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1.
Artículo en Inglés | MEDLINE | ID: mdl-33800225

RESUMEN

Dietitians as healthcare professionals could decrease their quality of life during the SARS-COV-2 pandemic period; therefore, this study aimed to compare Brazilian dietitians' perceptions of quality of life before and during the pandemic. This nationwide cross-sectional research aimed to evaluate Brazilian dietitians' quality of life before and in the course of the COVID-19 pandemic, using a previously validated self-administered instrument WHO-QOL-BREF in Brazilian-Portuguese. The questionnaire was composed of 26 items (four domains) to evaluate life quality (physical, psychological, social relationship, and environment). The questionnaire also presented some sociodemographic variables and three questions about the COVID-19 pandemic. It was applied using GoogleForms® platform (Google LLC, Mountain View, CA, USA). For the statistical analysis of data, Paired T-test, Chi-squared test, and Analysis of Variance were used. A total of 1290 Brazilian dietitians replied to the instrument. Comparing quality of life (QoL) before SARS-COV-2 (3.83 ± 0.59) and during the pandemic (3.36 ± 0.66), data was statistically different. Comparing prior and in the course of the COVID-19 pandemic, all variables and domains presented statistical differences (better before the pandemic period). Among Brazilian dietitians, the psychological health domain was the most affected. The Sars-Cov-2 pandemic negatively impacted the QoL of Brazilian dietitians since health professionals face changes in their lives because of work.


Asunto(s)
Nutricionistas , Brasil/epidemiología , Estudios Transversales , Humanos , Pandemias , Calidad de Vida , Encuestas y Cuestionarios
2.
Shokuhin Eiseigaku Zasshi ; 62(1): 20-27, 2021.
Artículo en Japonés | MEDLINE | ID: mdl-33658460

RESUMEN

The role of dietitians is important for consumers to practice self-care, which includes the use of the "Foods with Function Claims (FFC)". In this study, a nationwide internet survey was conducted to clarify the understanding and attitudes of dietitians towards the FFC 1 year and 4 years after its introduction (Surveys were conducted in 2015 and 2019, respectively). In the survey of 1 year after the introduction, the ratio of recognition of the FFC was 98%; however, only 35% correctly understood the characteristics of the FFC. Similarly, in the survey of 4 year after the introduction, only 42% of dietitians correctly answered the characteristics. At 4 year after, 56% of dietitians currently or previously have used the FFC. The dietitians who had been consulted about the use of the FFC accounted for 22% and about the adverse events accounted for 15%. The advice they gave at the consultation differed according to their experience of the use of the FFC. Of the ones who never used the FFC, 25% referred no information sources for the FFC. The place to educate primarily working dietitians needs to be prepared to let them provide appropriate information to consumers to support self-care including the appropriate use of the FFC.


Asunto(s)
Nutricionistas , Actitud , Humanos , Derivación y Consulta , Encuestas y Cuestionarios
3.
JAMA Netw Open ; 4(2): e2036725, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33576817

RESUMEN

Importance: Interprofessional collaborative practice (ICP), the collaboration of health workers from different professional backgrounds with patients, families, caregivers, and communities, is central to optimal primary care. However, limited evidence exists regarding its association with patient outcomes. Objective: To examine the association of ICP with hemoglobin A1C (HbA1c), systolic blood pressure (SBP), and diastolic blood pressure (DBP) levels among adults receiving primary care. Data Sources: A literature search of English language journals (January 2013-2018; updated through March 2020) was conducted using MEDLINE; Embase; Ovid IPA; Cochrane Central Register of Controlled Trials: Issue 2 of 12, February 2018; NHS Economic Evaluation Database: Issue 2 of 4, April 2015; Clarivate Analytics WOS Science Citation Index Expanded (1990-2018); EBSCOhost CINAHL Plus With Full Text (1937-2018); Elsevier Scopus; FirstSearch OAIster; AHRQ PCMH Citations Collection; ClinicalTrials.gov; and HSRProj. Study Selection: Studies needed to evaluate the association of ICP (≥3 professions) with HbA1c, SBP, or DBP levels in adults with diabetes and/or hypertension receiving primary care. A dual review was performed for screening and selection. Data Extraction and Synthesis: This systematic review and meta-analysis followed the PRISMA guideline for data abstractions and Cochrane Collaboration recommendations for bias assessment. Two dual review teams conducted independent data extraction with consensus. Data were pooled using a random-effects model for meta-analyses and forest plots constructed to report standardized mean differences (SMDs). For high heterogeneity (I2), data were stratified by baseline level and by study design. Main Outcomes and Measures: The primary outcomes included HbA1c, SBP, and DBP levels as determined before data collection. Results: A total of 3543 titles or abstracts were screened; 170 abstracts or full texts were reviewed. Of 50 articles in the systematic review, 39 (15 randomized clinical trials [RCTs], 24 non-RCTs) were included in the meta-analyses of HbA1c (n = 34), SBP (n = 25), and DBP (n = 24). The sample size ranged from 40 to 20 524, and mean age ranged from 51 to 70 years, with 0% to 100% participants being male. Varied ICP features were reported. The SMD varied by baseline HbA1c, although all SMDs significantly favored ICP (HbA1c <8, SMD = -0.13; P < .001; HbA1c ≥8 to < 9, SMD = -0.24; P = .007; and HbA1c ≥9, SMD = -0.60; P < .001). The SMD for SBP and DBP were -0.31 (95% CI, -0.46 to -0.17); P < .001 and -0.28 (95% CI, -0.42 to -0.14); P < .001, respectively, with effect sizes not associated with baseline levels. Overall I2 was greater than 80% for all outcomes. Conclusions and Relevance: This systematic review and meta-analysis found that ICP was associated with reductions in HbA1c regardless of baseline levels as well as with reduced SBP and DBP. However, the greatest reductions were found with HbA1c levels of 9 or higher. The implementation of ICP in primary care may be associated with improvements in patient outcomes in diabetes and hypertension.


Asunto(s)
Presión Sanguínea , Conducta Cooperativa , Diabetes Mellitus/terapia , Hemoglobina A Glucada/metabolismo , Hipertensión/terapia , Grupo de Atención al Paciente , Atención Primaria de Salud , Diabetes Mellitus/metabolismo , Educadores en Salud , Humanos , Hipertensión/fisiopatología , Enfermeras y Enfermeros , Nutricionistas , Manejo de Atención al Paciente , Farmacéuticos , Médicos , Trabajadores Sociales , Resultado del Tratamiento
4.
Nutrients ; 13(1)2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33430147

RESUMEN

The use of image-based dietary assessments (IBDAs) has rapidly increased; however, there is no formalized training program to enhance the digital viewing skills of dieticians. An IBDA was integrated into a nutritional practicum course in the School of Nutrition and Health Sciences, Taipei Medical University Taiwan. An online IBDA platform was created as an off-campus remedial teaching tool to reinforce the conceptualization of food portion sizes. Dietetic students' receptiveness and response to the IBDA, and their performance in food identification and quantification, were compared between the IBDA and real food visual estimations (RFVEs). No differences were found between the IBDA and RFVE in terms of food identification (67% vs. 71%) or quantification (±10% of estimated calories: 23% vs. 24%). A Spearman correlation analysis showed a moderate to high correlation for calorie estimates between the IBDA and RFVE (r ≥ 0.33~0.75, all p < 0.0001). Repeated IBDA training significantly improved students' image-viewing skills [food identification: first semester: 67%; pretest: 77%; second semester: 84%) and quantification [±10%: first semester: 23%; pretest: 28%; second semester: 32%; and ±20%: first semester: 38%; pretest: 48%; second semester: 59%] and reduced absolute estimated errors from 27% (first semester) to 16% (second semester). Training also greatly improved the identification of omitted foods (e.g., condiments, sugar, cooking oil, and batter coatings) and the accuracy of food portion size estimates. The integration of an IBDA into dietetic courses has the potential to help students develop knowledge and skills related to "e-dietetics".


Asunto(s)
Dietética/educación , Evaluación Nutricional , Nutricionistas/educación , Fotograbar , Tamaño de la Porción , Curriculum , Humanos , Internet
5.
J Nutr Educ Behav ; 53(1): 2-9, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33423752

RESUMEN

OBJECTIVE: To explore the real-time personal/employee safety experiences and perspectives of school nutrition professionals ranging from frontline staff to state leadership across the US as they responded to the initial weeks of the coronavirus pandemic. METHODS: A cross-sectional survey was administered electronically March 31-April 20, 2020, to school nutrition staff, managers, directors, and state agency personnel. Descriptive statistics were calculated, and a thematic analysis of an open-ended item was conducted. RESULTS: School nutrition professionals (n = 504) from 47 states responded. Most (86.6%) reported that ensuring employee safety was somewhat or much more difficult during the pandemic, and they were unaware of an emergency plan. Themes from open-ended responses regarding employee safety concerns included, exposure and transmission risk, processes, and personal concerns. CONCLUSIONS AND IMPLICATIONS: Attention to the safety and concerns of school nutrition employees is vital for continuation of these programs during this pandemic and for future emergency situations.


Asunto(s)
/prevención & control , Servicios Dietéticos/métodos , Servicios de Alimentación/estadística & datos numéricos , Nutricionistas/estadística & datos numéricos , Salud Laboral/estadística & datos numéricos , Instituciones Académicas/estadística & datos numéricos , Estudios Transversales , Servicios Dietéticos/estadística & datos numéricos , Humanos , Pandemias , Estados Unidos
6.
Nihon Koshu Eisei Zasshi ; 67(9): 573-581, 2020.
Artículo en Japonés | MEDLINE | ID: mdl-33041283

RESUMEN

Objectives The present study examined factors that affect learning about dental caries and periodontal disease before or after graduation or completion of training for dietitians and registered dietitians.Methods A questionnaire survey was conducted with members of the Aomori Prefectural Dietetic Association between October and November 2019, and 276 participants were included in the analysis. A multiple logistic regression analysis was performed to assess the characteristics associated with learning about dental caries and periodontal disease; odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. The following independent variables were assessed: age (<30, 30-39, 40-49, 50-59, or ≥60 years), license (dietitian or registered dietitian), and occupational field (medical institution [nutrition management or food service], administrative agency, nursing care insurance facility, school-related work, training instructor in training facility for dietitians and registered dietitians, or other).Results The multiple logistic regression analysis showed that dietitians and registered dietitians who had learned about dental caries and periodontal disease during training tended to be below the age of 40 years and have a registered dietitian license (dental caries: OR=2.79, 95% CI=1.08-7.24; periodontal disease: OR=6.51, 95% CI=1.71-24.84). Furthermore, dietitians and registered dietitians who had learned about dental caries and periodontal disease after graduation or training completion tended to be over the age of 40, have studied at a training facility (dental caries: OR=3.21, 95% CI=1.65-6.27; periodontal disease: OR=3.06, 95% CI=1.32-7.12), and be employed in the field of school-related work (dental caries: OR=4.23, 95% CI=1.03-17.27; periodontal disease: OR=5.56, 95% CI=1.15-26.98).Conclusions To facilitate increased cooperation among practitioners in the fields of nutrition and dental health, necessary opportunities for learning about dental caries and periodontal disease alongside experts should be provided to those who do not have a registered dietitian license and have not studied at training facilities.


Asunto(s)
Caries Dental , Dietética/educación , Educación Continua/métodos , Educación en Salud Dental , Aprendizaje , Nutricionistas/educación , Enfermedades Periodontales , Adulto , Curriculum , Femenino , Humanos , Persona de Mediana Edad , Encuestas y Cuestionarios
8.
Artículo en Inglés | MEDLINE | ID: mdl-32751853

RESUMEN

This study aimed to evaluate the perceptions of dietitians' wellbeing at work before and during the SARS-COV-2 pandemic in Brazil. This cross-sectional study was performed using a previously validated instrument to investigate the wellbeing of dietitians at work in Brazil. The questionnaire on the wellbeing of dietitians was composed of 25 items (with a 5-point scale), characteristics, and questions about the SARS-COV-2 period. The application was carried out with GoogleForms® tool from 26 May to 7 June 2020. The weblink to access the research was sent via email, messaging apps, and social networks. Volunteers were recruited nationwide with the help of the Brazilian Dietitians Councils, support groups, as well as media outreach to reach as many dietitians as possible. Volunteers received, along with the research link, the invitation to participate, as well as the consent form. A representative sample of 1359 dietitians from all the Brazilian regions answered the questionnaire-mostly female (92.5%), Catholic (52.9%), from 25 to 39 years old (58.4%), with a partner (63.8%), and with no children (58%). Most of the participants continue working during the pandemic period (83.8%), but they did not have SARS-COV-2 (96%), nor did their family members (80.7%). The wellbeing at work before SARS-COV-2 was 3.88 ± 0.71, statistically different (p < 0.05) from during the pandemic, with the wellbeing of 3.71 ± 0.78. Wellbeing at work was higher before the pandemic for all the analyzed variables. Analyzing variables separately before and during the pandemic, dietitians with partners, children and a Ph.D. presented higher scores for wellbeing at work. Professionals receiving more than five times the minimum wage have higher scores. During the pandemic, better wellbeing was observed for dietitians working remotely.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/psicología , Nutricionistas/psicología , Pandemias , Neumonía Viral/psicología , Lugar de Trabajo , Adulto , Brasil/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Estudios Transversales , Femenino , Humanos , Masculino , Neumonía Viral/epidemiología , Neumonía Viral/virología , Encuestas y Cuestionarios
9.
Lancet Gastroenterol Hepatol ; 5(10): 890-899, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32679040

RESUMEN

BACKGROUND: Functional gastrointestinal disorders are common and costly to the health-care system. Most specialist care is provided by a gastroenterologist, but only a minority of patients have improvement in symptoms. Although they have proven to be effective, psychological, behavioural, and dietary therapies are not provided routinely. We aimed to compare the outcome of gastroenterologist-only standard care with multidisciplinary care. METHODS: In an open-label, single-centre, pragmatic trial, consecutive new referrals of eligible patients aged 18-80 years with Rome IV criteria-defined functional gastrointestinal disorders were randomly assigned (1:2) to receive gastroenterologist-only standard care or multidisciplinary clinic care. The multidisciplinary clinic included gastroenterologists, dietitians, gut-focused hypnotherapists, psychiatrists, and behavioural (biofeedback) physiotherapists. Randomisation was stratified by Rome IV disorder and whether referred from gastroenterology or colorectal clinic. Outcomes were assessed at clinic discharge or 9 months after the initial visit. The primary outcome was a score of 4 (slightly better) or 5 (much better) on a 5-point Likert scale assessing global symptom improvement. Modified intention-to-treat analysis included all patients who attended at least one clinic visit and who had answered the primary outcome question. This study is registered with ClinicalTrials.gov, NCT03078634. FINDINGS: Between March 16, 2017, and May 10, 2018, 1632 patients referred to the hospital gastrointestinal clinics were screened, of whom 442 were eligible for a screening telephone call and 188 were randomly assigned to receive either standard care (n=65) or multidisciplinary care (n=123). 144 patients formed the modified intention-to-treat analysis (n=46 in the standard-care group and n=98 in the multidisciplinary-care group), 90 (63%) of whom were women. 61 (62%) of 98 patients in the multidisciplinary-care group patients saw allied clinicians. 26 (57%) patients in the standard-care group and 82 (84%) patients in the multidisciplinary-care group had global symptom improvement (risk ratio 1·50 [95% CI 1·13-1·93]; p=0·00045). 29 (63%) patients in the standard-care group and 81 (83%) patients in the multidisciplinary-care group had adequate relief of symptoms in the past 7 days (p=0·010). Patients in the multidisciplinary-care group were more likely to experience a 50% or higher reduction in all Gastrointestinal Symptom Severity Index symptom clusters than were patients in the standard-care group. Of the patients with irritable bowel syndrome, a 50-point or higher reduction in IBS-SSS occurred in 10 (38%) of 26 patients in the standard care group compared with 39 (66%) of 59 patients in the multidisciplinary-care group (p=0·017). Of the patients with functional dyspepsia, a 50% reduction in the Nepean Dyspepsia Index was noted in three (11%) of 11 patients in the standard-care group and in 13 (46%) of 28 in the multidisciplinary-care group (p=0·47). After treatment, the median HADS scores were higher in the standard-care group than in the multidisciplinary-care group (13 [8-20] vs 10 [6-16]; p=0·096) and the median EQ-5D-5L quality of life visual analogue scale was lower in the standard-care group compared with the multidisciplinary-care group (70 [IQR 50-80] vs 75 [65-85]; p=0·0087). The eight SF-36 scales did not differ between the groups at discharge. After treatment, median Somatic Symptom Scale-8 score was higher in the standard-care group than in the multidisciplinary-care group (10 [IQR 7-7] vs 9 [5-13]; p=0·082). Cost per successful outcome was higher in the standard-care group than the multidisciplinary-care group. INTERPRETATION: Integrated multidisciplinary clinical care appears to be superior to gastroenterologist-only care in relation to symptoms, specific functional disorders, psychological state, quality of life, and cost of care for the treatment of functional gastrointestinal disorders. Consideration should be given to providing multidisciplinary care for patients with a functional gastrointestinal disorder. FUNDING: None.


Asunto(s)
Prestación de Atención de Salud/economía , Gastroenterólogos/normas , Enfermedades Gastrointestinales/terapia , Síndrome del Colon Irritable/terapia , Adulto , Atención Ambulatoria/estadística & datos numéricos , Australia/epidemiología , Biorretroalimentación Psicológica/métodos , Femenino , Enfermedades Gastrointestinales/diagnóstico , Enfermedades Gastrointestinales/psicología , Humanos , Hipnosis/métodos , Análisis de Intención de Tratar/métodos , Comunicación Interdisciplinaria , Síndrome del Colon Irritable/diagnóstico , Síndrome del Colon Irritable/psicología , Masculino , Persona de Mediana Edad , Nutricionistas/normas , Psiquiatría/normas , Calidad de Vida , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
13.
Artículo en Inglés | MEDLINE | ID: mdl-32429386

RESUMEN

Altogether, 1588 dietitians were dispatched from the Japan Dietetic Association (JDA) to a disaster area for the first time on a nationwide scale following the 2011 Great East Japan Earthquake. Various studies have been conducted based on the activity reports, but the support that the disaster area requested was not documented. The purpose of this study is to identify the support that was needed in the disaster area. Therefore, we investigated the necessary support desired by dietitians who lived in the disaster areas. Questionnaires were sent to 1911 dietitians who were members of the JDA and lived in 3 affected prefectures in August 2012. In total, 435 dietitians (22.8%) completed the questionnaire. Among the questions on the questionnaire, we analyzed answers to the open-ended question: "Please write freely about the support that you wanted at the time of the disaster" (n = 332). Using qualitative descriptive analysis, we extracted data from the answers and categorized and labeled them into similar groups. These groups were divided into four categories: (1) "goods," (2) "establishing a system in advance of a large-scale disaster," (3) "information," and (4) "human resources." To provide "goods," "information," and "human resources" to the disaster area smoothly, it is important to plan a "system" in advance of large-scale disasters.


Asunto(s)
Planificación en Desastres , Terremotos , Nutricionistas , Desastres , Femenino , Humanos , Japón , Masculino , Encuestas y Cuestionarios
14.
Ann Intern Med ; 172(9): ITC65-ITC80, 2020 05 05.
Artículo en Inglés | MEDLINE | ID: mdl-32365374

RESUMEN

Eosinophilic esophagitis (EoE) is a relatively new disease that has reached an incidence similar to that of Crohn disease and ulcerative colitis. With this increased presence, greater recognition is essential. This applies both to children with nonspecific but potentially debilitating symptoms and to adults who have spent years behaviorally compensating for narrow esophageal strictures. The pathogenesis of EoE is rapidly being unraveled and is based on initiation of a type II allergic response to specific food antigens, leading to dense esophageal eosinophilia, chronic inflammation, and esophageal fibrosis. With greater familiarity and understanding of EoE, treatments are evolving, including identification and avoidance of food antigens; broad applications of topical steroids; and, eventually, pathway-specific biologic therapy.


Asunto(s)
Esofagitis Eosinofílica/diagnóstico , Esofagitis Eosinofílica/terapia , Alergólogos , Biopsia , Trastornos de Deglución/etiología , Trastornos de Deglución/terapia , Diagnóstico Diferencial , Dietoterapia/métodos , Dilatación , Esofagitis Eosinofílica/complicaciones , Estenosis Esofágica/etiología , Estenosis Esofágica/terapia , Esofagoscopía , Esófago/diagnóstico por imagen , Esófago/patología , Predisposición Genética a la Enfermedad , Glucocorticoides/uso terapéutico , Humanos , Hipersensibilidad/complicaciones , Inmunoglobulina G/sangre , Nutricionistas , Guías de Práctica Clínica como Asunto , Prevalencia , Inhibidores de la Bomba de Protones/uso terapéutico , Calidad de Vida
16.
Int J Med Inform ; 139: 104158, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32388157

RESUMEN

INTRODUCTION: Self-monitoring technologies produce patient-generated data that could be leveraged to personalize nutritional goal setting to improve population health; however, most computational approaches are limited when applied to individual-level personalization with sparse and irregular self-monitoring data. We applied informatics methods from expert suggestion systems to a challenging clinical problem: generating personalized nutrition goals from patient-generated diet and blood glucose data. MATERIALS AND METHODS: We applied qualitative process coding and decision tree modeling to understand how registered dietitians translate patient-generated data into recommendations for dietary self-management of diabetes (i.e., knowledge model). We encoded this process in a set of functions that take diet and blood glucose data as an input and output diet recommendations (i.e., inference engine). Dietitians assessed face validity. Using four patient datasets, we compared our inference engine's output to clinical narratives and gold standards developed by expert clinicians. RESULTS: To dietitians, the knowledge model represented how recommendations from patient data are made. Inference engine recommendations were 63 % consistent with the gold standard (range = 42 %-75 %) and 74 % consistent with narrative clinical observations (range = 63 %-83 %). DISCUSSION: Qualitative modeling and automating how dietitians reason over patient data resulted in a knowledge model representing clinical knowledge. However, our knowledge model was less consistent with gold standard than narrative clinical recommendations, raising questions about how best to evaluate approaches that integrate patient-generated data with expert knowledge. CONCLUSION: New informatics approaches that integrate data-driven methods with expert decision making for personalized goal setting, such as the knowledge base and inference engine presented here, demonstrate the potential to extend the reach of patient-generated data by synthesizing it with clinical knowledge. However, important questions remain about the strengths and weaknesses of computer algorithms developed to discern signal from patient-generated data compared to human experts.


Asunto(s)
Glucemia/análisis , Diabetes Mellitus/dietoterapia , Dieta , Estado Nutricional , Nutricionistas/estadística & datos numéricos , Grupo de Atención al Paciente/organización & administración , Automanejo , Algoritmos , Sistemas Especialistas , Conocimientos, Actitudes y Práctica en Salud , Humanos , Proyectos Piloto
17.
Rev Gaucha Enferm ; 41(spe): e20190121, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32294685

RESUMEN

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.


Asunto(s)
Personal de Salud , Cuidado Pastoral , Espiritualidad , Centros de Tratamiento de Abuso de Sustancias , Trastornos Relacionados con Sustancias/rehabilitación , Adulto , Femenino , Personal de Salud/ética , Personal de Salud/organización & administración , Personal de Salud/psicología , Humanos , Masculino , Meditación , Persona de Mediana Edad , Personal de Enfermería/psicología , Nutricionistas/psicología , Cuidado Pastoral/ética , Relaciones Profesional-Paciente , Psicología , Investigación Cualitativa , Religión , Respeto , Trastornos Relacionados con Sustancias/psicología
19.
Patient Educ Couns ; 103(8): 1645-1649, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32199691

RESUMEN

OBJECTIVE: Effective communication is fundamental to helping patients change behaviour. Few studies have operationalised how to quantify and improve the patient centeredness of communication during the dietitian outpatient consultation. We sought to evaluate the impact of a renal diet question prompt sheet (QPS) on patient centeredness (PC) in dietitian outpatient clinics and describe the impact of a renal diet QPS on the volume and pattern of communication between dietitians (n = 4) and patients/carers (n = 24, n = 11). METHODS: The Roter Interaction Analysis System was used to compute a PC index, the volume communication (number of questions and utterances) and categorise dietitian communication. RESULTS: The QPS was associated with significant improvements in the PC of communication (p = 0.004 and p = 0.001), without increasing the volume of communication. The QPS was also associated with an increase in the total number of questions asked (p < 0.0001) especially from patients (p = 0.0009); and an increase in the volume of communication devoted to education and counselling (p < 0.0001). CONCLUSIONS: This study describes a promising intervention to increase the patient centeredness of dietetic consultations in an outpatient setting. PRACTICE IMPLICATIONS: Whilst simple in design, the use of a QPS had a large effect on how patients and carers interact with the dietitian in the outpatient setting.


Asunto(s)
Consejo/métodos , Nutricionistas/psicología , Participación del Paciente , Atención Dirigida al Paciente , Relaciones Médico-Paciente , Derivación y Consulta/normas , Instituciones de Atención Ambulatoria , Comunicación , Dieta , Femenino , Humanos , Masculino
20.
J Nutr Gerontol Geriatr ; 39(2): 143-153, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32081103

RESUMEN

Objective: The purpose of this study was to explore dietetic students' facilitators, barriers, and perceptions of working with older adults.Method: A purposive sampling method was used to conduct individual, face-to-face-interviews with students majoring in human nutrition (n = 17). All interviews were audio recorded, transcribed verbatim, and coded using NVivo 11 software. A directed content analysis revealed the following themes under categories of (1) perception, (2) barriers, (3) facilitators, and (4) impact of experience.Results: For perception, students discussed older adults' positive and negative personality traits and their physical and cognitive deterioration. Such perception contributed to their view of barriers in interactions with older adults, which were both external and internal in nature. Students mentioned previous experience and knowledge about older adults as well as their own personalities served as major facilitators in interacting with older adults. Gaining experience working with older adults deepened students' understanding of and empathy for this population.Discussion: Findings offer insight into how to develop dietetic curricula to address students' perceptions and resulting barriers for training well-prepared registered dietitians motivated to serve the rapidly growing older adult population.


Asunto(s)
Curriculum , Dietética/educación , Nutricionistas/educación , Estudiantes/psicología , Adulto , Alabama , Femenino , Humanos
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