Practices and resilience of dieticians during the COVID-19 pandemic: a national survey in the United Arab Emirates

"The Year of Give": Dietitians' Experiences in Nova Scotia during the COVID-19 Pandemic

Purpose: Researchers explored the roles and responsibilities of dietitians in Nova Scotia during the first three waves of the COVID-19 pandemic. Methods: Twenty-two dietitians who had completed a survey agreed to participate in interviews to elucidate their views. Two group and 13 individual interviews were held with dietitians from diverse work sectors during the summer of 2021. Interviews were transcribed verbatim, organized using NVivo software, and analyzed thematically. The Social Ecological Model of Health framed the study by exploring the individual, interpersonal, community, organizational, and policy aspects of practice. Results: Major themes reflected constantly changing responsibilities, dealing with the impact of cancelled or delayed health services, coping with stress, and valuing/devaluing dietetics work. Professional education needs and conditions for successful practice were also identified. Conclusions: Dietitians' experiences varied depending on the sector in which they worked, with significant role changes unique to each sector. Emergency preparedness, infection control, health equity, and mental health/self-care were identified as areas for further education and development. The breadth of foundational dietetics training enabled dietitians to take on diverse responsibilities and leadership roles. This supports calls to enhance dietitians' scope of practice in Nova Scotia.

Prevalence of emotional burnout among dietitians and nutritionists: a systematic review, meta-analysis, meta-regression, and a call for action

BACKGROUND AND OBJECTIVES

Despite anecdotal evidence pointing to the high prevalence of job stress and burnout among dietitians and nutritionists, few studies have been conducted on this topic. Moreover, most studies are from Western countries. The objective of the current study, based on systematic review, meta-analysis, and meta-regression, is aimed to provide systematically graded evidence to assess the prevalence of emotional burnout among dietitians and nutritionists across age, sex, and cultural backgrounds.

METHODS

Two reviewers independently conducted a systematic search from 1 January 2000, to 1 April 2024 and was later updated to 15 November 2024, across seven databases: EBSCOhost Research Platform, EMBASE, PubMed/MEDLINE, ProQuest, ScienceDirect, Scopus, and Web of Science. The DerSimonian-Laird method was utilized to pool the data in this meta-analysis. Data from a total of 12,166 dietitians and nutritionists were extracted from 16 datasets (published in twelve research reports) covering a period of approximately 25 years. We measured the pooled prevalence of global burnout syndrome and its individual symptoms among dietitians and nutritionists. Subgroup meta-analyses were also conducted to identify a comprehensive set of moderators, including participants' age and sex.

RESULTS

The prevalence of global burnout syndrome in dietitians and nutritionists (K = 10, N = 10,081) showed an overall prevalence rate of 40.43% [23.69; 59.74], I² = 99.3%, τ [95% CI] = 1.18 [0.84; 1.97], τ² [95% CI] = 1.38 [0.71; 3.89], H [95% CI] = 12.68 [11.70; 13.74]. The prevalence of burnout dimensions/individual symptoms in dietitians and nutritionists (K = 2, N = 695) is summarized as follows: emotional exhaustion (EE) at 26.11% [15.14; 41.17], I² = 84.0%, τ = 0.21, τ² = 0.46, Q = 6.25, p < 0.001; depersonalization (DP) at 6.59% [1.08; 31.22], I² = 95.0%, τ = 1.72, τ² = 1.31, Q = 20.18, p < 0.001; and personal accomplishment (PA) at 59.29% [39.81; 76.23], I² = 89.3%, τ = 0.29, τ² = 0.54, Q = 9.36, p < 0.001. Meta-regression showed no difference by age or sex, p = 0.80, and p = 0.20, respectively.

CONCLUSION

This meta-analysis revealed that the prevalence of burnout among dietitians and nutritionists is as high as in other medical professionals. Furthermore, age and sex were not significantly associated with emotional burnout among dietitians and nutritionists. This study provides the impetus for policy changes to improve dietitians' and nutritionists' working conditions, as well as the overall quality of nutrition care.

Psychometric properties of an Arabic translation of the 10-item Connor-Davidson resilience scale (CD-RISC-10), the 8- and 10-item post-traumatic growth inventory-short form (PTGI-SF) scales

BACKGROUND

Given their clinical significance and impact on stress response and their potential malleability, resilience and posttraumatic growth (PTG) should receive greater attention as relevant constructs in clinical and research practice in the Arab context. We aimed through the present study to test the psychometric properties of Arabic translations of the 10-item Connor-Davidson Resilience scale (CD-RISC-10), the 10-item and the 8-item Post-Traumatic Growth Inventory-Short Form (PTGI-SF) in a sample of Lebanese adults from the general population.

METHODS

Three hundred eighty-seven Arabic-speaking participants (mean age = 26.17; 58.4% females) responded to a self-report web-based questionnaire. The forward and backward translation method was applied with the approval of the original developers of the scales.

RESULTS

Confirmatory factor analysis indicated that fit of the one-factor model was acceptable, and all indices suggested that configural, metric, and scalar invariance was supported across gender for all the three scales. The CD-RISC-10, the 10-item and the 8-item PTGI-SF yielded a good internal consistency, with a McDonald's ω of .89, .95, and .93, respectively. Higher resilience and higher PTG were significantly and positively associated with greater cognitive reappraisal and lower emotion suppression, supporting convergent validity.

CONCLUSION

We preliminarily suggest that these Arabic instruments are appropriate for use in Lebanese community adults to assess different positive responses after life crises, identify people with lack or low levels of resilience and growth who might need intervention, and monitor their response to therapy. Further cross-cultural validations should seek to extend their use in broader Arabic-speaking populations and settings.

A Snapshot of the Experience of Dietitians during the COVID-19 Crisis in Five Arab Countries: Findings from a Regional Cross-Sectional Study

COVID-19's intimidating spread has challenged the resilience of the global health systems, causing shifts in the practices of healthcare workers, including dietitians. The current study aimed to assess the change in dietitians' practices and duties in hospitals/clinics after the commencement of COVID-19 pandemic. This cross-sectional study was conducted in five Arab countries between November 2020 and January 2021. A convenient sample of 903 dietitians filled an online self-administered questionnaire to meet the study aims. Nearly 40.0% of the dietitians experienced a change in their workload and caseload during the pandemic. Besides, 18.7% of the dietitians had been assigned additional tasks in their facilities. Nearly half the dietitians (46.9%) had started giving remote nutrition consultations, associated with a 21% drop in the number of dietitians offering in-person consultations (p = 0.001). Approximately 58.9% of the dietitians provided nutrition care to COVID-19 patients, with 48.4% having access to personal protective equipment. Moreover, 17.0% of dietitians supported COVID-19 patients with enteral and parenteral nutrition. In addition, 45.0% of dietitians reported that managing COVID-19 was challenging given that it was a newly discovered condition.

A global overview of healthcare workers' turnover intention amid COVID-19 pandemic: a systematic review with future directions

BACKGROUND

Globally, the health workforce has long suffered from labour shortages. This has been exacerbated by the workload increase caused by the COVID-19 pandemic. Major collapses in healthcare systems across the world during the peak of the pandemic led to calls for strategies to alleviate the increasing job attrition problem within the healthcare sector. This turnover may worsen given the overwhelming pressures experienced by the health workforce during the pandemic, and proactive measures should be taken to retain healthcare workers. This review aims to examine the factors affecting turnover intention among healthcare workers during the COVID-19 pandemic.

METHODS

A mixed studies systematic review was conducted. The PubMed, Embase, Scopus, CINAHL, Web of Science and PsycINFO databases were searched from January 2020 to March 2022. The Joanna Briggs Institute's Critical Appraisal Tools and the Mixed Methods Appraisal Tool version 2018 were applied by two independent researchers to critically appraise the methodological quality. Findings were synthesised using a convergent integrated approach and categorised thematically.

RESULTS

Forty-three studies, including 39 quantitative, two qualitative and two mixed methods studies were included in this review. Eighteen were conducted in the Middle East, ten in the Americas, nine in the Asia-Pacific region and six in Europe. Nurses (n = 35) were included in the majority of the studies, while physicians (n = 13), allied health workers (n = 11) and healthcare administrative or management staff (n = 7) were included in a smaller proportion. Five themes emerged from the data synthesis: (1) fear of COVID-19 exposure, (2) psychological responses to stress, (3) socio-demographic characteristics, (4) adverse working conditions, and (5) organisational support.

CONCLUSIONS

A wide range of factors influence healthcare workers' turnover intention in times of pandemic. Future research should be more focused on specific factors, such as working conditions or burnout, and specific vulnerable groups, including migrant healthcare workers and healthcare profession minorities, to aid policymakers in adopting strategies to support and incentivise them to retain them in their healthcare jobs.

A Study of United States Registered Dietitian Nutritionists during COVID-19: From Impact to Adaptation

The COVID-19 pandemic introduced an unprecedented health crisis, requiring many Registered Dietitian Nutritionists (RDNs) to expand their duties and services, while other RDNs faced unemployment, reduced hours, and changes to their work environment. This study evaluated whether the pandemic impacted RDNs' weight, eating behaviors, and psychological factors, and whether professional training as an RDN was perceived as a protective factor in maintaining healthy habits. A 57-item, cross-sectional, online questionnaire including open-ended questions was distributed to RDNs residing in the United States. Over two months (January 2021 to February 2021), 477 RDNs completed the questionnaire. Among RDNs, 68.5% reported no weight change, 21.4% reported weight gain greater than 5 pounds, and 10.3% reported weight loss greater than 5 pounds. Approximately 75% (n = 360) reported their RDN professional training equipped them with the skills needed to maintain healthy eating behaviors. Reduced physical activity and mental health were the top qualitative themes that emerged regarding reasons for weight change. These findings suggest that RDN professional practice skills may have conferred some personal health benefits, as evidenced by smaller weight gains, the maintenance of healthy habits, and fewer reporting psychological effects relative to the general population and other health professionals, thereby limiting the impact of pandemic-induced work and life disruptions.