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PubMed2004

[Ancient dietetics - lifestyle and medicine].

The wide reaching meaning of eating and drinking is already recognized in antiquity. The declared aim of antique dietetics is the upbringing to a healthy lifestyle. Fundamental considerations of dietetic, theoretically organized ideas can be traced back to the Presocratics, who, for the first time in cultural history, let themselves be guided by direct observations from nature. Working from the meaning of dietetics as pure nutritional teaching, one can see in the Corpus Hippocraticum a significant, systematic attempt to put forth dietetics as a concept of lifestyle. Here a central aspect is that of equilibrium, as it is expressed in the rule of the four humours. Dietetics continually become a connecting link between Natural Philosophy and Anthropology and a lifestyle orientated to nature. Finally, Galen introduces a further systematization of the already existing and the increasingly modified. Nutrition and health are brought into association and the theoretical presupposed practically overturned. In late Antiquity dietetical outlooks continue to be discussed, which were transferred to the Middle Ages and still show practical relevance.

Dietetics↗
PubMed2002

Dietetic preceptors perceive their role to include a variety of elements.

Preceptors are widely used among supervised practice programs in dietetics education. The majority of information regarding preceptors and the preceptor model has been conducted outside of dietetics and has focused on the characteristics of a preceptor or the advantages and disadvantages to the preceptorship. The literature reveals that although many definitions are used to describe the "preceptor," the role of a dietetic preceptor in supervised practice has not been distinguished. The purpose of this study was to determine role perceptions among dietetic preceptors by their indications of how they currently practice vs how they believe they should practice. Directors of dietetic internships, coordinated programs, and approved preprofessional practice programs were selected via a stratified, random sampling to distribute survey materials to 3 preceptors in their programs. The mailed survey was used to gather data detailing demographic characteristics, characteristics of current precepting practices, and beliefs regarding how precepting should be executed. Utilizing concept analysis, a typology was devised. The Preceptor Typology instrument served as the foundation from which the questionnaire was based. Program directors distributed 409 survey packets; usable data were collected from 265 preceptors (64.8%). Descriptive statistics and cross-tabulations were used to analyze data. Preceptors were confident in their understanding of the preceptor role. Data revealed that preceptors perceive their role to include a variety of tasks, which may or may not be essential to the precepting role. Preceptors also indicated that they were satisfied with their performance of what they considered to be preceptor responsibilities. More than 80% specified an "excellent" or "good" understanding of what was expected of them, although greater than 85% indicated that preceptor training materials would be beneficial. Training programs should be designed to address the unique role of the preceptor and how precepting complements the sequence of dietetics education.

Data Collection↗
PubMed1995

Computer-assisted instruction improves clinical reasoning skills of dietetics students.

OBJECTIVE: The effects of a computer-assisted instruction (CAI) tutorial program on learning clinical reasoning skills were compared in undergraduate dietetics students. DESIGN: A drill-and-practice program to control for time on task, and tutorial program, and a simulation program, as the test vehicle, were developed. The tutorial and simulation programs presented data on a patient with cardiovascular disease. SETTING: Subjects were tested in 30 undergraduate dietetics programs. SUBJECTS: Participants were 413 undergraduate diet therapy students enrolled in a coordinated program in dietetics (CPD) or a didactic program in dietetics (DPD). INTERVENTION: After completion of lectures on cardiovascular disease, subjects were given the drill-and-practice program plus a simulation test (group 1), the tutorial plus a simulation test (group 2), or the simulation test only (group 3). MAIN OUTCOME MEASURES: Scores on the simulation test were compared. Variables included type of CAI, dietetics program, year in school, computer experience, and experience using a medical chart. Mastery of objectives related to lower- and higher-level clinical reasoning skills introduced in the tutorial program was computed. STATISTICAL ANALYSIS: One-way analysis of variance and Student-Newman Keuls tests were conducted to determine any differences among the three groups. Reliability was determined using the Kuder-Richardson Formula 20. RESULTS: The reliability coefficient of the stimulation test was 0.93. Group 2 higher on the simulation test than group 1 or group 3. As a group, the CPD students scored higher than the DPD students. When CPD and DPD students were divided into the three experimental groups, there was no significant difference between the CPD and DPD student simulation scores. Group 2 mastered all objectives for lower-level reasoning skills and the higher-level decision-making objective better than groups 1 and 3. APPLICATIONS/CONCLUSIONS: A computer tutorial program enhanced clinical reasoning skills in undergraduate dietetics students. This type of program could be used to supplement many topics taught in diet therapy and provide DPD students with experimental learning before their clinical intern practicums.

Analysis of Variance↗
PubMed1998

Teaching multiskilling in dietetics education.

OBJECTIVE: To investigate multiskilling in dietetics education programs, perceived benefits and barriers to multiskilling, and current and anticipated areas of cross training in the dietetics curriculum. SUBJECTS AND DESIGN: A descriptive survey was conducted using a researcher-developed questionnaire. The questionnaire was pilot tested and mailed in April 1996 to the directors of all 565 accredited and approved dietetics education programs in the United States. Reminder postcards were mailed in May 1996. Responses were received from 276 program directors (48.8%). STATISTICAL ANALYSIS PERFORMED: Chi(2) analysis and analysis of variance were performed to compare responses by program type. t Tests and correlations compared responses by program size. RESULTS: Faculty and students from programs with supervised experiences were more likely to be involved with cross training and multidisciplinary teams than were faculty and students from didactic programs. Dietetic technician programs identified the smallest number of benefits and coordinated programs reported the most barriers to cross training. Programs with fewer graduates were more involved with multiskilling. Programs currently included a mean (+/-standard deviation) of 9.1+/-6.3 out of 47 possible cross-training areas in their curricula. APPLICATIONS: A number of dietetics education programs provide opportunities for students to become multiskilled or cross trained, usually during supervised practice. The challenge for educators is to continue to find innovative ways to train and prepare students for future roles and responsibilities. Dietetics practitioners, especially those who are preceptors or mentors for students, also need to consider how they will meet the demands of future practice.

Curriculum↗
PubMed1992

Professional attitudes of dietetics students and practitioners.

The purpose of this study was to develop and validate an instrument for measuring differences in professional attitudes of dietetics students and practitioners. Comparisons were made between junior and senior dietetics students, new and experienced (5 years or more) registered members of The American Dietetic Association (ADA), and registered ADA members and registered nonmembers (individuals who dropped ADA membership). The sample consisted of 371 junior and senior students from 18 coordinated dietetics programs and 1,041 dietetics practitioners. Principal component analysis was used to categorize conceptually 51 professionalism statements into 13 factors identified as professional attitude scales. Mean scores for the two scales "personal obligations for professional development" and "mastery of substantive content" were highest for all three groups; lowest scores were for the scale "professional isolation." Overall, significant differences were found on eight scales for one or more of the comparison groups. Students rated the scale "respect for the profession's intellectual challenge" higher than did new and experienced registered ADA members. Discriminant analysis indicated that junior (70%) and senior students (65%) were successfully differentiated on four scales, new (62%) and experienced (60%) registered ADA members on five scales, and ADA members (70%) and nonmembers (72%) on four scales. Results of this study could be used by educators to support inclusion of concepts of professionalism in dietetics curriculums. Results also could aid practitioners in marketing their knowledge and skills by presenting a more positive professional image to clients.

Adult↗
PubMed1992

Factors affecting a student's choice of dietetics as a profession.

In order to design more effective recruitment strategies, 419 junior students in 38 coordinated dietetics programs completed self-administered questionnaires to identify factors that attracted them to the profession. The majority (43.9%) first became interested in a dietetics career while in college; 24.9% became interested before or during secondary school; and 17.7% were making a career change. Factors that most frequently led to a career in dietetics were a course in nutrition (32.9%), a friend or relative other than parent (31.0%), and a dietitian (30.3%). Students rated the opportunity to help others (95.2%) and the relationship of nutrition to health (94.0%) as characteristics of the profession that had a highly positive influence on their decision. Interests in health, disease, and health care (70.5%); teaching and health promotion (42.7%); sports and fitness (40.7%); counseling and behavior change (35.6%); and food and cooking (35.4%) were most frequently cited as influencing the choice of a dietetics career. Students were most interested in practicing dietetics as a consultant or in private practice (37.5%) or as a clinical dietitian (34.8%). New and innovative recruitment strategies should target high school and college students and pay special attention to second-career students. Interests such as health, disease, and health care and health promotion and characteristics of the profession such as the opportunity to help others attracted present dietetics students and should be emphasized in recruiting. The best marketing tools may be the practicing dietitian and a course in nutrition.

Adolescent↗
PubMed1990

Role delineation for dietetic practitioners: empirical results.

In order to meet its need for a current, integrated picture of the dynamic profession of dietetics, The American Dietetic Association, with assistance from American College Testing, undertook a study focusing on the roles of entry-level dietetic technicians and registered dietitians and beyond-entry-level registered dietitians. A nationwide mail survey was conducted on random samples of 3,559 dietitians who had been registered for up to 3 years, 6,647 dietitians who had been registered for more than 3 years, and all 1,226 graduates (in the previous 3 years) from the 70 ADA-approved programs preparing dietetic technicians that agreed to participate (out of the 77 ADA-approved programs). Response rates of 77.5%, 78.7%, and 68.5% were achieved for the two samples of registered dietitians and the sample of dietetic technicians, respectively. The results show that the most commonly chosen work setting for the three respondent groups was "inpatient-care, acute-care facility." There were substantial differences among the three groups in the types of activities performed and in the level of responsibility for various kinds of activities. The beyond-entry-level registered dietitians were involved in the broadest range of activities and had the most responsibility for policy setting and other administrative activities, such as preparing budgets. The results of the study provide a detailed description of dietetic practice over a broad range of practitioner-experience levels, practice settings, and client groups.

Administrative Personnel↗
PubMed1989

The history of dietetics. 1941.

Henry E. Sigerist's paper on the history of dietetics covers the entire development of dietetics since the emergence of the human species. Originating in early man's food-seeking instinct, dietetics had become an empirical science by the time of the ancient Greeks. They stressed the dietetic treatment of illness and began to formulate numerous rules. Regimina sanitatis, manuals containing precise dietetic prescriptions for the maintenance of good health, were widely circulated in the Middle Ages. In addition to new impulses initiated by Paracelsus, the author emphasizes the clinical and experimental studies pursued, from the 17th to the 19th centuries, by such scientists as Thomas Sydenham, Justus von Liebig, Carl von Voit and Gustav von Bunge. The author concludes by pointing out that, despite enormous progress, more than one half of the world's population still suffers from malnutrition. For this reason, he regards the social application of dietetic findings as the most urgent task facing us in the future.

Dietetics↗
PubMed1988

Quantitative management techniques in dietetics: improving practice through technology transfer.

A content analysis of articles appearing chronologically in the Journal of The American Dietetic Association since its inception in 1925 reveals the breadth and depth of management practice in the dietetic profession. This historical review highlights the introduction, demonstration, and adoption of management tools and techniques in the profession, with particular emphasis on quantitative management science techniques. Seven classifications of management science techniques were used for the content analysis. Although applications of forecasting, simulation, linear programming, and queuing models have been reported in the Journal, a gap is evident between the demonstration of management science techniques and operational use of these techniques in dietetic practice. Dietetic researchers, practitioners, and educators have vital roles in facilitating the transfer of quantitative management science technology into operational dietetic practice. Assessment of the state-of-the-art of dietetic management practice relative to proven quantitative management science techniques reveals the need for improved technology transfer to enhance professional ability in both tactical and strategic decision making.

Dietetics↗
PubMed1985

The effect of organizational level and practice area on managerial work in hospital dietetic services.

All areas of practice in hospital dietetic services include a management component; however, the nature of the managerial role in various areas of dietetic practice has not been identified clearly. The definition of dietetic practice in the Conceptual Framework for the Profession of Dietetics supports the importance of managerial skills. The effect of organizational level and practice area on managerial activities and roles of professional staff in hospital dietetic services was examined in this study. The nationwide sample included professionals in hospitals with 300+ beds. A total of 3,280 dietetic professionals participated. Five groups were defined: low administrative, low clinical, middle administrative, middle clinical, and upper administrative. Mintzberg identified 10 managerial roles and categorized them as interpersonal, informational, or decisional. The 10 roles were used as the basis for developing an 80-item instrument on which respondents rated each item for importance and time demand. Perceived importance of managerial activities tended to be greater at higher organizational levels. The managerial aspects of the lower clinical and upper administrative position were the most clearly defined. The lower clinical group tended to rate all of the managerial roles as significantly less important than did those in other positions; however, the middle clinical position included a substantial managerial responsibility.

Attitude of Health Personnel↗
PubMed1983

Perceptions of importance of management aspects of dietetic practice.

On an average, undergraduate dietetic majors tended to perceive management-related tasks much the same as did dietetic practitioners, i.e., that such tasks were less important in dietetic practice. Not all dietetic practitioners had the same perceptions, i.e., administrative practitioners rated management-related tasks as much more important than did clinical nutrition practitioners. The sample of educators, on the other hand, perceived the management-related tasks as almost equal in importance to the clinical-nutrition-related tasks. No one rated the management tasks as unimportant, which is encouraging. There appears to be a strong base on which to build. The concern is that undergraduate majors and clinical practitioners, in particular, do not perceive the area of management as equally important to the profession. This failure is of particular concern if the growth of the profession is to be in management areas. These findings are supportive of an anecdotal point of view which has long pervaded the conversations of many dietitians; namely, that clinical nutrition practice is synonymous with dietetic practice. In a sense, it is not unusual that undergraduates also seem to feel this way--they obviously have many role models who do. If the dietetic profession is to increase the number of its members in management positions, attitudes about the importance of management and the acquiring of management skills must change. One can speculate on the possibility of role model learning of the CUP students in this sample.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed2002

Assessing the dietetic needs of different patient groups receiving enteral tube feeding in primary care.

AIM: To examine the nature of all contacts between adult tube-fed patients and the dietetic service and to refine the current dietetic protocols to reflect the findings of the study with a view to improving patient care. METHODS: All adult patients referred to the Community Nutrition and Dietetic Service within a 6-month period were included in the study. Using a proforma developed from a retrospective case-note analysis, data were collected on the complications that prompted more frequent contacts than the department protocol. Data were analysed using the Statistical Package for the Social Sciences. RESULTS: The most common indication for home enteral feeding in this group of adult patients was a swallowing disorder resulting from a cerebrovascular accident (59.5%) followed by cancer (21.5%). There was a trend for cancer patients to need more intervention compared with those patients with other medical conditions. A significant difference was observed in the total contacts and telephone calls given to those patients in there own homes (P=0.019) and there was a trend towards more domicilary visits with this group. CONCLUSIONS: The department protocols have been revised to include a planned review within 2-6 weeks of initial dietetic assessment in the community for those patients who were identified to have the greatest need. More intensive dietetic monitoring has clear implications for dietetic services in the community.

Adolescent↗
PubMed2001

Factors affecting the use of dietetic services by patients with diabetes mellitus.

AIMS: Dietary counselling is vital for patients with diabetes, yet many do not access professional advice. This study investigated the use of dietetic services by patients with diabetes within Sunderland Health District. METHODS: Diabetic patients were identified from the laboratory module of the Hospital Information System (HIS). Eight thousand five hundred and ninety-seven patients were identified, and cross referenced to dietetic records, producing a comprehensive database for analysis. RESULTS: Only 58.8% of the sample had dietetic records. Those with records were more likely to be: older (63.8 vs. 61.7 years, P < 0.01); male (52.6% vs. 46.8%, P < 0.05); accessing hospital diabetes services (P < 0.001); to have lipids and renal function checked (both P < 0.001); and to have poor blood glucose control (HbA(1c) > 7.5% to 58.7% vs. 29.9%, P < 0.001). Frequent attenders were most likely to be women, those with poor control, and those with shorter duration of diabetes (P < 0.001). In a logistic regression model, duration of diabetes, insulin treatment, obesity and hyperlipidaemia were the main determinants of increased use. CONCLUSIONS: This study confirmed that many patients with diabetes do not make use of professional dietetic services, and has highlighted some of the routinely documented characteristics that are associated with use of dietetic services. There appears to be scope to improve uptake of dietetic services by patients with diabetes, and to investigate further individual factors that affect access and attendance.

Adult↗
PubMed2002

Position of the American Dietetic Association: food and nutrition misinformation.

It is the position of the American Dietetic Association that food and nutrition misinformation can have harmful effects on the health and economic status of consumers. It is the role of nationally credentialed dietetics professionals to advocate for and promote sound, science-based nutrition information to the public, function as primary nutrition educators to health professionals, and actively counter and correct food and nutrition misinformation. The federal government has recognized the strong link between nutrition and health in recent years. Consumers are taking greater responsibility for self-care and are hungry for food and nutrition information, creating opportunities for nutrition misinformation, health fraud, and quackery to flourish. The media are consumers' leading source of nutrition information, but news reports rarely provide enough context for consumers to interpret the advice given. Promoters turn preliminary findings into sales pitches with baseless claims, often for the sole purpose of economic gain. Effective nutrition communication is consumer focused and presented with sufficient context to allow consumers to weigh the information and determine whether it applies to his or her unique needs. Nationally credentialed dietetics professionals are best prepared to communicate sound advice and scientific advances about nutrition. These dietetics professionals have a responsibility to take an active role in providing accurate, easily understood food and nutrition information, interpreting emerging research for media and consumers and encouraging consumers to look for credentialed dietetics professionals as nutrition experts.

Consumer Advocacy↗
PubMed1993

Characteristics of advanced-level dietetics practice: a model and empirical results.

This article, which is the first of a two-part series, presents results for the first objective of The American Dietetic Association (ADA) 1991 Dietetic Practice Study: to determine the characteristics of advanced-level dietetics practice. A nationwide mail survey of ADA members was conducted on a stratified random sample of 8,012 beyond-entry-level (registered before April 1988) registered dietitians who were members of dietetic practice groups (DPGs). The sample was supplemented with two randomly selected control groups of 1,000 entry-level and 1,000 beyond-entry-level registered dietitians. The overall response rate was 63.1%. The 5,852 usable returns were representative of the dietetics population surveyed. A model of advanced-level professional practice was developed that specified minimum necessary requirements for advanced practitioners on five components: education and experience, professional achievement, approach to practice, professional role positions, and professional role contacts; measurement of a sixth component, advanced-level practice performance, was unsuccessful. A series of validation analyses found the model to be a statistically sound and reliable means of distinguishing advanced practitioners from other groups of dietitians in 8 of every 10 cases. A total of 461 (8.9%) dietitians met all requirements of the model and were classified as advanced practitioners. Projected estimations of advanced practitioners in the population of beyond-entry-level ADA members who are also members of DPGs ranged between 2,126 and 2,640 dietitians (3.5% to 4.3% of the ADA membership).(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed2005

Incorporating human genetics into dietetics curricula remains a challenge.

This descriptive survey was undertaken to assess integration of genetics into undergraduate didactic dietetic education. The response rate was 35% (n=82) of all directors (N=232) of accredited or approved Didactic Programs in Dietetics. Although most directors (n=58 of 82) agreed that genetics is an important component of dietetics education, they expressed concerns about already-crowded curricula and lack of time, resources, and knowledge. Thirty-eight directors indicated that they had no familiarity with the core competencies in genetics for all health professionals. Genetics is included in some way in 69 of the 82 programs that responded. Courses in which genetics was most likely to be incorporated included nutrition, physiology, microbiology, and biochemistry. Only four directors reported a required course entirely devoted to genetics. Programs were most likely to meet the knowledge competency of the role of genetic factors in maintaining health and preventing disease and least likely to address the genetic counseling process and indications for referral to specialists. Applications of genetics in dietetics will continue to grow in importance. Evidence from this study indicates that current curricula provide little to no genetics content. Nutrition faculty must become more knowledgeable about genetics before being expected to increase genetics content in entry-level dietetics curricula.

Curriculum↗
PubMed2006

Complementary and alternative medicine education in dietetics programs: existent but not consistent.

This descriptive survey was undertaken to determine the inclusion of complementary and alternative medicine topics into undergraduate didactic dietetics education. The response rate was 34% (n=92) of all directors (N=273) of didactic and coordinated dietetics programs. Almost all programs (n=81; 88%) include complementary and alternative medicine instruction in some form in their curricula; the majority of content is integrated into already existing nutrition courses. The nutrition courses most often containing complementary and alternative medicine were medical nutrition therapy, advance nutrition, and community nutrition. Topics addressed were varied and included herbal supplements, functional foods, Native-American healing, and quackery in medicine. Most directors indicated that complementary and alternative medicine is an important component of dietetics education, yet many indicated that students are not being adequately prepared in this area. The mean familiarity of program directors with complementary and alternative medicine competencies for dietetics practice was 6 on a scale, with 10 being the most knowledgeable. Respondents also identified whether complementary and alternative medicine and dietary supplement competencies were being addressed at all in their curricula. Lack of time seemed to be the limiting factor to incorporation of complementary and alternative medicine topics into the curricula. Evidence from this study indicates that current curricula are providing some complementary and alternative medicine content, but a core of knowledge is lacking. The complementary and alternative medicine competencies for entry-level dietetics practice anticipated by 2006 will be useful in helping educators adequately meet the needs of future professionals in the area of complementary and alternative medicine.

Complementary Therapies↗
PubMed2000

Food-safety educational goals for dietetics and hospitality students.

OBJECTIVE: To identify food-safety educational goals for dietetics and hospitality management students. DESIGN: Written questionnaires were used to identify educational goals and the most important food safety competencies for entry-level dietitians and foodservice managers. SUBJECTS: The sample included all directors of didactic programs in dietetics approved by the American Dietetic Association and baccalaureate-degree hospitality programs with membership in the Council on Hotel, Restaurant, and Institutional Education. Fifty-one percent of the directors responded. STATISTICAL ANALYSIS: Descriptive statistics were calculated. chi 2 analysis and independent t tests were used to compare educators' responses for discrete and continuous variables, respectively. Exploratory factor analysis grouped statements about food safety competence. Internal consistency of factors was measured using Cronbach alpha. RESULTS: Thirty-four percent of dietetics programs and 70% of hospitality programs required or offered food safety certification. Dietetics educators reported multiple courses with food safety information, whereas hospitality educators identified 1 or 2 courses. In general, the educators rated food-safety competencies as very important or essential. Concepts related to Hazard Analysis and Critical Control Points (HAACP), irradiation, and pasteurization were rated less highly, compared with other items. Competencies related to reasons for outbreaks of foodborne illness were rated as most important. APPLICATIONS/CONCLUSIONS: Food safety certification of dietitians and an increased emphasis on HAACP at the undergraduate level or during the practice component are suggested. Research is recommended to assess the level of food-safety competence expected by employers of entry-level dietitians and foodservice managers.

Certification↗