RESUMEN
BACKGROUND: At hospital level, clinical nutritionists play a fundamental role in health recovery, contributing to shorter hospital stays and addressing hospital malnutrition. However, in Latin America no studies have been conducted on the activities of the nutritionist and the factors influencing their performance. AIMS: to describe the activities of the clinical nutritionist in public and private hospital settings in Latin America and to determine the factors associated with disciplinary practice. METHODS: A cross-sectional analytical, quantitative study was conducted. Participants consisted of hospital nutritionists from 13 Latin American countries who had participated in a previously validated online survey on the activities performed during their daily work, obtaining a Professional Activities Score (PAS). RESULTS: 1222 nutritionists participated. Of the activities associated with the professional role, the only ones who reached over 75 % of execution were: performing nutritional intervention; performing nutritional assessment and diagnosis; providing counseling and dietary prescription; developing nutritional care plans for patients with nutritional problems; and performing the monitoring and evaluation of results of priority patients. The least frequent activities were: university teaching and collaborating in research. Regarding the reasons for not performing activities: 34.0 % reported not being included in the activities, 24.5 % mentioned lack of time, and 13.6 % indicated that the activities were conducted by another professional. Variables positively associated with an increase in the PAS were: having spent more years exercising the profession (Beta: 0.028, 95 % CI: 0.004; 0.051), and having a greater number of specialties (4 or more, Beta: 2.294, 95 % CI: 1.031; 3.557). Working in lower-complexity facilities (Low: Beta: -1.037, 95 % CI: -1.443; -0.630), and having more reasons for not performing the activities (3 or more: Beta: -3.105, 95 % CI: -4.111; -2.099) were inversely associated. From the sample, 1.8 % held a doctorate in clinical nutrition, 43.9 % had a specialty, and 64.4 % had a diploma or postgraduate degree in clinical nutrition. CONCLUSION: None of the activities related to the nutritionist work was performed on a 100 % basis. In Latin America, Ministries of Health should standardize and regulate the functions of the clinical nutritionist, as well as quantifying understaffing and proposing solutions to alleviate the shortage of these professionals, acknowledging the positive impact that they have on the recovery of hospital patients.
Asunto(s)
Nutricionistas , Humanos , Estudios Transversales , Apoyo Nutricional , Evaluación Nutricional , ConsejoRESUMEN
A clinical nutritionist (CN) is a university-educated professional trained to perform preventive and recovery functions in the health of patients. The actions of these professionals, both worldwide and in Latin America, may face barriers and opportunities that require careful identification and examination. The main objective of this study is to identify the most important barriers and opportunities for the clinical nutritionist in 13 Latin American countries. A qualitative study was carried out; the initial phase involved conducting in-depth individual interviews with 89 informants, experienced CNs from 13 Latin American countries. After calculating the mean and standard deviation, we ranked the top 10 most frequently reported barriers by assigning a score ranging from 1 to 10. Additionally, 3 opportunities were identified with a lower score from 1 to 3. Means and standard deviation were calculated to sort the responses. Results: the most important barrier was the absence of public policies that regulate and/or monitor compliance with the staffing of CNs according to the number of hospital beds, while the most important opportunity was the advances in technology such as software, body analysis equipment and other tools used in Nutritional Care. The identified barriers can interfere with the professional performance of CNs and, moreover, make it difficult to monitor the good nutritional status of patients. It is recommended to consider the barriers identified in this study, as well as the opportunities, with a view to improving the quality of hospital services with an adequate supply of nutritionists.