Importance Of Nutritional Care Research Articles

Attitudes and knowledge of dietitian practice among a representative sample of Israeli adults

BackgroundThere is confusion among members of the general public regarding the role of dietitians in healthcare. Little is known about public attitudes towards dietitians among the general public in Israel. ObjectivesThe present study aims to identify beliefs and attitudes about dietitians in clinical practice held by a representative sample of Israeli adults. MethodsThe present cross-sectional survey was conducted online. ResultsA total of 402 Israeli adults participated. The majority of respondents indicated that dietitians perform nutrition consultations and weight loss counselling. More than half of respondents knew that dietitians have at least a bachelor’s degree, but more than one third thought the degree was in alternative medicine. The majority of respondents ranked dietitians as the healthcare professionals with the greatest knowledge of human nutrition. Approximately have of respondents had been previously treated by a dietitian, and these people were more likely indicate the importance of nutrition care in treating chronic disease; further, they stated that dietitians utilize biochemical, anthropometric and other data in order to personalize nutrition care. In logistic regression analyses of specific dietitian roles, prior treatment by a dietitian emerged as a robust predictor of the role of the dietitian in healthcare. DiscussionRespondents identified dietitians as the professionals with the most knowledge of nutrition and the clinicians with whom they would most likely consult if they desired to change their eating habits.

Physicians' Perceptions of the Registered Dietitian Are Evolving

Physicians' perceptions of registered dietitians (RDs), specifically regarding order writing privileges (OWPs), are relatively unknown. A survey containing questions about demographics, RD competency, roles, and importance of nutrition care was administered to 109 physicians from a large hospital network caring for pediatric patients. Results were determined by t tests and analysis of variance. Physicians believed RDs are most responsible for nutrition education/counseling and least for food service. Those who strongly agreed with the importance of providing nutrition care were more likely to perceive RDs as responsible for that care. Physicians who perceived RDs should initiate diet orders reported higher perceptions regarding systemic effects of granting OWPs.

Enrolled nurses' perceptions of providing nutritional care to hospitalised older people in Singapore's acute care setting: A qualitative descriptive study.

Malnutrition is a growing challenge in health care as its prevalence among hospitalised older people is expected to intensify alongside the rapidly ageing world's population. Singapore's nursing framework adopts enrolled nurses as the main providers to nutritional care, where nutritional care is a process of screening, assessment, intervention, continuous monitoring and documentation. This is the first Asian study conducted on enrolled nurses' perceptions of nutritional care. To explore enrolled nurses' perceptions of providing nutritional care to hospitalised older people in Singapore's acute care setting. This is a qualitative descriptive study. Individual face-to-face semi-structured interviews using an interview guide were conducted with 15 enrolled nurses from September 2017 to January 2018. The collected data were analysed using content analysis. Four main categories were identified as follows: (1) The role of enrolled nurses in the provision of nutritional care, (2) Perceived enablers in nutritional care, (3) Perceived challenges in nutritional care and (4) Proposed strategies to improve nutritional care. This study provided insights to the perceived roles of enrolled nurses in nutritional care. It also outlined the enablers and challenges faced by the enrolled nurses and their suggestions to improve nutritional care provision. One critical finding was the need to better engage families and domestic helpers in nutritional care of older people. To optimise nutritional care delivery, healthcare institutions should explore ways to engage and involve families and domestic helpers during older patients' mealtimes. Nurses could also educate older people, their families and domestic helpers on the importance of nutritional care during hospitalisation.

A Review of Nutrition Support Guidelines for Individuals with or Recovering from COVID-19 in the Community.

COVID-19 negatively impacts nutritional status and as such identification of nutritional risk and consideration of the need for nutrition support should be fundamental in this patient group. In recent months, clinical nutrition professional organisations across the world have published nutrition support recommendations for health care professionals. This review summarises key themes of those publications linked to nutrition support of adults with or recovering from COVID-19 outside of hospital. Using our search criteria, 15 publications were identified from electronic databases and websites of clinical nutrition professional organisations, worldwide up to 19th June 2020. The key themes across these publications included the importance in the community setting of: (i) screening for malnutrition, which can be achieved by remote consultation; (ii) care plans with appropriate nutrition support, which may include food based strategies, oral nutritional supplements and referral to a dietitian; (iii) continuity of nutritional care between settings including rapid communication at discharge of malnutrition risk and requirements for ongoing nutrition support. These themes, and indeed the importance of nutritional care, are fundamental and should be integrated into pathways for the rehabilitation of patients recovering from COVID-19.

ASPECTOS CLÍNICOS DA MÁ NUTRIÇÃO NA COVID-19

The pandemic caused by the new coronavirus has sparked discussions among health professionals about the role of food and nutrition in the infectious condition caused by the SARS-CoV-2 virus in different population groups. Malnutrition, including obesity, may reflect more severe outcomes in the physiopathology of infection and systemic responses caused by COVID-19. The present work aims to make considerations directed to the nutritionist about the susceptibility of COVID-19 in individuals submitted to malnutrition, highlighting possible outcomes of the disease and the importance of nutritional care in maintaining the health of these patients. Therefore, maintaining a good nutritional status of these patients, combined with an adequate level of micronutrients will not guarantee protection against infection caused by COVID-19, however, it is essential to minimize the risks of worsening this disease.

Nutritional Care for Patients with Ebola Virus Disease in Ebola Treatment Units – Past and Current Experiences from Practitioners

Background In November 2014, the World health Organization (WHO), in collaboration with United Nations Children's Fund (UNICEF), and the World Food Programme, produced interim guidelines (iGL) on providing nutritional support to patients in Ebola treatment units (ETUs). They have been translated into French and issued by the Ministry of Health, UNICEF and WHO in adapted versions to be used in the current outbreak in the Democratic Republic of the Congo (DRC). This paper evaluates the use and usefulness of the 2014 iGL in the West Africa and current DRC Ebola virus disease (EVD) outbreaks and identifies experiences and lessons learned from practitioners on the operational aspects of nutritional care and support in ETUs. Methods Key-informants (n=26), from 12 organizations (Non-Governmental Organizations, United Nations, Red Cross Red Crescent Movement) were interviewed who were actively engaged in the nutritional and/or clinical care of EVD patients. Results There was a consensus among key informants that the 2014 iGL initially served a guiding purpose. However, the vast amount of learning from the 2014-2016 and current EVD outbreaks indicates that the interim guidelines need to be revised. Practitioners struggled to find operational solutions for nutritional care, and the challenges were plentiful, especially regarding 1) the different perceptions of the importance of nutritional care among ETU staff; 2) the difficulties around food preparation and distribution for EVD patients; 3) how to take into account the patients’ dietary preferences; 4) the nutritional care needed in relation to specific EVD symptoms; 5) who assumed roles in nutritional care in ETUs; 6) if and how feeding support was organized; 7) whether malnutrition needed to be addressed and how; and 8) whether the intake of specific nutrients could contribute to improved treatment outcomes. Information from the key-informants interviews resulted in numerous lessons learned and recommendations for nutritional support during current and future outbreaks. Conclusions This investigation underscored the importance of documenting experiences of practitioners on nutritional care in emerging infectious diseases for which limited scientific evidence exists and for which interim guidelines are produced to fill in knowledge gaps. It also emphasized the importance of nutritional care in ETUs during treatment.

Lack of focus on nutrition and documentation in nursing homes, home care- and home nursing: the self-perceived views of the primary care workforce

BackgroundMalnutrition is a comprehensive challenge for the nursing home, home care- and home nursing sector. Nutritional care and the subsequent documentation are a common and multifaceted healthcare practice that requires that the healthcare professionals possess complex combinations of competencies in order to deliver high-quality care and treatment. The purpose of this study was to investigate how a varied group of healthcare professionals’ perceive their own competencies within nutrition and documentation and how organizational structures influence their daily work and the quality of care provided.MethodsTwo focus groups consisting of 14 healthcare professionals were conducted. The transcribed focus group interviews was analyzed using the qualitative content analysis approach.ResultsSix categories were identified: 1) Lack of uniform and systematic communication affect nutritional care practices 2) Experience-based knowledge among the primary workforce influences daily clinical decisions, 3) Different attitudes towards nutritional care lead to differences in the quality of care 4) Differences in organizational culture affect quality of care, 5) Lack of clear nutritional care responsibilities affect how daily care is performed and 6) Lack of clinical leadership and priorities makes nutritional care invisible.ConclusionsThe six categories revealed two explanatory themes: 1) Absent inter- and intra-professional collaboration and communication obstructs optimal clinical decision-making and 2) quality deterioration due to poorly-established nutritional care structure. Overall, the two themes explain that from the healthcare professionals’ point of view, a visible organization that allocates resources as well as prioritizing and articulating the need for daily nutritional care and documentation is a prerequisite for high-quality care and treatment. Furthermore, optimal clinical decision making among the healthcare professionals are compromised by imprecise and unclear language and terminology in the patients’ healthcare records and also a lack of clinical guidelines and standards for collaboration between different healthcare professionals working in nursing homes, home care or home nursing.The findings of this study are beneficial to support organizations within these settings with strategies focusing on increasing nutritional care and documentation competencies among the healthcare professionals. Furthermore, the results advocate for the daily involvement and support of leaders and managers in articulating and structuring the importance of nutritional care and treatment and the subsequent documentation.

The role of the dietitian in the management of malnutrition in the elderly: A systematic review of current practices.

The prevalence of age-related malnutrition is increasing in almost all Western countries. Because of their expertise, dietitians should have a central role in the management of malnutrition. This review aimed to synthesise the literature on the role of the dietitian in the management of malnutrition in the elderly in comparison with other health professionals. In November 2018, a search of Embase, Medline Ovid, Cinahl Ebscohost, Cochrane Central, Web of Science and Google Scholar was undertaken using 'dietitian', 'elderly' and 'malnutrition' as the main search terms. Qualitative and quantitative empirical research studies that focussed on the role of dietitians as the (main) subject of the study were included. Data extraction and data synthesis were performed by the three authors using a thematic synthesis approach. Three themes emerged from the coding and synthesis of the 21 included studies. The first theme demonstrates that other health professionals' time for, and knowledge of, screening policies negatively affects the role of the dietitian. The second theme demonstrates that the importance of nutritional care is acknowledged. However, this does not always imply familiarity with dietetics nor does it always mean that other health professionals think involving dietitians is worth the effort. The third theme demonstrates that issues of workload appeared to be especially important in crossing or guarding role boundaries. The role of dietitians in managing age-related malnutrition is not always clear and coherent. Therefore, how dietitians shape their role to provide optimal management of malnutrition in the elderly is open to debate.

Doctors as a Part of Nutrition Care of Patients (Srinagar, Jammu and Kashmir)

Doctor’s main role and prior responsibility is medical treatment of patients. Doctors can also share their expertise in nutrition care of patients in hospitals. Optimum nutrition affects both the response to medical treatments and eventually recovery. Doctors are usually perceived as the best source of information, by patients. In addition, they must provide some nutrition information to patients, in order to provide good care to patients. Doctors can motivate patients to eat healthy and also guide patients for dietary modifications to help in recovery. The present study, exploratory in nature, was carried out in Srinagar to have an insight and know the role and perspective in patient care especially in context of nutrition services, in the hospitals. The objective of the study was to investigate about if doctors were a part of nutrition care. Study sample consisted of 62 doctors, representing 2% from each hospital. Data was gathered using an interview schedule followed by observation and discussion with doctors. A scoring pattern was formed to evaluate doctor’s perspective and their role in nutrition care of patients. Data was collected from 11 hospitals which provided nutrition services to patients which were included in the study. It was seen that doctors appeared to have a minimal role and little awareness of the assessment of nutritional needs of patients. Doctors reported that they briefly discussed the diet with some of their patients. Nutritional assessment was not done during the patients hospital stay. Their interaction with dietitians was also not adequate about patients nutrition care. It was concluded that there was a need to increase the awareness of doctors about the importance of nutrition care of patients. However what was encouraging was the response of the doctors towards the need for dietitians, providing a balanced diet and nutrition counselling, perhaps indicating some realization that dietitians were required for improving nutrition care of patients.

Providing Nutrition Care to Patients with Chronic Disease: An Irish Teaching Hospital Healthcare Professional Study

An increasing prevalence of noncommunicable diseases (NCDs) and chronic illness is putting an ever increasing burden on healthcare services and delivery worldwide. Diet contributes significantly to the development of NCDs. Nutrition should therefore be viewed as an important aspect of patient care and be addressed by all healthcare professionals (HCPs). Previous work has highlighted a lack of competency around providing nutrition advice in HCPs; however, positive attitudes towards the importance of nutrition care are well documented in this group. The aim of this study is to document and compare Irish HCPs self-perceived competency towards incorporating nutrition care into practice. The NUTCOMP questionnaire was completed by 206 HCPs in Sligo University Hospital. The findings showed positive attitudes towards the incorporation of nutrition care into HCP practice; however, confidence in knowledge and skills was low, thus missing vital opportunities to prevent and/or treat chronic diseases and improve outcomes in acute illness. Previous nutrition education was associated with greater self-perceived knowledge about and skills in providing nutrition care to patients and positively associated with attitudes towards incorporating nutrition care into practice. HCPs expressed a desire and unmet need for additional and ongoing educational intervention in the area of nutritional intervention.

The importance of nutritional care

The importance of nutritional care

Supplement improves nutrition and stresses caused by examination‐associated fasting in patients with liver cirrhosis

Cirrhotic patients tend to develop malnutrition by fasting, yet the importance of nutritional care during examination-associated fasting has not been investigated. This study aimed to examine the effects of a nutritional supplement on nutrition and stresses caused by examination-associated fasting in cirrhotic patients. Twenty-nine cirrhotic patients were enrolled in this study. No energy was supplied to patients in the fasting group (n = 11) prior to computed tomography or magnetic resonance imaging examination. A supplement of 200 kcal was given to the patients in the supplement group (n = 18) prior to computed tomography or magnetic resonance imaging examination. The effect of the supplement on stresses was evaluated by self-rating questionnaire. Changes in biochemical parameters were also investigated before and after computed tomography or magnetic resonance imaging examinations. There were no significant differences in age, sex, body mass index, or liver function tests between the two groups at the start of the study. In the supplement group, stress scores for physical symptoms (thirst and light-headedness) and mental symptoms (hunger, hypodynamia and fatigue) were significantly lower compared to those in the fasting group. Also in the supplement group, peripheral 3-hydroxybutyric acid and free fatty acids levels were significantly decreased compared to those in the fasting group, to within normal ranges. In addition, a decrease in prothrombin time was significantly inhibited by intake of the supplement. We demonstrated that a nutritional supplement improved nutrition and reduced both the physical and mental stresses associated with examination-associated fasting in cirrhotic patients.

Évaluation de l’état nutritionnel au cours de la cirrhose

The liver plays a key role in the metabolism of nutrients. Therefore, liver failure is often associated with malnutrition. It is well-established that malnutrition is an independent prognostic factor in patients with cirrhosis and liver failure. Since standard anthropometric and biological indexes are associated with liver dysfunction, nutritional assessment is difficult in patients with cirrhosis. In this review, we explain the various causes and mechanisms leading to malnutrition in cirrhosis. We also describe reliable methods used to assess the nutritional condition of these patients. Finally, we stress the importance of nutritional care in cirrhosis and liver dysfunction, describing its specific characteristics and indications.