc phdn tfch bang phdn mdm SPSS 16.0. S d dung kidm ^ n h Chi- Square hodc Fisher's Exact Test de so sanh cdc t^ Id.
Dao ddc nghien cdU: TrUdc khi tien hanh nghien cdu, cdc can bp nghien cdu se tdm viec chi tidt vd noi dung, muc dfch nghien cdu v6i lanh dao Benh vidn, cung vdi cdn bd cda cde Khoa Idm sdng, trinh bdy va giai thfch npi dung, muc dieh nghidn edU vdi ngudi benh va ngudi cham sdc. Cac doi tupng tham gia phdng van mpt each tu nguydn, khong bat budc vd cd quydn t d bd khdng tham gia nghien cdu ma khdng can bdt cd 1^ do ndo. Cae thdng tin ve ddi tupng dUdc gid bf mdt vd chl dUde sd dung vdi muc dfch nghien cdu, dem lai lpi fch cho cdng ddng.
k^QuA
B a n g 1 : H i e u b i d t v d d i n h d U S n g c d a n g u d i chdm s d c v a t h u c t r a n g d u p c t U v a n v e d n ud'ng v a dihh d u d n g c h o b d n h n h a n k h i r i a m v i d n
HiSu b i ^ v6 dinh dueng
Ngudi chdm sdc bdnh nhdn , (n=302) n 1 T«i6(%) _ H I & bl£t v6 thllc an. dinh duOnq cb ii&n quan ldi benh tdt
C6 Kh«ng KhOng biStMiOngtj ISi
Dinh duOng cd dnh hudn C4 KhOng Khdnq biSUihdngtij ldi
285 15 2
94.4 5,0 0.6 Qtd qud In'nh didu tri bdnh
182 87 33 Duoc tu van v6 3n udnq vi dinh dudn C6
Khdng Khdnq b i M l d n q t i i ldl
80 213 9
W3 1, 28.6 10.9 q
26.5 70.6 2.9 Nqudi t u v i n :
Bdcsy YtS Nqudi quenJho hdng
69 3 8
66,3 ••' 3,8 10,0 "
Y HOC THVC H A N H (878) - s 6 8/2013
Da sd ddi tupng (94,4%) nhan thdc dupc "Thdc dn lidn quan tdi benh tdt". Tuy vdy chT c d 60,3% ddi tupng cho rang "Dinh duPng c d anh hudng tdi qua trinh dieu tri benh" va cd^tdi gan 1 1 % khdng bidt/khdng tra Idi.
Theo p kien cda ngudi nhd/nguPi chdm sdc bdnh nhan: Chi c d 26,5% benh nhdn dupc tU vdn v d dn udng va dinh dUdng trong thdi gian nam vidn, ngudi dite ra cae t u van nay chd ydu Id bdc sy (86,3%), Noi dung cda cdc cudc t u van ndy mang tfnh ly thuydt. It mang tfnh thuc hdnh nhu: "An chdo, udng sfta", "An udng de c d sde khoe d e truydn hoa chat", "An udng dieu dp", "An nhieu loai thdc d n , khPng phai kidng",
"Bdnh nhan m d ndn dn mem", "An thdc an b d mdu"
Bang 2: Thue te dn udng ci!ia benh nhdn khi nam vidn
Ngudi chdm sdc b^nh nhdn (n=302) n 1 T»id(%l Thuc IS dn ufinq c5a bdnh nhan
"' An com nhu binh thUdnq An chdc AndiSddanddcbidtldidutii) Ktidc (my, phd, tnjvdn dich..)
121 105 12 64
40,1 34,8 4,0 21,2 Nd mua/cunq cap thiJc dn cho benh ntian Tunau/mangtUnhdtdi
l^ua ngodi bdnh vidn Mua cdnq dn benh vidn Khac (Injven dich, udnq sQa„)
73 165 33 31
24,2 54,6 10,9 10,3 Neu duoc iua chon nd cunq cap thirc an Tunau/manqtUnhdtd
Mua nqoai bdnh vidn Mua cdng tin bdnh vidn Mua nd/can bdytd chr dinh
Khdnq bj^l/khdnq tra idi 157 19 38 84 4
52,0 6,3 12,6 27,8 1,3 Chi cd 4,0% benh nhan dudc cung cap che dp an ddc biet (die dp dinh dudng didu tri). Ndi eung cd'p thdc an chd yeu la mua ngoai benh vien (54,6%)(p<0,05), t u nau/mang t d nha tdi (24,2%), ty le cdng tin benh vien cung cap la thap nhat (10,9%). Ly do mua ngoai bdnh vien la vi: "Khong biet ndi nao trong benh vien ban, nhd xa, nhieu mdn, gid re va ngon hdn trong cdng tin".
Mpt dieu ddng phai quan tam Id: khi dUde hdi neu dUOc iua chpn ndi cung cap thdc dn eho benh nhdn, tJ Ie lua ehpn ndi cung cap trong benh vien (cang tin, ndi can bd dinh dudng chi dvnh) la rat cao {40,4%)(p<O,O5). Tuy vay, ^ id lUa chpn tU nau/mang td nha tdi cung tdng len rat cao (52,0%) do vdn cho rang: "nha nau dn ngon hdn, dam bao ve sinh, hpp khau vi eiia ngUdi benh. gia re".
Bang 3: V kidn eua ngudi nhd benh nhdn v d sU can thiet cua Khoa dinh duPng trong bdnh vien
Su can thidt cda khoa dinh dudng
Y kidn vdsu can thidt c ClnthiSt Khdnq can thiet t. Ktidnqbidt/khdnqlraldi
Ngudi Cham sdc bdnh nhdn (n=302) n 1 T«id(%l a Khoa dinh dudnq
274 23 5
90.7 7,6 1,7
Da s d cac ddi tudng deu nhat trf v d s u can thiet eda Khoa dinh duPng trong bdnh vidn (90,7%). C h i j : d gdn 8% ngudi nhd bdnh nhdn cho rang khdng can thidt phai c d Khoa dinh dUSng.
Ly do tra Idi "khdng can thiet" vi; "Benh nh^, dn ngodi eung dUde", "Chl edn bdc sy t u van, tU vd nau nUdng", "Sd khdng dam bao v d sinh, gia dinh ndu sach se hdn", "Bac sy ludn bdn rdn, s d khPng ed didu kidn, thdi gian lam tdt v d dinh duQng", "Lam rupng, khd khdn vd kinh td, sp chi phi them"....
Ly do tra Idi can thiet vi: "Nhan dUpc cdc t u van chuydn sdu ve dn udng va dinh duflng", "Tien lpi, ngudi chdm sdc khdng phai di xa", "Phuc vu benh nhdn tdt hdn do bam sdt clid dp dn", "Bdnh nhan nang cdn can bd chuyen khoa dinh duPng theo doi", "Tin tudng vdo ngdnh y, can bp y t d , cdn bp dmh duPng"
Bang 4: Mong mudn cda ngUdi nhd benh nhdn v d Khoa dinh duPng
l^ong mudn Ngui^ Cham sdc bdnh nhdn (n=302) n I T«id(%l Vd nhdn iuc, nqud iam tronq Khoa dmh dudnq Cldchuydnmdnvddinhdudng
Niiidt tinh, nidm nd Hdi iiod, iiod ddnq y thdc dao dUc. chu ddo chuydn mdn
Cd sdc khoe Vd CO sdvat chat Day dd, tidn nqhi Bam bao vd sinii ATTP
Tiiuan tidn Vd phong Cdch piiuc vu
Tan Bnh, Chu ddo Hai hoa, hod ddnq Niianh nhen. nhidt tinh
Giacd Hop iy, khdng qud dat
Theo qid thi tnidnq Chiquantdmtdhiduqua
257 289 276 295 46 237 299 176 302 277 154 211 69 22
85,1 957 91,4 97,7 15,2 78,5 99.0 58,3 100,0 91,7 51,0 69,9 22,8 7,3 Ty le ddi tupng mong mudn can bp dinh duPng trong benh vien ehd yeu la. 'Tan tinh, ehu dao"(100,0%), "y thdc dao ddc, chu dao chuyen mdn"(97,7%). "nhiet tinh mem nd"(95,7%), "Hdi hod, hoaddng"(91,4%).
B A N LUAN
Da sd ddi tupng (94,4%) nhdn thdc dUde "Thdc dn lien quan tdi benh tat". Tuy vdy chi c6 60,3% ddi tUdng cho rang "Dinh duQng cd anii hudng tdi qua trinh dieu tri benh". Ve hieu biet vdi eham sdc dmh dudng, kdt qua cda ehung toi cao hdn vdi ket qua nghien cdu cCia Benh vien Npi tiet ndm 2011 (ty le ddi tupng c6 kien thdc ve ydu td nguy cd mac benh DTD kem la 91.9%
va tJ le cd kien thdc tot la 0,3%. Ty le ddi tUdng cd kien thdc ve phong va dieu tn benh DTO rat kem la 59,6%
va tp le ddi tudn g cd kien th Uc tdt la 4,1 %) [6].
Theo y kidn cda ngudi nha/ngudi cham sdc benh nhan: Chi c6 26.5% benh nhan dUdc tu van ve an udng va dmh duPng trong thdi gian nam vien. ngudi dua ra eac tUvan nay chu yeu la bac sy (86.3%). Ndi dung eCia cac eupc tu van nay mang tinh ly thuyet. it
Y HOC THirC HANH (878) - S 6 8/2013
mang tinh thUC hdnh nhU: "An chdo, udng sda", TJ Id bdnh nhdn dUdc tU vdn, dude can bd y td hudng d i n vd dinh dudng trong qua trinh didu trj Id rdt thdp (26,5%), sd bdnh nhdn dupe cht dinh chd dP dinh dUdng didu tri thdp (4,0%) vd ndi dung cda t u vdn, hudng d i n ndy mang tinh ly thuydt. It mang tfnh thUC hdnh. Tuy vdy mot didu ddng mdng Id nhdng hudng d i n , t u vdn ndy ehd ydu do bac sy (86,3%) thue hidn vd t^o dupe sutin tudng cho ngudi bdnh, nhung mdt cdu hdi ddt ra Id bdc sy cd dd thdi gian dd ldm cdng vide ndy khdng? Hay chdng ndn cd mdt dpi ngQ edn bd cd chuydn mdn vd dinh dudng Idm cdng vide ndyl.
TJ Id phuc vu bCra dn cda ngudi bdnh cda cdng tin bdnh vidn Id rdt'thdp (10.9%), nhu vdy gdn 90% nhu cdu cda ngudi bdnh vd bu^ dn khdng dupe qudn tJ trdn phudng didn an todn vd sinh thUC phdm vd d i m b i o dinh duQng cho ngudi bdnh. Hidn tUdng ndy khdng thd hidn ngudi bdnh khPng quan tdm tdi vide phuc vu eda cdng tin bdnh vidn vl qua dieu tra cho thdy ndu dupe dUdc cdn bp y td, cdn bd dmh dudng chi djnh, hudng ddn thi tp Id sd dung cac djch vu dinh dudng d cdng tin benh vidn cung dat tdi 40,4%. Do vSy. kdt q u i Id da sd ngudi chdm sdc benh nhdn ddu nhdt tri vd sU cdn thidt phai cd hoat ddng cda Khoa dinh dUdng trong benh vien (90,7%). Nhdng mong mudn cda ngudi benh, ngudi chdm sdc ngudi benh ddi vPi Khoa dmh duQng benh vien chd ydu la trinh do chuyen mdn tdt, d i m bao ve sinh an toan thuc pham. thai dp gan gui, gia ca hpp ly.... Qua nhdng thdng tin nay chung ta thdy dUdc rang 'khdi mem" ve Khoa dinh dUPng trong benh vien eCia ngudi benh, ngudi cham soc ngudi benh ehd yeu lieri quan tdl dieh vu dn udng, nha bdp ma chua ed dUdc ve nhiem vu quan trpng cda Khoa dinh dudng Id hoat dong "tUvan vd dinh duPng dieu tri".
KET LUAN
Thuc td vide s d dung cac djch vu chdm sdc dinh du8ng eho benh nhdn trong benh vien con rd't thap: T j le benh nhdn dUpc tu van dinh duflng trong thdi gian
nam vidn Id rdt thdp (26,5%), t f Id mua thue dn cua cdng tin bdnh vidn dat 10,9%.
Nhu cdu sd dung eac djch vu chdm sdc dinh dudng cho bdnh nhdn trong benti vien rat cao: Cd tdi 90,7%
thdy s u cdn ttiidt cda Khoa dinh duQng trong benh vidn, ndu cd Khoa Dinh dUPng thi cd tdi 40,4% t i ^ chpn thde dn eho bdnh nhdn t d Khoa dinh dUdng benh vidn,
Thdi dd, tdn tinh trong dng sit ciia dn bp dinh dudng Id mdi quan tdm hdng ddu cda ngudi chdm sdc bdnh nhdn: TJ Id mong mudn can bd dinh duQng trong bdnh vidn "Tdn'tinh, ehu dao"(100.0%). "V thdC dao ddc, ehu ddo chuydn mdn"(97,7%).
KI£'N NGHI
Ndng cao chdt lUdng djch vu chdm sdc dinh dU6ng cho bdnh nhdn trong benh vien de ddp dhg nhu cau eda ngudi bdnh.
T A I LI$lJ THAM K H A O
1. Pham Thu Hudng, Nguyin Thj Ldm, Nguyen Bich Ngoc, Trdn Chdu Quydn, Nghidm Nguydt Thu, Pham Th^ng (2006). Tlnh trang dinh duQng ciia bdnh nhdn nhdp vidn khoa tidu h6a va npi tiet tat benh vidn Bach Mai. Tap chf dinh duPng vd thuc phdm. Sd 3+4,85-91.
2. Briony Thomas, Jacki Bishop (2007). Manual of Dietetic Practice. 4th ed., Oxford, UK.
3. Jane A,Read et al(2005). Nutritional Assessment in Cancer: Comparing the Mini-Nutritional Assessment (MNA) with the Scored Patient-Generated Subjective Global Assessment (PG-SGA., Nutrition and Cancer, Vol.53, issue 1 September 2005, 51-56.
4. HdHuyKhoi.LeT^ij Hdp (2012). Phuong phap djch t l hoc dinh dUPng. Nha Xuat b i n Y hpc. 57-61.
5.' J. Kondmp et al, ESPEN (2003). Guidelines for Nutrition Screening 2002. Clinical Nutrition 22(4), 415- 421.
6. Nguyin Vinh Quang, Le Phong (2011). Dieu fra kien thine, thai dp va thut; hanh phong chong benh dai thao duPng tai Viet Nam ndm 2011, http:/rtjenhviennoitiettmnguong.com.vn/content/item/optio n/tt-t-ct/parent/phong-chong-dai-thao-duong.
KIEN THilC, THAI DO HIV/AIDS VA N H Q N G RAO CAN TRONG TIEP CAN, SlT DUNG mCH VU Ttr VAN XET NGHIEM HIV TIT NGUYEN TRONG PHONG LAY TRUYEN ME CON
a PHU Nff MANG THAI TAI THANH PHO VI THANH, HAU GMNG, NAM 2011
NGUYEN THI THANH HUONG, VO THI H O A N G LOAN, TOM T A T
Nghiin citu md ti dt ngang cd phan tieh kit hgp phuang phip nghiin cdu dinh lugng. djnh tinh di xac dinh kiin thOe, thii dd vi HIV/AIDS vi xie dinh nhOng rio dn tmng tu vin xit nghiim HIV tu nguyin d nhdm phu nO mang thai tai thanh pho Vi Thanh, tlnh Hiu Giang, tO thing 2-9/2011. Nghien cOu dinh lugng dMc thuc hiin qua phdng vi'n tn/c tiip bing bd ciu hoi cd cau trOe vdi 240 phu nO da sinh eon trong 6 thing qua, dugc chgn ngau nhien he thong tai cdng ddng. Nghiin eifu dinh tinh tren 19 ddi tugng bao gdm can bi quin
PHAN THANH TUNG, N G U Y I N V A N L A N H
Ip, can bd tu vi'n tai cic ca sd y ti tai thinh pho Vi Thanh vi cic phu nO da sinh con tmng 6 thing qua cd vi khdng cd sd dung djch vu TVXNTN, dugc chgn co chu dieh thdng qua 6 cudc phdng vin siu vi 2 cudc thio luin nhdm. Kit qui nghiin cho thiy: tp le DTNC cd kiin thOe, thai do dn thiet vi HIV/AIDS chl Sat 44,2%o va 28.3%o. NhQng rao dn trong sddung dich vu TVXNTN xuat phat to d phia cung cip va sd dung djch vu nhu cin bd y te true tiip khim thai khdng ehii ddng to vin hay cung cap thdng tin vi dich vu
Y H p c THUC HANH (878) - SO 8/2013
