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Brostow DP, Smith AA, Bahraini NH, Besterman-Dahan K, Forster JE, Brenner LA. Nutrition and Food Security Among Veterans: Operationalizing Nutritional Functioning. Arch Phys Med Rehabil 2024:S0003-9993(24)00948-1. [PMID: 38649010 DOI: 10.1016/j.apmr.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 04/03/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To assess injured military veterans' experiences, beliefs, and daily physical and psychosocial functioning in relation to food and nutrition. DESIGN We used a convergent mixed-methods study design and the International Classification of Functioning, Disability, and Health to operationalize the core constructs and influencing factors related to physical and psychosocial functioning, food, and nutrition. SETTING Three Veterans Affairs polytrauma rehabilitation centers. PARTICIPANTS Veterans who served in the United States military on or after September 11, 2001, and whose medical diagnoses met the criteria for polytrauma; at least 1 mild traumatic brain injury and at least 1 associated comorbidity (eg, posttraumatic stress disorder, chronic musculoskeletal pain, vestibular disturbances), for a total N of 43. INTERVENTIONS None. MAIN OUTCOME MEASURES Themes from survey responses and semistructured interview data were pooled into core constructs and influencing factors. RESULTS Thirty-seven veterans completed all surveys and participated in recorded interviews. Based on qualitative and quantitative data, veterans' relation to food and nutrition (ie, nutritional functioning) was found to be characterized by 5 core constructs, including food background, nutrition knowledge, meal aptitude, resource navigation, and navigation to/of food spaces. Nutritional functioning was found to be shaped by 5 influencing factors, including injuries and health conditions, ideological and cultural exposures, relations, current beliefs, and current behaviors. CONCLUSIONS Nutritional functioning (food background, nutrition knowledge, meal aptitude, resource navigation, navigation to/of food spaces) among injured veterans is complex and shaped by multiple physical, psychosocial, economic, and cultural factors.
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Affiliation(s)
- Diana P Brostow
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO; Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Alexandra A Smith
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO
| | - Nazanin H Bahraini
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO; Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Karen Besterman-Dahan
- VA VISN (Veteran Integrated Services Network) 5 Mental Illness Research Education and Clinical Center (MIRECC), Washington, DC; Department of Nutrition and Dietetics, College of Public Health, University of South Florida, Tampa, FL
| | - Jeri E Forster
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO; Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO; Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO; Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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Nishioka S, Wakabayashi H. Interaction between malnutrition and physical disability in older adults: is there a malnutrition-disability cycle? Nutr Rev 2023; 81:191-205. [PMID: 35831980 DOI: 10.1093/nutrit/nuac047] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Malnutrition and physical disability are urgent issues in super-aging societies and the 2 phenomena are closely linked in older adults. Both conditions have common underlying causes, including physiological changes due to aging and burdens imposed by disease or injury. Accordingly, a concept of the malnutrition-disability cycle was generated and a comprehensive literature search was performed. There was insufficient evidence to prove an interrelationship between malnutrition and physical disabilities, because of the study design and poor quality, among other factors. However, some evidence exists for the interaction between low body mass index and swallowing disorders, and the effects of some malnutrition and disability components. This review provides the rationale for this interaction, the concept of a malnutrition-disability cycle is proposed, and the available evidence is critically appraise.
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Affiliation(s)
- Shinta Nishioka
- is with the Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki City, Nagasaki, Japan
| | - Hidetaka Wakabayashi
- is with the Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
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3
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Zbären E, Padmanabhan S, Jent S. Monitoring/Evaluation in Nutritional Therapy for People with
Gastrointestinal Complaints: Online Survey with Dietitians. AKTUELLE ERNÄHRUNGSMEDIZIN 2022. [DOI: 10.1055/a-1895-2430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abstract
Introduction Dietary interventions are part of the therapy approach in
gastrointestinal disorders. However, guidance on what outcomes to assess (in the
form of a core outcome set) for dietitians to demonstrate the effectiveness of
their interventions is lacking. This study provides preliminary work for the
development of a core outcome set to systematically assess outcomes of nutrition
therapy in clients with gastrointestinal complaints by examining how
monitoring/evaluation are conducted by dietitians.
Methods This is a quantitative online survey for dietitians to assess the
current situation around the globe concerning monitoring and evaluation. An
online survey with 26 questions divided into six sections (rated importance,
implementation, resources/obstacles, instrument requirements,
statistical questions and experiences with the Nutrition Care Process) was
developed. The questionnaire was available in English, French and German.
Results In total 740 responses were analysed.
Monitoring/evaluation of clients with gastrointestinal symptoms was
rated by 98% to be quite important to very important. The systematic
implementation of monitoring and evaluation according to a concept/model
was rated by 57% as 'rather often' to 'very
often/always'.
Conclusion Dietitians are aware of the importance of the measurability of
dietetic interventions. The most dominant barriers are lacking time in daily
practice and lack of a suitable monitoring/evaluation instrument. A
suitable core outcome set in the field of gastrointestinal complaints is needed
to increase systematic monitoring/evaluation.
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Affiliation(s)
- Eveline Zbären
- Nutrition & Dietetics, Bern University of Applied Sciences,
Bern, Switzerland
| | | | - Sandra Jent
- Nutrition & Dietetics, Bern University of Applied Sciences,
Bern, Switzerland
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Al‐Adili L, Boström A, Orrevall Y, Lang NR, Peersen C, Persson I, Thoresen L, Lövestam E. Self‐reported documentation of goals and outcomes of nutrition care – A cross‐sectional survey study of Scandinavian dietitians. Scand J Caring Sci 2022; 37:472-485. [PMID: 36329640 DOI: 10.1111/scs.13131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 10/05/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The documentation of goals and outcomes of nutrition care in Electronic Health Records is insufficient making further exploration of this of particular interest. Identifying common features in documentation practice among Scandinavian dietitians might provide information that can support improvement in this area. AIMS To explore the associations between clinical dietitians' self-reported documentation of patients' goals and outcomes and demographic factors, self-reported implementation of the systematic framework the Nutrition Care Process 4th step (NCP) and its associated terminology, and factors associated with the workplace. METHODS Data from a cross-sectional study based on a previously tested web-based survey (INIS) disseminated in 2017 to dietitians in Scandinavia (n = 494) was used. Respondents were recruited through e-mail lists, e-newsletters and social media groups for dietitians. Associations between countries regarding the reported documentation of goals and outcomes, implementation levels of the NCP 4th step, demographic information and factors associated with the workplace were measured through Chi-square test. Associations between dependent- and independent variables were measured through logistic regression analysis. RESULTS Clinically practicing dietitians (n = 347) working in Scandinavia, Sweden (n = 249), Norway (n = 60), Denmark (n = 38), who had completed dietetic education participated. The reported documentation of goals and outcomes from nutrition intervention was highly associated with the reported implementation of NCP 4th step terminology (OR = 5.26; p = 0.009, OR = 3.56; p = 0.003), support from the workplace (OR = 4.0, p < 0.001, OR = 8.89, p < 0.001) and area of practice (OR = 2.02, p = 0.017). Years since completed dietetic training and educational level did not have any significant associations with documentation practice regarding goals and outcomes. CONCLUSION Findings highlight strong associations between the implementation of the NCP 4th step terminology and the documentation of goals and outcomes. Strategies to support dietitians in using standardized terminology and the development of tools for comprehensive documentation of evaluation of goals and outcome are required.
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Affiliation(s)
- Lina Al‐Adili
- Department of Food Studies, Nutrition and Dietetics Uppsala University Uppsala Sweden
| | - Anne‐Marie Boström
- Department of Neurobiology, Care Science and Society Division of Nursing, Karolinska Institutet Huddinge Sweden
- Theme Inflammation and Aging Karolinska University Hospital Huddinge Sweden
- Research and Development Unit Stockholms Sjukhem Stockholm Sweden
- Karolinska Institutet Huddinge Sweden
| | - Ylva Orrevall
- Department of Biosciences and Nutrition Karolinska Institute Stockholm Sweden
- Medical Unit Clinical Nutrition Women's Health and Allied Health Professionals Theme, Karolinska University Hospital Stockholm Sweden
| | - Nanna R. Lang
- Department of Nutrition and Health VIA University College Denmark
| | - Charlotte Peersen
- Department of Unit for Service and Intern Control Department of Service and Quality, Trondheim Municipality Trondheim Norway
| | - Inger Persson
- Department of Statistics Uppsala University Uppsala Sweden
| | - Lene Thoresen
- Cancer Clinic, St. Olavs Hospital Trondheim University Hospital Trondheim Norway
| | - Elin Lövestam
- Department of Food Studies, Nutrition and Dietetics Uppsala University Uppsala Sweden
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Gurugubelli VS, Fang H, Shikany JM, Balkus SV, Rumbut J, Ngo H, Wang H, Allison JJ, Steffen LM. A review of harmonization methods for studying dietary patterns. SMART HEALTH (AMSTERDAM, NETHERLANDS) 2022; 23:100263. [PMID: 35252528 PMCID: PMC8896407 DOI: 10.1016/j.smhl.2021.100263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Data harmonization is the process by which each of the variables from different research studies are standardized to similar units resulting in comparable datasets. These data may be integrated for more powerful and accurate examination and prediction of outcomes for use in the intelligent and smart electronic health software programs and systems. Prospective harmonization is performed when researchers create guidelines for gathering and managing the data before data collection begins. In contrast, retrospective harmonization is performed by pooling previously collected data from various studies using expert domain knowledge to identify and translate variables. In nutritional epidemiology, dietary data harmonization is often necessary to construct the nutrient and food databases necessary to answer complex research questions and develop effective public health policy. In this paper, we review methods for effective data harmonization, including developing a harmonization plan, which common standards already exist for harmonization, and defining variables needed to harmonize datasets. Currently, several large-scale studies maintain harmonized nutrient databases, especially in Europe, and steps have been proposed to inform the retrospective harmonization process. As an example, data harmonization methods are applied to several U.S longitudinal diet datasets. Based on our review, considerations for future dietary data harmonization include user agreements for sharing private data among participating studies, defining variables and data dictionaries that accurately map variables among studies, and the use of secure data storage servers to maintain privacy. These considerations establish necessary components of harmonized data for smart health applications which can promote healthier eating and provide greater insights into the effect of dietary patterns on health.
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Affiliation(s)
| | - Hua Fang
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, 01655, Massachusetts, USA
- Corresponding author. Tel.: +0-508-910-6411;
| | - James M Shikany
- Division of Preventive Medicine, University of Alabama at Birmingham, 1720 University Blvd, Birmingham, 35294, Alabama, USA
| | - Salvador V Balkus
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
| | - Joshua Rumbut
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, 01655, Massachusetts, USA
| | - Hieu Ngo
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
| | - Honggang Wang
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
| | - Jeroan J Allison
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, 01655, Massachusetts, USA
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, 55455, Minnesota, USA
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Integrating a New Dietetic Care Process in a Health Information System: A System and Process Analysis and Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052491. [PMID: 35270184 PMCID: PMC8909013 DOI: 10.3390/ijerph19052491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 12/04/2022]
Abstract
Managing routinely collected data in health care and public health is important for evaluation of interventions and answering research questions using “real life” and ”big data”. In addition to the technical requirements of information systems, both standardized terminology and standardized processes are needed. The aim of this project was to analyse and assess the integration of standardized terminology and document templates for a dietetic care process (DCP) into the health information system (HIS) in a hospital in Austria. Using an action research approach, the DCP was analysed through four expert interviews and the integration into the HIS through two expert interviews with observations. Key strengths and weaknesses for the main criteria (“integration of the ICF catalogue”, “adaption of the document templates”, “adaption of the DCP”, and the “adaption of the user authorizations”) were presented and proposals for improvement given. The system and process integration of the DCP is possible, and the document templates can be adapted with the software currently in use. Although an increase in resources and finances required is to be expected initially, the integration of a standardized dietetic terminology in combination with a standardized process is likely to improve the quality of care and support outcomes management and research.
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Vo R, Smith M, Patton N. Power, autonomy and interprofessional practice in dietitian clinical decision making: An interpretive study in acute hospitals. J Hum Nutr Diet 2021; 35:124-133. [PMID: 33998048 DOI: 10.1111/jhn.12917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
Dietitians learn clinical decision making (CDM) predominantly as an autonomous cognitive process that considers the needs and preferences of the patient. Although interprofessional education is increasing in tertiary dietetic programmes, a paucity of research exists that explores the nature of how practising dietitians make decisions, independent or otherwise. This qualitative interpretative study explored the nature of experienced dietitian CDM in the acute care setting. Philosophical hermeneutic principles guided text construction and interpretation via in-depth, semi-structured interviews with practising dietitians with at least 3 years of experience. A reference focus group commented on the emerging findings, increasing the rigour of the research. Ten dietitians participated in the interviews and there were five dietitians in the reference focus group. CDM was found to be a highly social phenomenon with varying degrees of autonomy involving complex power relations with various other health professionals, in particular, medical practitioners. Dietitians respond to existing power relations in key ways, including building and maintaining relationships, advocating on behalf of the patient and negotiating decisions with other healthcare staff when in pursuit of improved health and nutrition related outcomes for patients. Strategic interprofessional communication skills are foundational to effective patient care and advancing the role of the dietitian. Power and autonomy in dietitian CDM are important concepts that could inform interprofessional education when seeking to promote both effective dietetic and interprofessional practice.
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Affiliation(s)
- Ruth Vo
- Faculty of Science, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Megan Smith
- Faculty of Science, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Narelle Patton
- Faculty of Science, Charles Sturt University, Wagga Wagga, NSW, Australia
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Phillips CA, Pollock BH. Big Data for Nutrition Research in Pediatric Oncology: Current State and Framework for Advancement. J Natl Cancer Inst Monogr 2020; 2019:127-131. [PMID: 31532530 DOI: 10.1093/jncimonographs/lgz019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/20/2019] [Accepted: 07/01/2019] [Indexed: 01/02/2023] Open
Abstract
Recognition and treatment of malnutrition in pediatric oncology patients is crucial because it is associated with increased morbidity and mortality. Nutrition-relevant data collected from cancer clinical trials and nutrition-specific studies are insufficient to drive high-impact nutrition research without augmentation from additional data sources. To date, clinical big data resources are underused for nutrition research in pediatric oncology. Health-care big data can be broadly subclassified into three clinical data categories: administrative, electronic health record (including clinical data research networks and learning health systems), and mobile health. Along with -omics data, each has unique applications and limitations. We summarize the potential use of clinical big data to drive pediatric oncology nutrition research and identify key scientific gaps. A framework for advancement of big data utilization for pediatric oncology nutrition research is presented and focuses on transdisciplinary teams, data interoperability, validated cohort curation, data repurposing, and mobile health applications.
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Affiliation(s)
- Charles A Phillips
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Brad H Pollock
- Department of Public Health Sciences, School of Medicine, University of California, Davis, CA.,University of California Davis Comprehensive Cancer Center, Sacramento, CA
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Gäbler G, Coenen M, Fohringer K, Trauner M, Stamm TA. Towards a nationwide implementation of a standardized nutrition and dietetics terminology in clinical practice: a pre-implementation focus group study including a pretest and using the consolidated framework for implementation research. BMC Health Serv Res 2019; 19:920. [PMID: 31783855 PMCID: PMC6884883 DOI: 10.1186/s12913-019-4600-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 10/03/2019] [Indexed: 02/08/2023] Open
Abstract
Background & Aims In order to assure high quality of nutrition and dietetic care as well as research, the implementation of a standardized terminology, such as the World Health Organization (WHO) International Classification of Functioning, Disability and Health for Dietetics (ICF-Dietetics) is indispensable. The aim of this study was to explore the clinical practicability and applicability of the ICF-Dietetics in the field of nutrition and dietetic practice prior to the implementation in order to develop criteria (points to consider) for a targeted implementation strategy. Methods A focus group study including a pretest of the ICF-Dietetics was conducted. Subsequently, facilitators and barriers for a nationwide implementation of the ICF-Dietetics in clinical nutrition and dietetic practice were identified and linked to interventions (combining theory-based and group-based approach) using the Consolidated Framework of Implementation Research (CFIR) to organize and represent data and summarized in a logic model. Results In the pretest 55 clinical documentations which consisted of 248 different ICF-Dietetics categories were received. In four focus groups with 22 health professionals, 66 relevant higher-level themes and implementation strategy criteria (points to consider) were identified. These themes referred to all five domains of the CFIR, namely intervention characteristics, inner setting, outer setting, characteristics of individuals and implementation process and contained important barriers and facilitators that were linked to six implementation objectives as well as six context requirements and five main actors. Conclusions This study provides facilitators and barriers to be addressed when implementing the ICF-Dietetics in clinical practice and shows potential interventions based on this analysis. A nationwide implementation was mainly seen as a great advantage for enhancing quality and continuity of care and for providing comparable data. However, it requires further refinements and a multifaceted implementation strategy where the engagement of leadership of institutions plays a crucial role. These results have provided a foundation for a targeted implementation strategy to increase the success, reproducibility and comparability.
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Affiliation(s)
- Gabriele Gäbler
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
| | - Michaela Coenen
- LMU Munich, Department of Medical Information Processing, Biometry and Epidemiology (IBE), Chair of Public Health und Health Services Research, Marchioninistr. 17, 81377, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
| | - Katrin Fohringer
- Department of Medicine III, Division of Gastroenterology and Hepatology, Medical Nutrition Therapy and Dietetics, Vienna General Hospital, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Michael Trauner
- Department of Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Tanja A Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
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Gäbler G, Coenen M, Lycett D, Stamm T. Towards a standardized nutrition and dietetics terminology for clinical practice: An Austrian multicenter clinical documentation analysis based on the International Classification of Functioning, Disability and Health (ICF)-Dietetics. Clin Nutr 2019; 38:791-799. [DOI: 10.1016/j.clnu.2018.02.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 02/08/2018] [Accepted: 02/26/2018] [Indexed: 01/07/2023]
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Comprehensive Geriatric Assessment and Nutrition-Related Assessment: A Cross-Sectional Survey for Health Professionals. Geriatrics (Basel) 2019; 4:geriatrics4010023. [PMID: 31023991 PMCID: PMC6473726 DOI: 10.3390/geriatrics4010023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 02/09/2019] [Accepted: 02/12/2019] [Indexed: 01/06/2023] Open
Abstract
(1) Background: It is important to assess physical and nutritional status using the Comprehensive Geriatric Assessment (CGA). However, the correlation between the CGA usage and nutritional-related assessments remain unclear. This study aims to clarify the correlation between the CGA usage and other nutritional-related assessments. (2) Methods: We conducted a questionnaire survey on clinical use of CGA, assessment of sarcopenia/sarcopenic dysphagia/cachexia, and defining nutritional goals/the Nutrition Care Process/the International Classification of Functioning, Disability, and Health (ICF)/the Kuchi–Kara Taberu Index. (3) Results: The number of respondents was 652 (response rate, 12.0%), including 77 who used the CGA in the general practice. The univariate analyses revealed that participants using the CGA tended to assess sarcopenia (P = 0.029), sarcopenic dysphagia (P = 0.001), and define nutritional goals (P < 0.001). Multivariate logistic regression analyses for the CGA usage revealed that using ICF (P < 0.001), assessing sarcopenia (P = 0.001), sarcopenic dysphagia (P = 0.022), and cachexia (P = 0.039), and defining nutritional goals (P = 0.001) were statistically significant after adjusting for confounders. (4) Conclusions: There are correlations between the use of CGA and evaluation of sarcopenia, sarcopenic dysphagia, and cachexia and nutritional goals.
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Lövestam E, Steiber A, Vivanti A, Boström AM, Devine A, Haughey O, Kiss CM, Lang NR, Lieffers J, Lloyd L, O'Sullivan TA, Papoutsakis C, Peersen C, Thoresen L, Orrevall Y. Use of the Nutrition Care Process and Nutrition Care Process Terminology in an International Cohort Reported by an Online Survey Tool. J Acad Nutr Diet 2018; 119:225-241. [PMID: 30553587 DOI: 10.1016/j.jand.2018.09.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 09/04/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Dietitians in countries across the world have been implementing the Nutrition Care Process (NCP) and Terminology (NCPT) during the past decade. The implementation process has been evaluated in specific countries and in smaller international studies; however, no large international study comparing implementation between countries has been completed. OBJECTIVE The aim of this study was to describe and compare the level of NCP/NCPT implementation across 10 countries. METHODS A previously tested web-based survey was completed in 2017 by 6,719 dietitians across 10 countries. Participants were recruited through e-mail lists, e-newsletters, and social media groups for dietitians. Nondietitians were excluded through screening questions and targeted dissemination channels. MAIN OUTCOME MEASURES AND STATISTICAL ANALYSIS The main outcome of interest was the level of implementation of each of the four NCP steps. Differences in implementation between the NCP (process) and NCPT (terminology) were also measured. Differences between groups were assessed using Kruskal-Wallis test and Mann-Whitney U test. Multiple linear regression was used to assess relationships between the main outcomes and respondent demographic information. RESULTS Australia, New Zealand, and the United States had higher implementation rates compared with other countries surveyed. Awareness of the NCP was high in most countries (>90%) but lower in Greece (50%). All countries had a higher implementation level of the NCP (process) compared with the NCPT (terminology). Dietitians working with inpatients reported the highest implementation levels while those working in public health reported the lowest. CONCLUSIONS Dietitians in countries with more experience in NCP/NCPT implementation and a clear implementation strategy had higher levels of implementation. To achieve a successful NCP/NCPT implementation among dietitians, there is a need to promote the value of a standardized dietetic language together with the more easily implemented process. There is also a need to promote NCP/NCPT for all areas of practice, and develop strategic plans for implementation of the NCP and NCPT.
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Lorentzen SS, Papoutsakis C, Myers EF, Thoresen L. Adopting Nutrition Care Process Terminology at the National Level: The Norwegian Experience in Evaluating Compatibility with International Statistical Classification of Diseases and Related Health Problems, 10th Revision, and the Existing Norwegian Coding System. J Acad Nutr Diet 2018; 119:375-393. [PMID: 29685825 DOI: 10.1016/j.jand.2018.02.006] [Citation(s) in RCA: 239] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Indexed: 11/29/2022]
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