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PloS One 2021Healthcare professionals provide paid care at work and potentially have caregiving responsibilities outside of work; work responsibilities in addition to child and/or...
Healthcare professionals provide paid care at work and potentially have caregiving responsibilities outside of work; work responsibilities in addition to child and/or elder care is considered double- or triple-duty care. Employees may experience conflict and/or enrichment as their work and family responsibilities interface. This study's purpose is to explore the work and family interface of Registered Dietitian Nutritionists (RDNs), determine the prevalence of work-family conflict and enrichment, and identify characteristics associated with higher work-family conflict and enrichment scores. A survey instrument assessing caregiving responsibilities and work-family conflict and enrichment was distributed electronically to 4,900 RDNs throughout the United States. Frequencies, means, correlative relationships, and ANCOVA were calculated using SAS software 9.04. Of 1,233 usable responses, nearly two-thirds of RDNs (65.5%) reported providing either double-duty or triple-duty care. About half of RDNs (47.2%) reported work-family conflict and fewer (14.8%) reported family-work conflict. Additionally, most RDNs (79.4%) reported work-family enrichment and even more (85.2%) reported family-work enrichment. Higher work-family conflict scores had correlative relationships with higher levels of burnout, lower life satisfaction, and higher intent to quit. Higher work-family enrichment scores had correlative relationships with lower burnout, higher job satisfaction, higher career satisfaction, higher life satisfaction, and lower intent to quit. Understanding the unpaid caregiving responsibilities of RDNs and the interface of work/family responsibilities may provide insight into career planning for RDNs and guide managers of RDNs in efforts to amplify the contribution of RDNs.
Topics: Adult; Aged; Burnout, Professional; Caregivers; Delivery of Health Care; Family; Family Conflict; Female; Health Personnel; Humans; Job Satisfaction; Male; Middle Aged; Nutritionists; Surveys and Questionnaires; United States
PubMed: 33690670
DOI: 10.1371/journal.pone.0248109 -
Alimentary Pharmacology & Therapeutics Apr 2023
Topics: Humans; Nutritionists; Surveys and Questionnaires; Health Knowledge, Attitudes, Practice
PubMed: 36952272
DOI: 10.1111/apt.17446 -
Journal of Renal Nutrition : the... Jan 2022This study described the job responsibilities and modalities of care among dialysis dietitians in the United States and their observations regarding the nutrition needs...
OBJECTIVE
This study described the job responsibilities and modalities of care among dialysis dietitians in the United States and their observations regarding the nutrition needs of their patients, during the COVID-19 pandemic.
DESIGN AND METHODS
Cross-sectional online survey captures dietitian characteristics and responsibilities, dialysis facility characteristics, and patient needs. We recruited US dialysis dietitians. We used chi-square tests to compare respondent stress and facility-level policies regarding eating/drinking and oral nutrition supplements based on facility ownership type.
RESULTS
We received 191 complete or partial survey responses. Sixty-three percent of respondents stated that their center banned eating/drinking during dialysis due to COVID-19 masking policies. DaVita and non-profit facilities were significantly more likely to still allow eating/drinking during dialysis (31% and 29%, respectively) compared to Fresenius facilities (7%). A common theme in open-ended responses regarding nutrition care for COVID-19-positive patients was providing less care to these patients. A majority of respondents admitted to stress from working in healthcare during COVID-19. The majority of respondents indicated that patients were taking precautions such as having a family member or friend grocery shop for them (69%) or going to the store less often (60%). Just over a quarter of respondents indicated that affordability of food was a concern among patients. Seventy-two percent reported that patients were cooking at home more often, 60% had observed an increase in serum phosphorus, and 72% an increase in interdialytic weight gain.
CONCLUSIONS
Due to the increased risk of malnutrition and symptoms that can affect dietary intake in COVID-positive patients, and the economic conditions leading to increased rates of food insecurity, dietitians must be proactive in preventing and/or treating malnutrition through adequate protein and energy intake. Eating/drinking bans should not become permanent and dialysis centers should take precautions to allow intradialytic meals and oral nutrition supplement protocols to continue during the pandemic.
Topics: COVID-19; Cross-Sectional Studies; Humans; Nutritionists; Pandemics; Renal Dialysis; SARS-CoV-2; United States
PubMed: 34465503
DOI: 10.1053/j.jrn.2021.07.006 -
Journal of the Academy of Nutrition and... Jan 2020The US health care system has been undergoing substantial changes in reimbursement for medical and nutrition services. These changes have offered opportunities and...
The US health care system has been undergoing substantial changes in reimbursement for medical and nutrition services. These changes have offered opportunities and challenges for registered dietitian nutritionists (RDNs) to bill for medical nutrition therapy and other nutrition-related services. During the past 10 years, the Academy of Nutrition and Dietetics has periodically surveyed RDNs providing medical nutrition therapy in ambulatory care settings to learn about their knowledge and patterns of coding, billing, and payment for their services. In 2018, the Academy of Nutrition and Dietetics conducted the latest iteration of this survey. This article compares the results of the 2008, 2013, and 2018 surveys to examine changes in RDNs' knowledge of billing code use and reimbursement patterns over time; understand the potential influences on coding and billing practices in a changing health care environment; and understand the effects of newer practice settings and care delivery models on billing and reimbursement for medical nutrition therapy services. Results from these surveys demonstrate that during the past 10 years RDNs' knowledge of billing and coding has been stable and very low for RDNs not in supervisory roles or private practice. RDNs reported an increase in providing medical nutrition therapy services to patients with multiple conditions. Since 2013, a dramatic increase was noted in the reported proportion of reimbursement from private/commercial health insurance plans. Results also indicate that most RDNs are not aware of changes in health care payment. Individual RDNs need to understand and be held accountable for the business side of practice and their value proposition in today's health care environment.
Topics: Adult; Clinical Coding; Delivery of Health Care; Dietetics; Female; Humans; Insurance, Health, Reimbursement; Knowledge; Male; Middle Aged; Nutrition Therapy; Nutritionists; Surveys and Questionnaires; United States
PubMed: 31353317
DOI: 10.1016/j.jand.2019.05.008 -
Nutrition, Metabolism, and... Apr 2022It is well accepted by the medical literature that polycystic ovary syndrome (PCOS) is an extremely heterogeneous condition and that a multidisciplinary approach,...
It is well accepted by the medical literature that polycystic ovary syndrome (PCOS) is an extremely heterogeneous condition and that a multidisciplinary approach, involving gynecologists, endocrinologists, primary healthcare providers, mental health professionals, and nutritional professionals, especially dietitians, is fundamental to provide an immediate care and to counteract long-term risk factors related to the comorbidity of PCOS. Although lifestyle modifications are the first step intervention in the treatment of PCOS, unfortunately, the involvement of dietitian in clinical practice remains sporadic. The goal of this viewpoint is to put a greater emphasis on the role of dietitian in the management of PCOS by highlighting frequently faced difficulties in the clinical settings and the importance of a three-step nutritional care: accurate assessment; lifestyle, nutritional, and supplementary intervention; long-term follow-up. The intention is to raise awareness among dietitians themselves and other health providers as well as to express an exceeding necessity of evidence-based guidelines formulated specifically for nutritional professionals, which would allow a uniform approach with respect to heterogeneity and complexity of PCOS at the international level.
Topics: Endocrinologists; Female; Humans; Life Style; Motivation; Nutritionists; Polycystic Ovary Syndrome
PubMed: 35168829
DOI: 10.1016/j.numecd.2022.01.003 -
Canadian Journal of Dietetic Practice... Sep 2014
Topics: Achievement; Canada; Dietetics; Evidence-Based Medicine; Goals; Humans; Leadership; Nutrition Policy; Nutritionists; Societies, Scientific; Workforce
PubMed: 26066812
DOI: 10.3148/cjdpr-2014-015 -
Journal of the Academy of Nutrition and... Jun 2020The Academy of Nutrition and Dietetics (Academy) develops and maintains foundational documents that apply to all registered dietitian nutritionists (RDNs) and nutrition...
The Academy of Nutrition and Dietetics (Academy) develops and maintains foundational documents that apply to all registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs): Scope of Practice for the RDN and NDTR; Standards of Practice in Nutrition Care and Standards of Professional Performance for RDNs and NDTRs; and the Academy and the Commission on Dietetic Registration Code of Ethics for the Nutrition and Dietetics Profession. The Quality Management Committee of the Academy has developed resources that assist RDNs and NDTRs in understanding how to work to the fullest extent of their individual scope of practice to increase professional satisfaction, achieve future employment and position goals, and provide safe and reliable services. These resources are the definition of terms list, practice tips and case studies, and scope of practice decision algorithm, which build on Academy foundational documents. They support quality practice by answering questions such as "how can I become more autonomous in my practice" and "how can I use telehealth technology in my practice?" The foundational Academy documents and practice application resources assist all RDNs and NDTRs in recognizing their individual competence and practicing within their scope of practice.
Topics: Academies and Institutes; Clinical Competence; Codes of Ethics; Dietetics; Humans; Nutrition Therapy; Nutritionists; Standard of Care
PubMed: 32446565
DOI: 10.1016/j.jand.2020.03.003 -
Journal of Primary Health Care Dec 2015Dietetic intervention is effective in the management of nutrition-related conditions and their comorbidities. New Zealand has an increasing need for primary and... (Review)
Review
INTRODUCTION
Dietetic intervention is effective in the management of nutrition-related conditions and their comorbidities. New Zealand has an increasing need for primary and preventive health care to reduce the burden of non-communicable disease.
AIM
To review the recent evidence of effectiveness of dietetic intervention in primary health care on health and wider economic outcomes. Health benefits and cost benefits of employing dietitians to perform nutrition intervention in the primary health care setting are evaluated in the areas of obesity in conjunction with diabetes and cardiovascular disease, and malnutrition in older adults.
METHODS
An electronic literature search of four scientific databases, websites of major dietetic associations and high-impact nutrition and dietetic journals was conducted. Randomised controlled trials and non-randomised studies conducted from 2000 to 2014 were included.
RESULTS
Dietetic intervention demonstrates statistically and clinically significant impacts on health outcomes in the areas of obesity, cardiovascular disease, diabetes, and malnutrition in older adults, when compared to usual care. Dietitians working in primary health care can also have significant economic benefits, potentially saving the health care system NZ$5.50-$99 for every NZ$1 spent on dietetic intervention.
DISCUSSION
New Zealand must look to new models of health care provision that are not only patient-centred but are also cost-effective. This review demonstrates that dietitians in primary health care can improve patients' health and quality of life. Increasing the number of dietitians working in primary health care has the potential to make quality nutrition care accessible and affordable for more New Zealanders.
Topics: Cardiovascular Diseases; Cost-Benefit Analysis; Diabetes Mellitus; Humans; Malnutrition; New Zealand; Nutritionists; Obesity; Primary Health Care
PubMed: 26668838
DOI: 10.1071/hc15324 -
Journal of Renal Nutrition : the... Nov 2023Recent surveys highlight gross workforce shortage of dietitians in global kidney health and significant gaps in renal nutrition care, with disparities greater in... (Review)
Review
BACKGROUND
Recent surveys highlight gross workforce shortage of dietitians in global kidney health and significant gaps in renal nutrition care, with disparities greater in low/low-middle income countries.
OBJECTIVE
This paper narrates ground experiences gained through the Palm Tocotrienols in Chronic Hemodialysis (PaTCH) project on kidney nutrition care scenarios and some Asian low-to-middle-income countries namely Bangladesh, India, and Malaysia.
METHOD
Core PaTCH investigators from 3 universities (USA and Malaysia) were supported by their postgraduate students (n = 17) with capacity skills in kidney nutrition care methodology and processes. This core team, in turn, built capacity for partnering hospitals as countries differed in their ability to deliver dietitian-related activities for dialysis patients.
RESULTS
We performed a structural component analyses of PaTCH affiliated and nonaffiliated (Myanmar and Indonesia) countries to identify challenges to kidney nutrition care. Deficits in patient-centered care, empowerment processes and moderating factors to nutrition care optimization characterized country comparisons. Underscoring these factors were some countries lacked trained dietitians whilst for others generalist dietitians or nonclinical nutritionists were providing patient care. Resolution of some challenges in low-to-middle-income countries through coalition networking to facilitate interprofessional collaboration and task sharing is described.
CONCLUSIONS
We perceive interprofessional collaboration is the way forward to fill gaps in essential dietitian services and regional-based institutional coalitions will facilitate culture-sensitive capacity in building skills. For the long-term an advanced renal nutrition course such as the Global Renal Internet Course for Dietitians is vital to facilitate sustainable kidney nutrition care.
Topics: Humans; Nutritional Status; Delivery of Health Care; Surveys and Questionnaires; Renal Dialysis; Kidney; Nutritionists
PubMed: 37597574
DOI: 10.1053/j.jrn.2023.08.003 -
The Proceedings of the Nutrition Society May 2015The need to support people to change diet-related behaviour is widely advocated and how to do this effectively in practice is an expanding area of research. Important... (Review)
Review
The need to support people to change diet-related behaviour is widely advocated and how to do this effectively in practice is an expanding area of research. Important factors to consider are how healthcare practitioners communicate with their patients and how that communication may affect diet-related behaviour change and subsequent outcomes. The aim of the present paper is to discuss communication skills for behaviour change (CSBC), focusing predominantly on registered dietitians who are required to communicate effectively and have an important role in supporting patients to change diet-related behaviour. The views of dietitians in relation to CSBC have been investigated and respondents have consistently reported that they perceive these skills to be of vital importance in practice. Patient views have reiterated the importance of good CSBC in one-to-one consultations. However, pre-qualification training of dietitians is thought to deliver practitioners who are competent at a minimum level. The need for ongoing continuous professional development (CPD) in relation to CSBC has been recognised but currently most CPD focuses on updating knowledge rather than improving these essential skills. Measuring CSBC in a consistent and objective manner is difficult and an assessment tool, DIET-COMMS, has been developed and validated for this purpose. DIET-COMMS can be used to support CSBC development, but concerns about logistical challenges and acceptability of implementing this in practice have been raised. Although a suitable assessment tool now exists there is a need to develop ways to facilitate assessment of CSBC in practice.
Topics: Behavior Control; Behavior Therapy; Clinical Competence; Communication; Congresses as Topic; Education, Continuing; European Union; Evidence-Based Medicine; Humans; Nutrition Policy; Nutritionists; Patient Compliance; Precision Medicine; Professional Role; Professional-Patient Relations
PubMed: 25582531
DOI: 10.1017/S0029665114001724