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1.
Rev Gaucha Enferm ; 41(spe): e20190121, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32294685

RESUMO

OBJECTIVE: To know the spiritual care practices of health workers in the context of an inpatient unit for the treatment of addictive disorders, aiming to incorporate an expanded care practice. METHOD: Qualitative study considering the Convergent Care Research theoretical framework. The data collection occurred using semi-structured interviews, with three rounds of conversations and informal chats with 14 health professionals, from July to November 2017. The analysis followed the steps of apprehension, synthesis, theorization and transference. RESULTS: Four categories emerged: respect for user ethical values; addressing the beliefs and values of professionals; the health professional-user relationship; and collective spiritual care. The main actions highlighted were individual (relaxation and prayer) and collective (meditation, spirituality and the 12 steps). CONCLUSION: The rounds of conversations carried out in this research allowed workers to talk about spiritual care in addiction, to better understand its relevance to meet the needs of the patient.


Assuntos
Pessoal de Saúde , Assistência Religiosa , Espiritualidade , Centros de Tratamento de Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Adulto , Feminino , Pessoal de Saúde/ética , Pessoal de Saúde/organização & administração , Pessoal de Saúde/psicologia , Humanos , Masculino , Meditação , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem/psicologia , Nutricionistas/psicologia , Assistência Religiosa/ética , Relações Profissional-Paciente , Psicologia , Pesquisa Qualitativa , Religião , Respeito , Transtornos Relacionados ao Uso de Substâncias/psicologia
3.
Arerugi ; 68(10): 1213-1220, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31827030

RESUMO

BACKGROUND & AIM: In the clinical field of food allergies, dietary management towards patients is done inadequately. One plausible reason for this is the possible deficiency of food allergy education during the training courses for registered dietitians. This time, we will investigate the actual situations of food allergy education practiced in the training courses of registered dietitians, and reveal the point at issue. METHOD: We conducted a factual survey via mailing method towards registered dietitian and dietitian nutritionist training facilities throughout the whole country. The survey items include the existence of lectures or practical trainings about food allergies, the pre-graduate education of food allergies, and much more. RESULTS: We got answers from 213 facilities (collection rate 75%). Lectures about food allergies were conducted in 96% of the facilities, and the median of the lecture hour was 210 minutes. Similarly, practical trainings were conducted in 74% of the facilities, and the median was 90 minutes. The rate of people who strongly feel the need for food allergy education was 49%, and the rate for people who felt it was 50%. However, the rate of an ideal educational condition was 32%, and the rate of people who didn't have any plans of increasing the number of lectures and practical trainings were 82%. The major reasons for this were, the crammed condition of the curriculums, and the difficulties conducting lectures and practical trainings that span over several fields of expertise. CONCLUSION: In the training courses of registered dietitians, the practice of food allergy education is hardly adequate, and the educational sites seem to recognize the problem, but they are also pessimistic regarding the improvement of the situation due to the difficult problems that were revealed in this survey. From now on, it is strongly expected for the government and its people to work together to improve the current situation.


Assuntos
Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/terapia , Nutricionistas/educação , Humanos , Japão , Inquéritos e Questionários
4.
BMC Med Educ ; 19(1): 458, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31823774

RESUMO

BACKGROUND: This study investigated employers' perspectives on the impact of a supervised practice program (SPP), guided by international accreditation standards on the skill development and potential employability of dietetics students. MAIN BODY: This study was based on qualitative research. Fifteen potential employers, who also served as SPP preceptors, participated in this study. Participants were interviewed using semi-structured questionnaire. All interviews were conducted face-to-face by a trained interviewer. Participates were invited to discuss their own experiences in the current SPP, their perceptions of the impact of SPP on skills and attributes of graduates, and their overall ideas of how SPP may contribute to the employability of graduates. This study found that the SPP program guided by international accreditation standards shaped the duties and responsibilities of preceptors/supervisors and promoted a beneficial relationship between preceptors and SPP students. The benefits to graduates include bridging the gap between classroom didactic knowledge and practice; improving workplace self-confidence; developing competencies such as critical-thinking, communication, interviewing, and counselling skills in various multidisciplinary and multicultural settings. In addition, the preceptors suggested that accreditation-guided SPP contributes to the employability of graduates. Also, they opined that it reduced the need for orientation and shortened the probation time because students were familiar with the work environment and work flow. This lead to the improved preparedness for work. CONCLUSION: SPP based on set of competencies guided by international accreditation standards provides an up-to-date curriculum, improves the quality of the nutrition and dietetics services, and increases the potential employability of the graduates.


Assuntos
Acreditação , Emprego , Nutricionistas/educação , Nutricionistas/normas , Preceptoria , Sociedades , Competência Clínica , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pesquisa Qualitativa
5.
Can J Diet Pract Res ; 80(4): 163, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31736395
6.
J Nutr Sci Vitaminol (Tokyo) ; 65(5): 435-442, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31666481

RESUMO

This study aimed to verify the relationship between assignment of professional registered dietitians (RDs) and other healthcare professionals and body weight or functional outcome in underweight patients. This was a secondary analysis of the nation-wide survey data from Kaifukuki (convalescent) rehabilitation wards (KRWs). Data of patients aged ≥20 y with disabilities and body mass index (BMI) <18.5 kg/m2 and who were discharged from 1,099 KRWs were analyzed. The primary outcome was BMI at discharge. Secondary outcomes were Functional Independence Measure (FIM) at discharge and returning to home. Patients were divided into two groups: those in KRWs with ≥1 or <1 dedicated RD per ward (KRW/RD+ and KRW/RD-, respectively). Of 5,843 eligible participants (female, 63%; median age, 82 y; hip/vertebral/knee fracture, 47%; stroke, 34%; disuse syndrome secondary to acute illness, 11%; others, 8%), 1,288 and 4,555 were from the KRW/RD+ and KRW/RD- groups, respectively. At discharge, KRW/RD+ patients had higher FIM (93 vs. 90) and BMI (17.1 vs. 17.0 kg/m2) than did KRW/RD- patients. Multivariable analysis showed that assignment of dedicated RDs (B=0.213, 95% confidence interval [CI], 0.036-0.389), number of nurses (B=0.023, 95% CI, 0.003-0.043), and daily rehabilitation dose were significantly associated with changes in body weight. Furthermore, these factors positively affected BMI at discharge. Number of nurses and rehabilitation dose correlated with FIM, but assignment of RDs did not correlate with FIM. In conclusion, assignment of RDs, nurses, and sufficient rehabilitation dose may contribute to BMI gain. Nurses and daily rehabilitation dose may positively affect functional recovery.


Assuntos
Índice de Massa Corporal , Pessoal de Saúde/estatística & dados numéricos , Hospitais de Reabilitação/estatística & dados numéricos , Nutricionistas/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricos , Magreza/reabilitação , Idoso , Idoso de 80 Anos ou mais , Convalescença , Avaliação da Deficiência , Feminino , Avaliação Geriátrica , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Desempenho Físico Funcional , Recuperação de Função Fisiológica , Magreza/enfermagem , Resultado do Tratamento
7.
J Int Soc Sports Nutr ; 16(1): 52, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718652

RESUMO

BACKGROUND: Similar to other combat sports, mixed martial arts (MMA) includes divisional weight classes. The purpose of our research was to further investigate the amount of weight professional MMA fighters lost prior to weighing in for competition, their methods used to cut weight, and their sources of advice on how to cut weight. METHODS: This survey was administered to 92 male professional MMA athletes. The survey questions included duration of overall weight loss prior to competition, methods of weight-cutting, and their sources of advice regarding weight cutting. RESULTS: When comparing the number of methods of weight cutting with the source of advice, those who received their advice from social media used slightly more methods of weight cutting (M = 4.86, SD = 1.27) than those who did not (M = 4.02, SD = 1.55); t(90) = - 2.53, p < .05. MMA athletes that used the help of a registered dietitian nutritionist also reported using the least amount of methods for weight-cutting than any other category (M = 3.84, SD = 1.67). Those that used teammates and did not use a registered dietitian nutritionist used slightly more methods (M = 4.46, SD = 1.41) than those who used a registered dietitian nutritionist. CONCLUSIONS: The findings of this study report that professional MMA athletes do undergo rapid weight loss through various methods to make weight for competition. This study adds evidence to the literature that most professional MMA athletes undergo RWL for competition without the guidance of a registered dietitian nutritionist. It is unclear what the effect of using a registered dietitian nutritionist may have on an MMA athletes' ability to reduce weight in a safe and effective manner. Future research should seek to investigate if employing a registered dietitian nutritionist may lead to a higher rate of success for MMA athletes to make weight, and help reduce adverse risks of RWL.


Assuntos
Atletas , Artes Marciais , Autorrelato , Perda de Peso , Programas de Redução de Peso/métodos , Humanos , Masculino , Nutricionistas , Mídias Sociais
8.
Eur J Cancer Care (Engl) ; 28(6): e13168, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31571296

RESUMO

OBJECTIVE: Extensive research has documented the negative nutritional impact of head neck cancer (HNC) treatment, but few studies have addressed the patients' experiences. The purpose of this study was to describe how patients with HNC experience the nutritional situation and perceive nutritional support from diagnosis to the post-treatment phase. METHODS: Patients with HNC were recruited from a randomised pilot study. Individual interviews were conducted after radiotherapy with 10 participants aged 49 - 70 years and analysed by qualitative content analysis. RESULTS: Undergoing surgery was experienced as a poor nutritional starting point for the upcoming radiotherapy. During radiotherapy, increasing side effects made the participants customise their meals to improve food intake. About halfway through radiotherapy, virtually no food intake was experienced and hospital admissions and initiations of tube-feeding occurred in this period. Oral nutritional supplements were recommended for all, but eventually became unbearable to ingest. When radiotherapy was finally completed, the participants felt discouraged about the persistent side effects preventing them from resume eating. The participants missed tailored information about development of side effects and involvement of a dietitian when reflecting on the treatment-period. CONCLUSION: The comprehensive nutritional problems experienced by patients with HNC require early nutritional assessments and improved individually tailored nutritional support.


Assuntos
Atitude Frente a Saúde , Neoplasias de Cabeça e Pescoço/psicologia , Neoplasias de Cabeça e Pescoço/terapia , Estado Nutricional , Apoio Nutricional/psicologia , Radioterapia/efeitos adversos , Idoso , Dieta , Suplementos Nutricionais , Ingestão de Alimentos , Nutrição Enteral , Comportamento Alimentar , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical/efeitos adversos , Noruega , Avaliação Nutricional , Nutricionistas , Projetos Piloto , Pesquisa Qualitativa
9.
Public Health Genomics ; 22(3-4): 119-131, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31597141

RESUMO

BACKGROUND: Commercial technology-enabled personalised nutrition is undergoing rapid growth, yet its uptake in dietetics practice remains low. This survey sought the opinions of dietetics practitioners on personalised nutrition and related technologies to understand the facilitators and barriers to its application in practice. METHOD: A cross-section of registered dietitians were recruited in the USA, UK, Australia, Canada, Israel, Mexico, Portugal, Spain, and South Africa. The questionnaire sought their views on the risks of genetics technology, the ethics of genetic testing, the usefulness of new personalised nutrition technologies, entrepreneurism, and the perceived importance of new technologies to dietetics. Validated scales were included to assess personality (Big Five) and self-efficacy (NGSEI). The survey was available in English, Spanish, and Portuguese. Regression analyses were performed to identify factors associated with the integration of nutrigenetic testing into practice, and to identify factors associated with the perceived importance of bio-information, and mobile technology to dietetics practice. RESULTS: A total of 323 responses (response rate 19.7%) were analysed. Dietetics practitioners who had integrated personalised nutrition technology into practice perceived technologies to be less risky (p = 0.02), biotechnology to be more important (p < 0.01), and professional skills to be less important (p = 0.04) than those who had not. They were also more likely to see themselves as entrepreneurs (p < 0.01) and to perceive lower risks to be associated with technology (p < 0.01). Practitioners of nutrigenetics were lower on neuroticism (p < 0.01) and higher on self-efficacy (p < 0.01), extraversion (p < 0.01), and agreeableness (p < 0.01). A higher perceived importance of biotechnology to dietetics practice was associated with higher perceived usefulness of omics tests (p < 0.01). Perceived importance of information technology was associated with the perceived importance of biotechnology (p < 0.01). Mobile technology was perceived as important by dietitians with the highest level of education (p = 0.02). CONCLUSIONS: For dietitians to practice technology-enabled personalised nutrition, training will be required to enhance self-efficacy, address the risks perceived to be associated with new technologies, and instil an entrepreneurial mindset.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Dietética/normas , Nutricionistas/psicologia , Medicina de Precisão/normas , Adulto , Idoso , Austrália , Tecnologia Biomédica/normas , Canadá , Feminino , Humanos , Invenções/normas , Masculino , México , Pessoa de Meia-Idade , Portugal , Inquéritos e Questionários , Terapias em Estudo/normas , Adulto Jovem
10.
PLoS One ; 14(10): e0223159, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31603900

RESUMO

OBJECTIVE: As a result of unhealthy lifestyles, reduced numbers of healthcare providers are having to deal with an increasing number of diabetes patients. In light of this shortage of physicians and nursing staff, new concepts of care are needed. The aim of this scoping review is to review the literature and examine the effects of task delegation to non-physician health professionals, with a further emphasis on inter-professional care. RESEARCH DESIGN AND METHODS: Systematic searches were performed using the PubMed, Embase and Google Scholar databases to retrieve papers published between January 1994 and December 2017. Randomised/non-randomised controlled trials and studies with a before/after design that described the delegation of tasks from physicians to non-physicians in diabetes care were included in the search. This review is a subgroup analysis that further assesses all the studies conducted using a team-based approach. RESULTS: A total of 45 studies with 12,092 patients met the inclusion criteria. Most of the interventions were performed in an outpatient setting with type-2 diabetes mellitus patients. The non-physician healthcare professionals involved in the team were nurses, pharmacists, community health workers and dietitians. Most studies showed significant improvements in glycaemic control and high patient satisfaction, while there were no indications that the task delegation affected quality of life scores. CONCLUSIONS: The findings of the review suggest that task delegation can provide equivalent glycaemic control and potentially lead to an improvement in the quality of care. However, this review revealed a lack of clinical endpoints, as well as an inconsistency between the biochemical outcome parameters and the patient-centred outcome parameters. Given the vast differences between the individual healthcare systems used around the world, further high-quality research with an emphasis on long-term outcome effects and the expertise of non-physicians is needed.


Assuntos
Diabetes Mellitus Tipo 2/psicologia , Satisfação do Paciente/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Qualidade de Vida/psicologia , Biomarcadores/sangue , Glicemia/metabolismo , Agentes Comunitários de Saúde/organização & administração , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/terapia , Feminino , Hemoglobina A Glicada/metabolismo , Índice Glicêmico , Humanos , Masculino , Pessoa de Meia-Idade , Profissionais de Enfermagem/organização & administração , Nutricionistas/organização & administração , Farmacêuticos/organização & administração , Médicos de Atenção Primária/organização & administração , Médicos de Atenção Primária/provisão & distribução
11.
Nutr Clin Pract ; 34(6): 858-868, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31549444

RESUMO

Registered dietitian nutritionists (RDNs), like other healthcare professionals, are often searching for ways to improve their skills and advance their practice. One way RDNs have expanded their skills is by learning to place small bowel feeding tubes (SBFTs). However, it is also important that staffing RDNs to place SBFTs makes sense for their institution and their patient population. Although it is unknown how many RDNs place SBFTs, feeding tube placements by RDNs have been in practice for almost 2 decades, and it is within the RDN scope of practice. This article is a review of the literature, including indications for SBFT, possible benefits of RDNs placing SBFTs, development and maintenance of an RDN-led SBFT program, and assessment of clinical and institutional outcomes for this procedure.


Assuntos
Nutrição Enteral/métodos , Intubação Gastrointestinal/métodos , Nutricionistas/organização & administração , Competência Clínica , Nutrição Enteral/economia , Custos de Cuidados de Saúde , Instalações de Saúde , Humanos , Intestino Delgado , Intubação Gastrointestinal/economia , Nutricionistas/educação , Avaliação de Resultados em Cuidados de Saúde , Guias de Prática Clínica como Assunto
12.
Rocz Panstw Zakl Hig ; 70(3): 235-241, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31515982

RESUMO

The role of dietitians is to counsel patients on special dietary modifications, develop dietary plans and provide dietary advice for healthy lifestyle in order to promote health and prevent disease. As lifestyle changes have become a primary reason for the increasing prevalence of non-communicable diseases in recent decades, it appears that nutritional therapy should play an important role in the multidisciplinary healthcare system. The aim of the review was to evaluate the role of nutritional support provided by dietitians in the prevention and treatment of chronic diseases in terms of its clinical and cost-effectiveness, according to their range of activity and qualifications. The evaluation was based on the review of the current literature. The costs of the treatment of non-communicable diseases encompass the costs of the treatment of the disease itself, costs of its complications and costs resulting from the decline of the productivity of patients. The results of studies indicate that nutritional support provides not only clinical but also cost benefits in the prevention and treatment of various non-communicable diseases. Every €1 spend on dietary counseling of patients with obesity or obesity-related diseases approximately returns a net €14 to €63 over a period of five years. Dietitians appear to be more effective in counseling overweight or obese patients with present risk factors compared to other specialists, however the barriers to accessing a qualified dietitian and problems with the reimbursement for services still exist. As adequate professional qualifications of dietitians appear to be an important factor determining the effectiveness of implemented dietary care, an additional training courses for dietitians and enhanced cooperation of hospitals and medical universities are needed.


Assuntos
Doença Crônica/terapia , Dietoterapia/métodos , Educação em Saúde/métodos , Doenças não Transmissíveis/terapia , Apoio Nutricional/métodos , Nutricionistas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papel Profissional , Inquéritos e Questionários
13.
Glob Health Action ; 12(1): 1656452, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31512960

RESUMO

In low- and middle-income countries, nutrition support strategies are often suboptimal or non-existent in hospital settings. This is further compounded by high rates of malnutrition in these countries. The first four dietitians graduated in Malawi in 2017 providing a new opportunity to build capacity to introduce nutrition support in an acute care setting. A paediatric nutrition support program was implemented at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi including the hiring of a local dietitian. This capacity building paper explains the development and introduction of the nutrition support program including a description of perceptions of health professionals at QECH working alongside the dietitian. In the first four months of the program at QECH, the dietitian provided nutrition support to 183 different patients across paediatric wards. Nutritional interventions predominantly included infant formula and breastmilk fortification, provision of therapeutic feeds orally or via nasogastric tubes, increased dietary protein intake for children identified to be at high risk, and nutritional counselling to caregivers. More complex nutritional interventions were also given such as the insertion of gastrostomy tubes to deliver nutrition directly to the stomach. Following the introduction of the program, qualitative interviews were done with health professionals at QECH including nurses (n = 5) and physicians (n = 11). All participants emphasized the importance and impact of the nutrition support program in enhancing the care of hospitalized children, therefore improving outcomes such as tolerability of clinical interventions, decreased duration of stay, and reduced risk of hospital readmission. In conclusion, there is a need for nutrition support provided by a dietitian for different paediatric patients which was corroborated by positive feedback from health professionals at QECH. Integration of dietitians into the healthcare system by respective Ministries of Health will require advocacy around the potential for nutrition support to strengthen the quality of care of vulnerable children. A Chichewa abstract for this paper is available in a supplementary file.


Assuntos
Aconselhamento , Recursos em Saúde/provisão & distribução , Estado Nutricional , Nutricionistas , Criança , Humanos , Lactente , Entrevistas como Assunto , Malaui , Corpo Clínico Hospitalar/psicologia , Pesquisa Qualitativa , Qualidade da Assistência à Saúde
14.
Ir Med J ; 112(7): 967, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31553148

RESUMO

Aims To examine; (a) the number of registered dietitians (RDs) with blended tube fed (BTF) patients, work setting and caseload; (b) attitudes and experiences towards BTF; (c) current BTF supports and future resources required. Methods An online survey collected information from Irish RDs over one month. Data was examined using cross-tabulations and Mann-Whitney U tests. Free-text was categorized into thematic domains. Results A significant number of RDs with HEN paediatric patients concurrently managed BTF patients (n = 27/48, 56.3%, p<0.05). The majority were based in tertiary hospitals (HEN; n = 20/48, 41.7%, BTF; n = 12/27, 44.4%). Equal numbers were willing to support BTF or on a patient-case basis (n = 36/77, 46.8%). International guidelines were most used to inform RDs (n = 40/69, 58.0%). Professional training workshops were the preferred learning method (n = 60/73, 82.2%). Conclusion Overall, BTF appears to be a growing practice. Community services, professional guidelines, training and information are needed.


Assuntos
Nutrição Enteral/estatística & dados numéricos , Nutricionistas/estatística & dados numéricos , Criança , Nutrição Enteral/métodos , Nutrição Enteral/normas , Serviços de Assistência Domiciliar , Humanos , Nutricionistas/psicologia , Pediatria , Inquéritos e Questionários
15.
Stud Health Technol Inform ; 264: 1674-1675, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438287

RESUMO

Although the symptoms of food allergy are diverse and sometimes dangerous to life, we have not been able to effectively share information on patients' food allergies. In this study, we developed a program to prescribe the allergic formula for each patient and to establish a series of processes for safe allergenic meal delivery based on the standards and guidelines of food allergy management. We then assessed the utility of the "introduction of food allergy program" by comparing the number of allergic prescriptions before and after the program application for inpatients. Through the development and introduction of the program, all hospital staffs, including medical staff and dieticians, can share information on food allergy patients. Systematic management of food allergy patients from doctor's prescriptions has provided the basis for safe meal preparation.


Assuntos
Hipersensibilidade Alimentar , Alérgenos , Humanos , Disseminação de Informação , Nutricionistas , Prescrições
16.
Rev Gastroenterol Mex ; 84(3): 303-309, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31383293

RESUMO

INTRODUCTION AND AIMS: Probiotics are effective in gastrointestinal disease management. In Mexico, there are no studies on the use and prescription of probiotics by healthcare professionals. Our aim was to evaluate probiotic use and prescription on the part of gastroenterologists and nutritionists. MATERIALS AND METHODS: An online survey questionnaire was sent to members of the Asociación Mexicana de Gastroenterología (n = 1042), the Asociación Mexicana de Nutriología (n = 220), and healthcare professionals registered at the Fourth International Symposium: Intestinal Microbiota (n = 1328). RESULTS: Response was 34% (997 questionnaires answered) and 570 (64%) of the respondents were women. Mean participant age was 36.2 years (range 18-83). Thirty-six percent of the participants were gastroenterologists, 46% were nutritionists, and 18% were chemists and microbiologists. Seventy-one percent of the respondents knew the Food and Agriculture Organization (FAO) definition of probiotics and recommended them «always¼ (64.9%), «rarely¼ (31.7%), and «never¼ (3.6%). Gastroenterologists indicated probiotics for the treatment of disease (56.5%) and nutritionists for health maintenance (39%). Ninety-seven percent of the gastroenterologists and 98% of the nutritionists evaluated probiotics as effective in gastrointestinal symptom management and considered them safe. The majority of the respondents did not know which probiotic strain was contained in the commercial probiotic product. CONCLUSIONS: The survey results showed that the participating gastroenterologists and nutritionists understood the concept of probiotics, recommended them frequently, and considered them safe. The gastroenterologists prescribed probiotics as therapeutic agents and the nutritionists to maintain health. There was a lack of knowledge about the microbial composition of the products containing probiotics available in Mexico.


Assuntos
Gastroenterologistas/estatística & dados numéricos , Nutricionistas/estatística & dados numéricos , Probióticos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Uso de Medicamentos/estatística & dados numéricos , Feminino , Gastroenteropatias/terapia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Internet , Masculino , México , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
17.
Int J Clin Pharm ; 41(5): 1282-1289, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31302884

RESUMO

Background Hyperphosphatemia is a common consequence in end stage renal disease. It is associated with increased cardiovascular risk and mortality, also development of hyperparathyroidism and mineral bone disease. A patient educational program involving physician, pharmacist and dietician was developed to manage hyperphosphatemia among hemodialysis patients. Objective To investigate the efficacy of the program in optimal phosphate control among hemodialysis patients. Setting Kuala Lipis Hospital, Malaysia. Method This was a non-randomized, single-arm community trial running for a period of 6 months. The program consisted of a small group seminar and individual counseling sessions. Two individual counseling sessions were conducted for each patient, focusing on diet and medication adherence, by an accredited dietician and pharmacist respectively. The group seminar was delivered by a multidisciplinary team involving a physician, pharmacist and dietician. Topics included basic knowledge of hyperphosphatemia, phosphate binder and dietary phosphate control. Eligible and consented patients had knowledge and medication adherence assessment, measurement of pre-dialysis serum calcium, albumin, phosphate, haemoglobin and alkaline phosphatase before and after the educational program. Main outcome measure Phosphate level, knowledge and medication adherence assessment. Results Fifty-seven patients completed the program and were included into final data analysis. The median (IQR) phosphate level (mmol/L) was 1.86 (1.45-2.24) before and decreased to 1.47 (1.21-1.91) and 1.49 (1.28-1.81) 3 months and 6 months after PEP (p < 0.001). The percentage of patients with uncontrolled phosphate level was reduced from 59.3 to 35.6% and 42.1% after the PEP (p = 0.003). The mean knowledge score almost doubled after the intervention, with a mean pre-score of 8.61 (95% CI 7.85-9.37) to mean post-score of 15.31 (95% CI 14.85-15.76). The adherence to phosphate binder also improved from 17.2 to 41.4% after PEP (p = 0.007). Conclusion A multidisciplinary patient education program is an effective approach to manage hyperphosphatemia among hemodialysis patients in Malaysia.


Assuntos
Hiperfosfatemia/prevenção & controle , Educação de Pacientes como Assunto , Diálise Renal/efeitos adversos , Diálise Renal/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Aconselhamento , Dieta , Feminino , Humanos , Falência Renal Crônica/sangue , Falência Renal Crônica/terapia , Conhecimento , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Nutricionistas , Equipe de Assistência ao Paciente , Farmacêuticos , Fosfatos/sangue , Médicos , Adulto Jovem
18.
J Sports Sci ; 37(21): 2467-2474, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31345110

RESUMO

This study aimed to explore how social media is being used by sports nutritionists as part of service provision, as well as practitioners' experiences and opinions of its use in practice. An exploratory sequential mixed methods approach was used during this research. Forty-four sports nutritionists completed an online survey detailing their personal and professional social media use. Semi-structured follow-up interviews were conducted with 16 participants who volunteered to do so. Survey responses were collated and reported as descriptive statistics. Interviews were thematically analysed. Social media was used by 89% of sports nutritionists to support practice, of which 97% perceived its use to be beneficial. Platforms were used to deliver information and resources, and support athletes online via pages, groups and 1-2-1 messaging. Social media facilitated improved communication between the practitioner and the athlete, as well as facilitating mobile and visual learning. Lack of digital intervention training and time were reported as challenges to social media use in practice. Sports nutritionists have embraced social media as an extension of service provision. Professional education should now consider supporting nutritionists' in developing digital professionalism.


Assuntos
Nutricionistas , Mídias Sociais/estatística & dados numéricos , Esportes , Atletas/psicologia , Atitude do Pessoal de Saúde , Comunicação , Utilização de Instalações e Serviços , Humanos , Irlanda , Aprendizagem , Aplicativos Móveis/estatística & dados numéricos , Nutricionistas/psicologia , Smartphone/estatística & dados numéricos , Reino Unido
19.
BMJ Health Care Inform ; 26(1)2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31201200

RESUMO

BACKGROUND: Dietitians increasingly interact with electronic health records (EHRs) and use them to alert prescribers to medication inaccuracies. OBJECTIVE: To understand renal dietitians' use of electronic prescribing systems and influence on medication accuracy in inpatients. In outpatients to determine whether renal dietitians' use of the electronic medication recording might improve accuracy. METHODS: In inpatients we studied the impact of dietetic advice on medical prescribing before and after moving from paper recommendations to ePrescribing. In outpatients, when dietitians recommended changes in dialysis units, we assessed the time to patients receiving the new medications. We trained dietitians to use the ePrescribing system and assessed accuracy of medication lists at the start and end of the study period. RESULTS: Inpatients: before the use of EHRs, 25% of proposals were carried out and took an average of 20 days. This rose to 38% using an EHR and took an average of 4 days.Outpatients: in dialysis units dietitians recommend initiating and stopping medications and advise on repeat medications. Most recommendations were during multidisciplinary team (MDT) meetings; the average time to receive medications was 10 days. Drug histories updated by dietitians increased after the start of the study and accuracy of medication lists improved from 2.4 discrepancies/patient to 0.4. CONCLUSION: Dietitians can make medication suggestions directly using EHR, delivering more timely change to patient care and improving accuracy of patients' medication lists. Allowing the whole of the MDT to contribute to the EHR improves data completeness and therefore patient care is likely to be enhanced.


Assuntos
Registros Eletrônicos de Saúde , Prescrição Eletrônica , Nutricionistas , Humanos , Erros de Medicação/prevenção & controle , Diálise Renal , Fatores de Tempo
20.
J Urol ; 202(4): 689-695, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31091175

RESUMO

PURPOSE: We explored the prevalence and trends of self-reported complementary and alternative medicine use among patients with prostate cancer using CaPSURE™ (Cancer of the Prostate Strategic Urologic Research Endeavor). MATERIALS AND METHODS: A total of 7,989 CaPSURE participants completed questionnaires between 1996 and 2016 on the use of nearly 70 complementary and alternative medicine types. Participants were defined as users if they indicated that they had ever used complementary and alternative medicines. To evaluate trends among 7,696 patients with newly diagnosed prostate cancer we considered complementary and alternative medicine use within 24 months of diagnosis and calculated the percent change in complementary and alternative medicine use between groups defined by the year of diagnosis. RESULTS: Of patients with prostate cancer 56% reported complementary and alternative medicine use on at least 1 questionnaire. Multivitamin and omega-3 fatty acid use was common at 40% and 24% of patients, respectively. Compared to nonusers greater proportions of complementary and alternative medicine users were college educated, had a higher household income and lived in the West and Midwest. Median prostate specific antigen at diagnosis was 5.8 (IQR 4.4-8.4) and 6.2 ng/ml (IQR 4.7-10.1) among users and nonusers, respectively (p <0.01). Between those diagnosed in 1996 to 2000 and 2011 to 2016, complementary and alternative medicine use increased 128% from 24% to 54%. When comparing participants diagnosed in 2006 to 2010 with those diagnosed in 2011 to 2016, a 108% increase was seen in supplemental vitamin D use and a -48% decrease was seen in supplemental vitamin E use. CONCLUSIONS: Many patients with prostate cancer reported complementary and alternative medicine use. Multivitamins and omega-3 fatty acids were commonly ingested and vitamin D use increased dramatically from 2006 to 2010 compared to 2011 to 2016. These data can guide clinical discussions and decision making such as nutritionist referral and help prioritize future research.


Assuntos
Terapias Complementares/tendências , Neoplasias da Próstata/terapia , Idoso , Tomada de Decisão Clínica , Terapias Complementares/estatística & dados numéricos , Ácidos Graxos Ômega-3/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Nutricionistas , Encaminhamento e Consulta , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos , Vitamina D/administração & dosagem
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