Healthcare services provided by registered dietitians and dietitians have been changing because of evolving lifestyles and population dynamics, leading to subsequent changes in the occupational ...status and experiences of these professionals. However, few studies have examined occupational stress among registered dietitians and dietitians. This study involved a cross-sectional survey to investigate the status and associated factors of work engagement among registered dietitians and dietitians, whose professions differ based on licensing processes and scope of work. A total of 3,593 questionnaires were distributed, 1,890 responses were received, and 1,654 valid questionnaires were analyzed. Work engagement was measured using the Utrecht Work Engagement Scale. Multiple regression analysis was conducted to examine the associations between work engagement and each factor. The work engagement scores of dietitians were significantly lower than those of registered dietitians. Further, work engagement was associated with age, workplace, coworker support, and effort-reward ratio for both registered dietitians and dietitians. However, exercise habit was a significant factor associated with work engagement only among dietitians. Work engagement among registered dietitians was comparable to that of typical Japanese workers, whereas it was lower among dietitians. The findings highlight the importance of considering associated factors to improve work engagement further, especially among dietitians.
Provision of parental nutrition (PN) is complex, enteral and PN requirements frequently change.1 2 It is imperative that patients undergo detailed regular nutritional assessment to avoid growth ...faltering. This includes identifying individual nutritional needs. Generic guides exist for PN requirements however, individual assessment is multifactorial1 2 which dietitians are uniquely placed to evaluate and ensure adequate growth.2 3 Despite this, dietitians are not always included in managing paediatric PN. This study assesses if dietitian involvement in PN is essential to ensure adequate growth.Children receiving PN were identified retrospectively via clinical records between January2022-June 2022. Patients excluded if on critical care ward or >18 years. Dietetic assessment identified through electronic notes. Growth was assessed calculating changes in weight-for-age Z-scores (delta-Z-Score) from start to end of PN.78 children identified. 73 complete data.Abstract OC59 Table 1Cohort demographicsSpeciality commenced PN (n=73)Neonates11Immunology (including bone marrow transplant)24Gastroenterology8Oncology 12Surgery15Other3Age commencing PN (mean SD)5.11y (5.9y) Male:FemaleM=45 F=28 50/73 patients had dietetic assessment prior to commencing PN. Further 8 assessed on average 6 days after PN commenced range 2–15 days. Dietitian initial PN assessment of these 8 recommended 25% no changes, 50% to increase macronutrients due to not meeting requirements and poor growth, 25% to reduce macronutrients due to requirements being exceeded.Delta Z-scores changed on average by +0.31 (range -2.21 to + 4.96) for patients assessed by a dietitian and -0.724 (range -1.89 to +0.39) for patients not seen by a dietitian. The interquartile ranges of each group was 1.06 and 1.01 for no dietitian and dietitian involvement respectively.Average length of time patients received PN when assessed by dietitian 55.5days (SD 56.5d) and 21.06days (SD 16.63d) for those not seen by dietitian.In total, 79% PN patients were assessed by a dietitian, those without dietetic assessment prior to commencing PN, have 75% risk of inappropriate nutrient provision.Patients with dietetic assessment are more likely to have positive growth trajectory. As it is essential to meet energy and protein requirements for adequate growth, it can be concluded that PN patients not reviewed by a dietitian are less likely to meet their individual requirements. This study has shown that it is essential for paediatric patients receiving PN in an acute setting to be assessed by a dietitian to ensure adequate growth. It highlights the importance of dietitians being integral members of teams that manage paediatric PN in acute settings. Joosten K, Embleton N, Yan W, et al. Espghan/Espen/ESPR/CSPEN guidelines on pediatric parenteral nutrition: energy. Clinical Nutrition. 2018;37(6):2309–14. Johnson T, Sexton E. Managing children and adolescents on parenteral nutrition: challenges for the nutritional support team. Proceedings of the Nutrition Society. 2006;65(3):217–21. Vlug LE, Nagelkerke SC, Jonkers-Schuitema CF, et al. The role of a nutrition support team in the management of intestinal failure patients. Nutrients. 2020;12(1):172.
In this study, a report of dietitian-led nutrition interventions for patients with COVID-19 during ICU and ward-based rehabilitation is provided. As knowledge of COVID-19 and its medical treatments ...evolved through the course of the pandemic, dietetic-led interventions were compared between surge 1 (S1) and surge 2 (S2).
A prospective observational study was conducted of patients admitted to the ICU service in a large academic hospital (London, UK). Clinical and nutrition data were collected during the first surge (March-June 2020;
= 200) and the second surge (November 2020-March 2021;
= 253) of COVID-19.
A total of 453 patients were recruited. All required individualized dietetic-led interventions during ICU admission as the ICU nutrition protocol did not meet nutritional needs. Feed adjustments for deranged renal function (
= 0.001) and propofol calories (
= 0.001) were more common in S1, whereas adjustment for gastrointestinal dysfunction was more common in S2 (
= 0.001). One-third of all patients were malnourished on ICU admission, and all lost weight in ICU, with a mean (SD) total percentage loss of 8.8% (6.9%). Further weight loss was prevented over the remaining hospital stay with continued dietetic-led interventions.
COVID-19 patients have complex nutritional needs due to malnutrition on admission and ongoing weight loss. Disease complexity and evolving nature of medical management required multifaceted dietetic-led nutritional strategies, which differed between surges.
Clinician perspectives may inform health service strategies to meet optimal nutrition needs for infants with cystic fibrosis (CF). We conducted a qualitative study with CF‐specialized dietitians ...(registered dietitians RDs) and physicians between July to December 2020 to characterize the current state of infant nutrition care delivery and organize input into a conceptual model to inform CF care program strategies. Among 42 participants, 36 completed survey responses and 6 completed interviews; 93% were RDs. Three global themes emerged in the current care model: nutrition management, family centered connections, and collaborative care delivery. Within nutrition management, clinicians emphasized providing education, setting goals, and maintaining adequate follow‐up with families. Under family centered connections, clinicians expressed the need to foster relationships with families and link families to resources for assistance to social stressors such as food insecurity. Collaborative care delivery for clinicians interviewed was defined by sharing expertise from across the interdisciplinary team. Based on the timing of this study, clinicians reported compelling examples for various modes of telehealth and home weight monitoring to facilitate and support these domains of nutrition care, including potential advantages for education, supporting family needs, and communication. We integrate these themes to propose a conceptual model to organize complementary in‐person and telehealth activities and enhance quality infant CF nutrition care delivery. Future implementation can refine this model through testing of practical telehealth interventions to optimize nutrition outcomes for infants with CF.
Carbohydrate counting is an important component of type 1 diabetes management that is taught at the time of diagnosis. We implemented and validated a nutrition quiz to assess fundamental carbohydrate ...counting and nutrition knowledge in newly diagnosed patients. An interactive standard assessment for newly diagnosed type 1 diabetes patients was feasible and reliable to implement for patients and caregivers, but participants with public insurance scored lower overall. This assessment may help to identify nutrition knowledge gaps and provide opportunities for timely education, and providers should place additional focus on nutrition education for patients with public insurance.
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