Assessment of nutritional knowledge, attitudes and practices among caregivers of institutionalised individuals with special healthcare needs in Kottayam, Kerala

This study aimed to assess the knowledge, attitude and practices (KAP) of caregivers working in institutional settings and to identify factors influencing the nutritional well-being of individuals under their care. The research was conducted among 145 caregivers from government, private and non-governmental institutions in Kottayam, Kerala, selected using purposive sampling. Data were collected through a semi-structured questionnaire covering sociodemographic characteristics and caregivers’ knowledge, attitude and practices, followed by a nutrition education intervention delivered through posters and PowerPoint presentations. Statistical analysis revealed that the majority of caregivers were female (95%), 52% possessed graduate-level qualifications and 63% had received prior nutrition training. The findings showed satisfactory general knowledge related to balanced diets, hydration and feeding positions, but limited understanding of micronutrient sources, feeding difficulties and special dietary requirements. Attitudes towards nutrition were largely positive, with 65% recognising its importance in the growth and development of individuals with special healthcare needs, although awareness of therapeutic diets such as gluten- and casein-free diets was comparatively low. Care practices were generally adequate with respect to hygiene, texture modification and hydration, but gaps were noted in consulting dietitians, managing food allergies and ensuring appropriate meal frequency. Significant positive correlations were observed between knowledge and attitude, as well as between attitude and practice. The study concludes that structured nutrition education, regular refresher training and the involvement of qualified dietitians are essential to address existing gaps and enhance the quality of nutritional care in institutional settings.