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  • Dietitian Preceptor Knowledge, Skills, Attitudes, and Training: Key Informant Perceptions
    Canadian Journal of Dietetic Practice and Research • Vol. 72 • No. 3 • pp. e147 - e154
    Purpose: Through consultation with Canadian dietitian informants, we aimed to identify the desired knowledge, skills, and attitudes (KSA) for preceptors, training opportunities, and the barriers that prevent preceptor training. Methods: In this qualitative study, an open-ended survey was sent electronically to 100 key informants across Canada. Informants had experience as preceptors or with dietitian preceptors. Informants were asked to reflect upon the desired KSA, training needs, and barriers to training for dietitian preceptors. Categories of responses under each of these headings were developed on the basis of informants’ responses. Results: Forty-nine key informants completed the survey, for a 49% response rate. Of the respondents, 41% (20/49) were in clinical practice and 35% (17/49) worked in community/public health areas. The knowledge and skills domains consisted of themes related to teaching and learning, including assessing, planning, and evaluating. Attitudes expressed included considering learners as colleagues and the training of learners as a professional responsibility. Perceived barriers to training preceptors included workload demands and a lack of recognition from peers and employers for this work. Dietitian preceptor training opportunities ranged from no training to formal programs. Conclusions: These findings are integral to the basic understanding of the desired KSA and training needs of Canadian dietitian preceptors.
  • Use of Oral Nutrition Supplements In Long-term Care Facilities
    Canadian Journal of Dietetic Practice and Research • Vol. 70 • No. 4 • pp. 194 - 198
    Purpose: Practices related to oral nutrition supplement (ONS) use were examined in elderly people living in longterm care (LTC) facilities. Methods: Thirteen LTC facilities within a large regional health authority participated, and 17 people responsible for prescribing ONS in their facilities were interviewed, using a key informant telephone survey. A survey on ONS practice wasmodified, pilot tested, and used. Results:Oral nutrition supplements were primarily prescribed by nursing staff (59%), followed by physicians, registered dietitians, or other staff; ONS use was prescribed for decreased intake, unintentional weight loss, or wound healing. Various ONS products (e.g., Ensure, Boost, or Resource 2.0) were prescribed. Only 18% of respondents reported using alternative food options first to supplement nutritional intake, before introducing ONS. In terms of follow-up and evaluation, the measures of improvement included weight gain, wound healing, or improved well-being; reasons for discontinuation included weight gain, increased intake, or death. Conclusions: Within LTC settings, the prescription and monitoring of ONS vary considerably. Evidence-based guidelines for the prescription and monitoring of ONS and for the use of a food-first strategy should be developed, implemented, and evaluated to optimize the nutritional health of the elderly in LTC facilities.
  • Effect of Gastrostomy on Growth in Children with Neurodevelopmental Disabilities
    Canadian Journal of Dietetic Practice and Research • Vol. 66 • No. 1 • pp. 19 - 24
    Chronic malnutrition and growth failure are frequent consequences of feeding difficulties in neurodevelopmentally disabled children. Gastrostomy feeding has been used successfully to alleviate chronic malnutrition as well as distress and frustration associated with feeding. Unfortunately, caregivers are often resistant to gastrostomy placement. In order to determine the impact of gastrostomies in 20 children with neurodevelopmental disability (NDD), a questionnaire was used to collect caregivers’ perceptions both before and after gastrostomy. The questionnaire assessed caregivers’ retrospective perceptions of quality of life, feeding difficulties, and the burdens and benefits of gastrostomies. To determine impact on growth, height and weight were measured once before and three times after gastrostomy (at six, 12, and 24 months). The number of times a child was fed and the amount of time spent feeding decreased significantly following gastrostomy (p<0.001 and p<0.05, respectively). Growth for all children improved following gastrostomy (p<0.001). Pregastrostomy problems improved significantly following gastrostomy, as did caregivers’ perceptions of quality of life for both themselves and their child (p<0.001). These results indicate that gastrostomy has a positive impact on growth for neurodevelopmentally disabled children, and on quality of life for both children and caregivers. Caregivers may find these results encouraging if they are faced with a decision about gastrostomy placement for their child.
  • Effect of Nutrition Counselling On Client Perceptions and Eating Behaviour
    Canadian Journal of Dietetic Practice and Research • Vol. 67 • No. 4 • pp. 171 - 177
    Purpose: Demonstrating the effectiveness of nutrition counselling is imperative, not only to promote successful patient outcomes but also to secure funding. This study therefore assessed the value and effectiveness of nutrition counselling. Methods: To measure clients’ perceptions of the value of inpatient counselling, the Clients’ Perceptions about Nutrition Counselling (CPNC) instrument was administered to 164 clients one week after hospital discharge. To determine if inpatient nutrition counselling is effective in promoting changes in eating behaviours, the same clients were asked to complete the Health Habits and History Questionnaire (HHHQ) before counselling and then at three and six months following discharge. Results: The majority of respondents who completed the CPNC indicated that the information provided by the dietitian was useful, that the dietitian was knowledgeable, and that they knew what to eat after speaking with the dietitian and had changed their diet according to the recommendations. From the HHHQ, respondents counselled for heart health diet modifications (n = 45) significantly lowered their intake of energy (p<0.002), fat, saturated fat, sodium, and cholesterol (all p<0.001) over time. Conclusions: These results suggest that inpatient nutrition counselling is perceived as valuable and results in positive dietary behaviours, the majority of which are sustained at six months.
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