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Journal of Human Nutrition and... Jun 2021Multi-component lifestyle interventions are the first line treatment for obesity. Dietitians are ideally placed healthcare professionals to deliver such interventions....
BACKGROUND
Multi-component lifestyle interventions are the first line treatment for obesity. Dietitians are ideally placed healthcare professionals to deliver such interventions. However, only a small proportion of patients with obesity are referred by general practice to dietitians, and the reasons for this are not clear. The present study aimed to explore general practice healthcare professionals' (GPHCPs) experiences and perceptions of dietitians in the context of obesity management.
METHODS
A convenience sample of GPHCPs practicing in the UK was recruited via a targeted social media strategy, using virtual snowball sampling. Data were collected using semi-structured interviews and analysed using framework analysis.
RESULTS
In total, 20 participants were interviewed (11 general practice nurses and nine general practitioners). Experiences of referring patients with obesity for dietetic intervention resulted in two main themes: (i) access barriers and (ii) the dietetic consult experience. Three themes emerged from participants' perceptions of a role for general practice dietitians: (i) utilising dietetic expertise; (ii) access to dietitian; and (iii) time. Participants experienced barriers to accessing dietitians for obesity management and felt that having a dietitian working within their general practice team would help address this. Having a dietitian embedded within their general practice team was perceived to have the potential to alleviate GPHCPs' clinical time pressures, offer opportunities for upskilling, and may improve patient engagement with obesity management.
CONCLUSIONS
GPHCPs perceived that embedding a dietitian within their general practice team would be valuable and beneficial for obesity management. Our findings provide support for the funding of general practice dietitian roles in the UK.
Topics: Dietetics; Female; General Practice; General Practitioners; Humans; Male; Nurses; Nutritionists; Obesity Management; Patient Care Team; Professional Role; Qualitative Research; Referral and Consultation; United Kingdom
PubMed: 33438804
DOI: 10.1111/jhn.12855 -
JBI Evidence Synthesis Dec 2021This scoping review aims to examine and map the evidence regarding communication skills in dietetic practice and the education strategies used to develop them....
OBJECTIVE
This scoping review aims to examine and map the evidence regarding communication skills in dietetic practice and the education strategies used to develop them. Specifically, the review will address usage in practice, perceptions, and experiences, as well as the teaching and assessment of communication skills in student dietitians and dietitians.
INTRODUCTION
Communication skills are a key element of practice for dietitians. Dietetic practice is evolving, and there is a need to explore the breadth of literature on communication skills for contemporary practice and how these skills are taught.
INCLUSION CRITERIA
This scoping review will consider empirical research on dietitians' or nutritionists' communication skills. This will include skills used in dietitian-patient communication, in communication interactions in different employment contexts, and diverse forms of communication (verbal, written, technological). We will consider the views of student dietitians, dietitians, and patients, as well as evidence regarding how communication skills are taught and assessed in dietetics. Sources may include experimental, quasi-experimental, observational, and qualitative studies.
METHODS
The following electronic databases will be searched: MEDLINE, Embase, CINAHL, ERIC, and PsycINFO. There will be no date limits. Reference lists of eligible studies will be back-searched. Google Scholar will be used for forward citation tracking. Conference proceedings from the previous five years will be searched for eight conferences of the professional associations of dietetics and health care education. ProQuest Dissertations and Theses, and WorldCat Dissertations and Theses will be searched for unpublished literature. The findings will be summarized in tabular format and a narrative synthesis.
Topics: Communication; Dietetics; Humans; Nutritionists; Qualitative Research; Review Literature as Topic
PubMed: 34149024
DOI: 10.11124/JBIES-20-00559 -
British Dental Journal Nov 2022Malnutrition is prevalent in patients with head and neck cancer (HNC) at diagnosis but can occur at any stage of the treatment pathway. The impact of disease burden and...
Malnutrition is prevalent in patients with head and neck cancer (HNC) at diagnosis but can occur at any stage of the treatment pathway. The impact of disease burden and treatment side effects can lead to altered anatomy, compromised quality and quantity of saliva and impaired swallowing function, which can result in deleterious effects on nutritional status. Optimising nutrition status is critical, as malnutrition is adversely associated with treatment tolerance and outcomes, wound healing, morbidity, mortality, quality of life and survival. Dietitians are integral members of the HNC multidisciplinary team and are uniquely qualified in the assessment, management and optimisation of nutritional status across the care pathway. This includes providing informational counselling to patients and carers on the short- and long-term nutritional impact of planned treatments alongside multidisciplinary members. Dietitians lead on the recommendation, provision and monitoring of nutrition support, which can be via the oral, enteral or parenteral route. Oral nutrition support includes dietary counselling, nourishing dietary, food fortification advice and high energy/protein oral nutritional supplements. Enteral nutrition support, or tube feeding, can be required on a short- and/or long-term basis and dietitians support appropriate decision-making for the type of tube and timing of placement across the care pathway.
Topics: Humans; Nutritionists; Quality of Life; Nutritional Support; Malnutrition; Head and Neck Neoplasms; Nutritional Status
PubMed: 36369557
DOI: 10.1038/s41415-022-5107-8 -
Journal of Human Nutrition and... Aug 2021Oral health is affected by dietary practices and may impact quality of life. Collaboration between dietetics and dental professionals for oral health promotion and...
BACKGROUND
Oral health is affected by dietary practices and may impact quality of life. Collaboration between dietetics and dental professionals for oral health promotion and disease prevention is recommended. The present study aimed to determine the knowledge and practice of dentists and dietitians on diet and dental health.
METHODS
The study comprised a cross-sectional online questionnaire, which was disseminated electronically to dentists and dietitians in the UK and Ireland, via national networks. Questions assessed participants' knowledge of the cariogenicity of different foods, snacking behaviours, familiarity with UK dietary guidelines, dietary advice and their recommendations for cross-professional consistency.
RESULTS
In total, 418 responses were received (60% dentists, 40% dietitians). Inter-profession knowledge differences were observed for the cariogenicity of sports drinks (p < 0.001), chocolate/confectionary (p < 0.001), yoghurt (p < 0.001) and sugar-coated breakfast cereals plus milk (p < 0.0001). Dentists showed greater concern over the timings and frequency of food consumption than dietitians. A greater proportion of dentists felt nutrition and oral health counselling is a key component of regular patient care (58.4% versus 8.2%, p < 0.001). Only 18% of dietitians, compared to 56% of dentists, considered that they had received sufficient training about diet and dental health. Both professions indicated the need for multi-disciplinary training.
CONCLUSIONS
Dietitians and dentists differ with respect to their knowledge about the effects of snacks and snacking behaviours on dental health, as well as how they prioritise this in their clinical practice. Both professions show a willingness to work collaboratively to ensure accurate and consistent advice-giving and expertise-sharing.
Topics: Adult; Counseling; Cross-Sectional Studies; Dentists; Diet; Diet, Cariogenic; Female; Health Knowledge, Attitudes, Practice; Humans; Ireland; Male; Middle Aged; Nutrition Policy; Nutritionists; Oral Health; Snacks; Surveys and Questionnaires; United Kingdom
PubMed: 33411983
DOI: 10.1111/jhn.12842 -
Journal of the Academy of Nutrition and... Nov 2022Pediatrics spans the first 2 decades of life and is a dynamic period with rapid changes in size and physical ability, cognitive development, behavior, and nutrient...
Academy of Nutrition and Dietetics: Revised 2022 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Pediatric Nutrition.
Pediatrics spans the first 2 decades of life and is a dynamic period with rapid changes in size and physical ability, cognitive development, behavior, and nutrient needs. Registered dietitian nutritionists (RDNs) who work with the pediatric population provide the nutrition knowledge and support needed to promote optimal health and nutrition during this time across a variety of settings. The Pediatric Nutrition Practice Group, along with the Academy of Nutrition and Dietetics Quality Management Committee, have updated the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for RDNs working with pediatric populations. The SOP and SOPP for RDNs in Pediatric Nutrition provide indicators that describe 3 levels of practice: competent, proficient, and expert. The SOP uses the Nutrition Care Process and clinical workflow elements for delivering patient/client care. The SOPP describes the 6 domains that focus on professional performance. Specific indicators outlined in the SOP and SOPP illustrate how these standards apply to practice. The SOP and SOPP are intended to be used as a self-evaluation tool for assuring competent practice in pediatric nutrition and for determining potential education and training needs for advancement to a higher practice level in a variety of settings.
Topics: Humans; Child; Nutritionists; Dietetics; Clinical Competence; Academies and Institutes; Nutrition Therapy
PubMed: 36272737
DOI: 10.1016/j.jand.2022.07.005 -
Casopis Lekaru Ceskych 2020Setting the right eating habits is one of the basic pillars of non-pharmacological treatment of obese patient. Nutritional interventions led by dietitians are a key part...
Setting the right eating habits is one of the basic pillars of non-pharmacological treatment of obese patient. Nutritional interventions led by dietitians are a key part of obesity management. The principle of modern nutritional therapy is not the transmission of general information about nutrition, but individualized recommendations. The task of a dietitian is to provide information that is specific, requested, at the right time and in the right form, information that is understandable to the patient and can be included in his/her life. Dietitian creates a therapeutic relationship with the patient based on trust and accompanies them on his path to mastering the principle of a diet for weight loss. There is thus a shift from a rigid approach to dietary treatment of obese patients, where instead of prescribing a diet aiming at weight loss, the patient is given space for their own active involvement. Emphasis is placed on the long-term sustainability of the newly set regime. Therefore, not only the present comorbidities of obesity, but also other factors such as the patient's daily routine, level of physical activity and individual habits are considered in a well-performed nutritional intervention.
Topics: Diet; Exercise; Female; Humans; Male; Nutritionists; Obesity; Weight Loss
PubMed: 33297688
DOI: No ID Found -
Mayo Clinic Proceedings Mar 2020
Topics: Diet, Mediterranean; History, 20th Century; Nutritionists; United States
PubMed: 32138891
DOI: 10.1016/j.mayocp.2019.12.012 -
Israel Journal of Health Policy Research Feb 2020A recurring problem in medical institutions is patients not always receiving food meeting their nutritional and medical needs. A proposed contributing factor is non-...
BACKGROUND
A recurring problem in medical institutions is patients not always receiving food meeting their nutritional and medical needs. A proposed contributing factor is non- inclusion of dietitians in food service staff. Recently, positions for food service dietitians in hospitals were created. For the newly defined role of "Food Service Dietitian", comprehensive training courses were developed (70 dietitians participated).
OBJECTIVE
To examine the impact of the addition of the role of a "Food Service Dietitian" in medical institutions on suitability of foods served, food costs and food waste.
METHODS
A three years (2014-2017) national case study to examine the new role's impact was carried out, in 18 hospitals, nine of which employ a food service dietitian (intervention), and 9 without (control). The number of nutritional analyses of menus was checked, as was the extent of kitchen staff training, and how often night meals were served for all patients. Data were gathered regarding food costs and waste with respect to food distributed to staff and patients. Food costs savings and waste reduction were calculated, based on reduction in provision of unnecessary meals, at a cost of 18 NIS per day per meal.
RESULTS
Kitchen staff training was carried out in all intervention institutions, and not in the controls. In most controls, nutritional analyses were not performed, whereas in the intervention hospitals, full analyses were performed and tailoring of menus to specific department requirements improved significantly. In most intervention hospitals, late night snacks were provided, this not being so in the controls. Total food cost savings of $229,569 per annum was seen in the six intervention hospitals, attributable to 4 factors: 1.Meals not delivered to fasting patients, or those receiving parenteral/enteral nutrition- cost savings of 328,500 NIS ($93,857)2.Better tailoring and monitoring of food delivered to the wards and staff (bread, cheese, milk etc)- annual cost savings of 235,000 NIS ($67,142) in the hospitals with a food service dietitian.3.Checking expiry dates of medical foods, and improved communication between the wards, the kitchen and the food distribution centers, has lessened food waste with savings of 5% from the medical food budget per annum of 40,000 NIS ($11,428).4.As a result of dietitian-performed nutritional analyses, tailoring of food provided according to the patient's medical and nutrition needs was improved. In one hospital, after re-evaluation of serve sizes in high protein diets, sizes were reduced while retaining adequacy, with immediate cost savings of 200,000 NIS ($57,142) per annum.
CONCLUSIONS
Implementation of the new role of Food Service Dietitian led to cost savings and significant improvements in adherence to the nutritional care plan.
Topics: Adult; Female; Food Service, Hospital; Hospitals; Humans; Israel; Male; Nutritionists; Nutritive Value; Organizational Case Studies; Patient Satisfaction; Refuse Disposal
PubMed: 32014056
DOI: 10.1186/s13584-020-0362-0 -
Health Expectations : An International... Jun 2019The aim of this study was to compare patients' and dietitians' perceptions of patient-centred care (PCC) in dietetic practice. (Comparative Study)
Comparative Study
AIM
The aim of this study was to compare patients' and dietitians' perceptions of patient-centred care (PCC) in dietetic practice.
METHODS
Participants were as follows: (a) adult patients who had attended ≥1 individual dietetic consultation with an Accredited Practicing Dietitian (APD) working in primary care; and (b) APDs with experience working in primary care. A cross-sectional survey was undertaken using a patient- and dietitian-reported inventory to measure PCC in dietetic practice. The inventory comprised of five previously validated scales: The Communication Assessment Tool; the 9-item Shared Decision-Making Questionnaire; the Patient-Doctor Depth of Relationship Scale; the Schmidt Perception of Nursing Care Scale-Seeing the Individual Patient sub-scale; and the Person-Centred Practice Inventory-Staff -Providing Holistic Care sub-scale. Descriptive statistics were used to analyse participant characteristics and to compute total scores for the five scales. The Mann-Whitney U test was used to compare median scores between patients and dietitians.
RESULTS
One-hundred and thirty-three patients and 180 dietitians completed the survey. Patients reported significantly higher scores compared to dietitians for "shared decision-making" (P = 0.004), but significantly lower scores for "providing holistic and individualized care" (P = 0.005), "knowing the patient/dietitian" (P = 0.001) and "caring patient-dietitian relationships" (P =0.009).
CONCLUSION
This study highlighted potentially important differences between patients' and dietitians' perceptions of PCC and identified key aspects of dietetic care requiring practice improvements. Strategies are needed to bridge gaps between dietitians' and patients' perceptions and enhance PCC in dietetic practice. These findings suggest that dietitians should focus on individualizing nutrition care, gaining a holistic understanding of their patients and knowing/understanding each patient.
Topics: Adult; Australia; Cross-Sectional Studies; Decision Making, Shared; Female; Holistic Health; Humans; Male; Middle Aged; Nutrition Therapy; Nutritionists; Patient-Centered Care; Patients; Professional-Patient Relations; Surveys and Questionnaires
PubMed: 30672086
DOI: 10.1111/hex.12868 -
Nutrients Jan 2024Many patients undergo small bowel and colon surgery for reasons related to malignancy, inflammatory bowel disease (IBD), mesenteric ischemia, and other benign... (Review)
Review
Many patients undergo small bowel and colon surgery for reasons related to malignancy, inflammatory bowel disease (IBD), mesenteric ischemia, and other benign conditions, including post-operative adhesions, hernias, trauma, volvulus, or diverticula. Some patients arrive in the operating theatre severely malnourished due to an underlying disease, while others develop complications (e.g., anastomotic leaks, abscesses, or strictures) that induce a systemic inflammatory response that can increase their energy and protein requirements. Finally, anatomical and functional changes resulting from surgery can affect either nutritional status due to malabsorption or nutritional support (NS) pathways. The dietitian providing NS to these patients needs to understand the pathophysiology underlying these sequelae and collaborate with other professionals, including surgeons, internists, nurses, and pharmacists. The aim of this review is to provide an overview of the nutritional and metabolic consequences of different types of lower gastrointestinal surgery and the role of the dietitian in providing comprehensive patient care. This article reviews the effects of small bowel resection on macronutrient and micronutrient absorption, the effects of colectomies (e.g., ileocolectomy, low anterior resection, abdominoperineal resection, and proctocolectomy) that require special dietary considerations, nutritional considerations specific to ostomized patients, and clinical practice guidelines for caregivers of patients who have undergone a surgery for local and systemic complications of IBD. Finally, we highlight the valuable contribution of the dietitian in the challenging management of short bowel syndrome and intestinal failure.
Topics: Humans; Nutritionists; Nutrition Disorders; Colectomy; Inflammatory Bowel Diseases
PubMed: 38257141
DOI: 10.3390/nu16020246