School of Medical and Health Science, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia.
Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
J Hum Nutr Diet. 2022 Jun;35(3):466-478. doi: 10.1111/jhn.12961. Epub 2021 Nov 23.
The nutrition care process (NCP) and its associated standardised terminology (NCPT, referred to collectively as NCP/T) forms a problem-solving framework fundamental to dietetic practice. Global implementation would assist in confirming outcomes from dietetic care, but implementation rates have varied between countries. We investigated which factors predict NCP/T knowledge and use among dietetic professionals in an international cohort, aiming to understand how implementation can be strengthened.
The validated International NCP Implementation Survey was disseminated to dietitians in 10 countries via professional networks. Implementation, attitudes and knowledge of the NCP/T along with workplace and educational data were assessed. Independent predictive factors associated with higher NCP/T knowledge and use were identified using backward stepwise logistic regression.
Data from 6149 respondents was used for this analysis. Enablers that were independent predictors of both high knowledge and frequent use of NCP/T were peer support, recommendation from national dietetic association and workplace requirements (all p < 0.001). Country of residence and working in clinical settings (p < 0.001) were demographic characteristics that were independent predictors of high knowledge and frequent use of NCP/T. A high knowledge score was an independent predictor of frequent NCP/T use (p = 0.002).
Important modifiable enablers for NCP knowledge and use rely on organisational management. National dietetic organisations and key stakeholders such as employers are encouraged to integrate active NCP/T support in their leadership initiatives. This could take the form of policies, formalised and structured training strategies, and informatics initiatives for the integration in electronic health records.
营养护理过程（NCP）及其相关标准化术语（NCPT，统称 NCP/T）构成了饮食实践的基本问题解决框架。全球实施将有助于确认饮食护理的结果，但实施率在各国之间存在差异。我们调查了国际队列中哪些因素可以预测营养护理过程/术语知识和使用情况，旨在了解如何加强实施。
通过专业网络向 10 个国家的营养师分发了经过验证的国际营养护理过程实施调查。评估了 NCP/T 的实施、态度和知识，以及工作场所和教育数据。使用向后逐步逻辑回归确定与 NCP/T 知识和使用较高相关的独立预测因素。
使用 6149 名受访者的数据进行了这项分析。同行支持、国家营养师协会的推荐和工作场所要求是 NCP/T 高知识和高使用的独立预测因素（均 p<0.001）。居住国家和在临床环境中工作（p<0.001）是 NCP/T 高知识和高使用的独立预测因素。高知识得分是 NCP/T 频繁使用的独立预测因素（p=0.002）。
NCP 知识和使用的重要可修改促进因素依赖于组织管理。鼓励国家营养师协会和雇主等主要利益攸关方在其领导倡议中纳入积极的 NCP/T 支持。这可以采取政策、正式和结构化培训策略以及电子健康记录中信息学倡议的形式。
