Knowledge, Attitudes, and Practices of Healthcare Professionals Toward Malnutrition Management: A Cross-Sectional Study from Al-Hawija General Hospital and Related Health Sectors, Kirkuk, Iraq

Abstract

Background: Hospital malnutrition affects 20–50% of inpatients globally, contributing to increased morbidity, prolonged stay, and mortality. Healthcare professionals (HCPs) are frontline in its detection and management, yet their knowledge, attitudes, and practices (KAP) remain largely undocumented in the Al-Hawija district, Kirkuk, Iraq. Objective: To assess the KAP of HCPs toward malnutrition management in Al-Hawija General Hospital and affiliated health facilities. Methods: A descriptive cross-sectional survey (N=126) used a structured Arabic questionnaire covering demographics, knowledge (13 items: Yes/No/Don't know), attitudes (10 Likert items, 1–5), practices (10 frequency items, 1–5), and open-ended barriers/recommendations. Results: Pharmacists (40.5%) and nurses (34.1%) predominated; only 17.5% had received clinical nutrition training. Mean knowledge score was 8.12±2.31/13 (62.5%); mean attitude score 3.66±0.55/5 (73.2%); mean practice score 3.09±1.10/5 (51.5%), revealing a significant KAP gradient (Attitudes > Knowledge > Practices). Critical knowledge gaps included unfamiliarity with MUST/NRS-2002 tools (70.6% 'Don't know'). Trained HCPs scored significantly higher on practices (3.67 vs. 2.96). Primary reported barriers were the absence of dietitians, insufficient training, and lack of standardised protocols. Conclusions: HCPs demonstrate positive attitudes but suboptimal knowledge and practices. Mandatory training, multidisciplinary nutrition teams, and standardised protocols are urgently needed.