Schiller M R, Miller M, Moore C, Davis E, Dunn A, Mulligan K, Zeller P
Medical Dietetics Division, Ohio State University, Columbus 43210-1234, USA.
J Am Diet Assoc. 1998 Sep;98(9):977-82; quiz 983-4. doi: 10.1016/S0002-8223(98)00224-7.
Assess outcomes of patient nutrition counseling.
A descriptive study based on the results of a telephone interview performed 2 to 8 weeks after counseling.
SUBJECTS/SETTING: Subjects were 400 adult patients referred for nutrition counseling at 2 academic health centers. Of these, 274 patients received nutrition counseling during hospitalization and 126 as outpatients.
Descriptive statistics were used to summarize data and the Mann-Whitney U statistic and logistic regressions were used to test significant differences (P < .05) between inpatient and outpatient counseling outcomes.
Most patients (83%) gave a partial or full description of their diet modifications and 79% had a moderate or good understanding of their diet. Most patients reported that the dietitian's advice was suited to their special needs (88%) and that they knew what to eat (83%). A majority (62%) had made dietary changes, but 17% said they had had trouble changing their diets as suggested. After talking with a dietitian, 57% felt better emotionally, 37% felt better physically, 64% felt in control of their condition, and 43% noticed improved health indicators. Initial analysis indicated that outpatients reported better outcomes than inpatients; further analysis showed that these differences could be attributed to younger ages among the outpatient sample.
APPLICATIONS/CONCLUSIONS: Patient nutrition counseling has positive outcomes. Therefore, key counseling points should be introduced or reinforced in inpatient settings, in conjunction with multiple-session protocols during the pre- and/or posthospitalization continuum of care. Dietitians, managers, administrators, and credentialing agencies should work together to secure and promote the necessary physical, personnel, and financial resources to make this happen.
评估患者营养咨询的效果。
一项描述性研究，基于咨询后2至8周进行的电话访谈结果。
研究对象/研究地点：研究对象为在2家学术健康中心接受营养咨询转诊的400名成年患者。其中，274名患者在住院期间接受了营养咨询，126名患者为门诊患者。
采用描述性统计方法汇总数据，使用曼-惠特尼U统计量和逻辑回归分析来检验住院患者和门诊患者咨询效果的显著差异（P <.05）。
大多数患者（83%）对其饮食调整进行了部分或完整描述，79%对其饮食有中等或良好的理解。大多数患者报告称营养师的建议符合他们的特殊需求（88%），并且他们知道该吃什么（83%）。大多数人（62%）已做出饮食改变，但17%表示按建议改变饮食有困难。与营养师交谈后，57%的患者情绪好转，37%的患者身体状况好转，64%的患者感觉能掌控自身病情，43%的患者注意到健康指标有所改善。初步分析表明门诊患者报告的效果优于住院患者；进一步分析显示这些差异可归因于门诊样本中患者年龄较轻。
应用/结论：患者营养咨询有积极效果。因此，应在住院环境中引入或强化关键咨询要点，并在住院前和/或住院后连续护理期间采用多环节方案。营养师、管理人员、行政人员和认证机构应共同努力，确保并促进必要的物质、人员和财政资源，以实现这一目标。
