Defining the Practice of Dietitians in Malaysia Using the Nutrition Care Process in Patients with Type 2 Diabetes Mellitus

Jamilah Abd Jamil, E. Myers, W. C. S. Swee
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Abstract

(1) Background: The quality of dietetic care is crucial to improve patient outcomes. The aim of this study was to measure the current practices regarding the provision of nutrition care in type 2 diabetes mellitus (T2DM) among dietitians in Malaysia. (2) Methods: A 49-item online survey was distributed via Malaysian Dietitians’ Association and Ministry of Health Malaysia social media platforms. Self-reported dietetic practices in the management of T2DM were evaluated against practice guidelines. (3) Results: A total of 173 dietitians completed the survey, with a response rate of 62%. Three-quarters of dietitians in the public sector consulted patients within two to three weeks or more than four weeks versus less than two weeks (86.3%) among private dietitians (p-value < 0.001). More than 95% of private dietitians spent 31–60 min or more than 60 min on new cases versus 71% among public dietitians (p-value < 0.001). Group counseling was only practiced among public dietitians (36.0%). Different practice settings led to the current findings. A limited use of behavioral counseling theories and strategies was observed among dietitians from both sectors. Limited adherence to nutrition-related recommendations (62.8%) and lack of readiness for diet/lifestyle changes (45.5%) were the key challenges faced by dietitians when managing T2DM. (4) Conclusions: The survey indicates that there is a need for the development of comprehensive training to increase the utilization of behavioral counselling. Practice setting is an element to consider when designing training.
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定义马来西亚营养师在2型糖尿病患者营养护理过程中的实践
(1)背景:饮食护理质量对改善患者预后至关重要。本研究的目的是衡量目前马来西亚营养师对2型糖尿病(T2DM)提供营养护理的做法。(2)方法:通过马来西亚营养师协会和马来西亚卫生部社交媒体平台进行49项在线调查。根据实践指南对T2DM管理中自我报告的饮食习惯进行评估。(3)结果:共有173名营养师完成调查,回复率为62%。公立部门四分之三的营养师在两到三周或四周以上的时间内咨询患者,而私立营养师不到两周(86.3%)(p值< 0.001)。超过95%的私人营养师在新病例上花费31-60分钟或超过60分钟,而公共营养师为71% (p值< 0.001)。团体咨询只在公共营养师中进行(36.0%)。不同的实践环境导致了目前的发现。在这两个部门的营养师中观察到行为咨询理论和策略的有限使用。对营养相关建议的遵守有限(62.8%)和缺乏改变饮食/生活方式的准备(45.5%)是营养师在管理T2DM时面临的主要挑战。(4)结论:调查表明,有必要开展综合培训,以提高行为咨询的使用率。练习环境是设计训练时要考虑的一个因素。
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