Implementation of the Nutrition Care Process and the Nutrition Care Process Terminology Among German- and French-Speaking Dietitians in Switzerland: A Secondary Analysis of the Swiss International Nutrition Care Process and Terminology Implementation Survey Data

Abstract

Background

Successful implementation of the Nutrition Care Process (NCP) and the Nutrition Care Process Terminology (NCPT) depends on many factors, one of which is the spoken language of the users. Exploring implementation barriers and enablers in a multilingual country such as Switzerland, with a specific focus on dietitians speaking German and French, may provide valuable insights for successful implementation in other multilingual countries.

Objective

The aim of this study was to compare the enablers and barriers encountered by Swiss German- and French-speaking dietitians in the implementation of NCP and NCPT in their daily work.

Design

The multinational observational INIS study was conducted between February-April 2017 using an online survey. Swiss data from the study were analyzed in a secondary analysis in August 2021.

Participants

In Switzerland, 237 registered dietitians participated in the INIS study. In this secondary analysis, a total of 228 (German-speaking n = 144, French-speaking n = 84) questionnaires were included. Nine participants were excluded because either they had incomplete surveys or had not completed dietetics training.

Main outcome measurements

Primary variables were barriers and enablers to the use of NCP and NCPT in their daily work. Furthermore, characteristics, familiarity with NCP and NCPT, and the extent of implementation of standardized nutrition diagnoses according to NCPT were analyzed.

Statistical analyses performed

Descriptive statistics, including summary statistics with percentages, were used. Differences between the two groups were analyzed using the Fisher exact test.

Results

The most common barrier was lack of time; no significant differences were found between the two groups regarding implementation barriers. Some statistically significant differences were found in the frequency of mentioning enablers, such as “recommendation by the association to use NCP and NCPT” (German-speaking 89%, French-speaking 77%; P < 0.05), “requirement by the workplace” (German-speaking 75%, French-speaking 53%; P < 0.01), “allocated time to practice” (German-speaking 63%, French-speaking 43%; P < 0.05), and “electronic healthcare records” (German-speaking 81%, French-speaking 44%; P < 0.001).

Conclusions

Some differences in enablers were found between German- and French-speaking dietitians, although the two groups were similar for all barriers and many enablers. In multilingual countries such as Switzerland, implementation strategies may need to be adapted to the language and the dietitians’ specific experiences of using NCP and NCPT to ensure optimal use throughout the country.