Journal of Human Nutrition and Dietetics最新文献

Background

Although studies have demonstrated ChatGPT′s potential as an AI nutritionist, no research has yet investigated the factors influencing its adoption and actual use of ChatGPT as a virtual nutrition assistant among dietetic students.

Objective

In this study, we examined factors influencing ChatGPT′s actual usage among dietetic students, focusing on the role of trust in its adoption for academic and clinical nutrition tasks.

Methods

A web-based survey was conducted among dietetic students in Taiwan with prior experience using ChatGPT. The survey was designed based on an extended Technology Acceptance Model. Partial least squares structural equation modeling was applied to assess the structural model and test hypotheses.

Results

In total, 150 dietetic students (82% female, mean age = 20.66 ± 3.96 years) completed the survey. Regarding specific nutrition-related tasks, ChatGPT′s actual use scores were highest for “understanding nutrition knowledge” and “analyzing the calorie and nutrient content of a dietary record”, while lower scores were observed for “preparing for the registered dietitian exam” and “analyzing patients′ nutritional status and providing dietary recommendations”. The PLS-SEM model respectively explained 28.2% and 44.6% of the variance in actual use (AU) for academic and clinical nutrition tasks. Trust (TR) and behavioral intention to use (BIU) independently predicted AU for academic tasks, including understanding nutrition knowledge (BIU: β = 0.336 and TR: β = 0.341) and preparing for the registered dietitian exam (BIU: β = 0.310 and TR: β = 0.311). For clinical tasks, such as analyzing the calorie and nutrient contents of a dietary record (β = 0.523) and evaluating patients′ nutritional status (β = 0.381), TR was the sole significant predictor.

Conclusions

Trust is a key factor driving the adoption and actual use of ChatGPT as an AI nutrition assistant, particularly in clinical nutrition tasks.

Introduction

Uncovering the impact of medical nutrition therapy (MNT) on resulting outcomes depends on high quality standardized documentation that can be analyzed. A valid, reliable tool is necessary to evaluate documentation for quality. The Nutrition Care Process-Quality Evaluation and Standardization Tool (NCP-QUEST) was developed to evaluate nutrition care documentation quality including NCP chains, component linkages, and reassessment.

Methods

Our aim was to determine the validity and reliability of the NCP-QUEST in a sample of people with diabetes. This study is a secondary analysis of Diabetes Registry data from the Academy of Nutrition and Dietetics Health Informatics Infrastructure (ANDHII). Sample size was derived from the Diabetes Registry data from ANDHII collected between May 2017 and June 2019 (n = 15 patient cases, 30 total encounters). Main outcomes are the validity and reliability of the NCP-QUEST. Patient cases were audited using the NCP-QUEST. Validity was evaluated using content validity index (CVI) calculations, and reliability was determined using Krippendorff's alpha (α) coefficient and interrater correlation coefficient (ICC).

Results

The NCP-QUEST was found to have high validity (relevance: S-CVI-UA = 0.96, S-CVI-Ave=0.98; clarity: S-CVI-UA = 0.92, S-CVI-Ave=0.96), moderate interrater reliability (α = 0.6684, ICC = 0.72), and low to moderate intra-rater reliability (rater 1 α = 0.8598, rater 2 α = 0.3194). The NCP-QUEST exposed gaps in documentation of clear NCP links.

Conclusion

The NCP-QUEST was found to be valid and reliable in a sample of people with diabetes. Revisions should be considered to improve agreement reliability before incorporation into practice.

Introduction

Weight control is a cornerstone of Type 2 Diabetes (T2D) management. The low-calorie diet program continuous low energy diets (CLED) is currently offered to patients for remission in the United Kingdom, but this may not suit all patients. Intermittent Low Energy Diets (ILED) may be an alternative approach. This survey explored patient characteristics and dietary choice priorities to predict preference for CLED, ILED, and other diets to inform future patient-centered advice.

Methods

622 participants (> 18 years) with a diagnosis of T2D recruited via a patient volunteer database, social media and the Prolific research register completed an online survey. Demographics, health characteristics, T2D treatment factors and dietary choice priorities were analyzed to predict preference between CLED and ILED. In addition, we explored qualitative reasons why participants were choosing between these two diets as well as other calorie-restricted diets.

Results

CLED preference was significantly higher among all the < 65 age groups (than those aged > 74), and those who prioritized reduced medicine dependency (1.75 times more likely) and prioritizing speed of weight loss (2.59 times more likely) over improving blood sugar. ILED preference was associated with prioritizing flexibility of food choice (2.73 times more likely) and prioritizing diets which fit in with family meals and social events (2.5 times as likely) over professional support. Content analysis showed that CLED and ILED diets weren't the most popular dietary choice, with more patients expressing preferences for a daily food based moderate calorie-restricted diet and low carbohydrate diets. Simplicity to follow was a common theme across all diets, demonstrating the importance of ensuring that any prescribed diet has clear and easy instructions.

Conclusion

Patients' dietary preferences are influenced by a range of factors including the outcome and the extent to which the diet will fit into their lifestyles. Understanding patient perspectives about desired dietary outcomes and how they envisage the diet fitting into their lives will enable professionals to provide helpful patient-centered advice which may increase the likelihood of adherence.

Objectives

To investigate perspectives of maternity hospital leadership regarding food insecurity during pregnancy, their views on whether the hospital can or should address this determinant of health and how best to respond.

Method

This qualitative study utilised in-depth, individual interviews conducted at the Royal Women's Hospital, Australia. A total of 23 participants were interviewed and designated as high-level or mid-level leaders based on the level of authority. Major themes were identified after inductive data analysis.

Results

High- and mid-level leaders acknowledged the health impact of food insecurity during pregnancy, but held discordant views on whether the hospital could, or should, intervene to enhance food security. High-level leaders considered the hospital capable of and responsible for addressing food insecurity and gave suggestions for interventions. In contrast, many mid-level leaders perceived that the hospital does not have capacity nor an obligation to respond, citing barriers such as perceptions of acute healthcare boundaries, belief that other sectors should intervene, and resource limitations.

Conclusions

Leveraging high-level leadership enthusiasm and addressing mid-level leadership barriers are critical steps towards healthcare-based responses to food insecurity during pregnancy.

Aims

Pregnancy is a key opportunity to support women in achieving healthy dietary patterns due to increased motivation and frequent exposure to healthcare professionals. However, it is unclear whether changes made during pregnancy can be maintained postpartum. This study examined the impact of an antenatal dietary intervention, initiated early to mid pregnancy, on postpartum dietary intake.

Methods

In the Healthy Gut Diet (HGD) study, participants were randomised to a dietary intervention or usual care. The intervention was integrated with behaviour change techniques and informed by the lived experience of women with Gestational Diabetes Mellitus (GDM). Dietary intake was assessed using food frequency questionnaires at baseline, 36 weeks' gestation, and 12 weeks' postpartum. Outcomes included alignment with the Australian Guide to Healthy Eating, intakes of core food groups, key macro- and micronutrient intakes, prebiotic and fermented food intake, and overall diet quality. Between-group differences postpartum were assessed using independent t-tests, and longitudinal effects were evaluated with linear mixed-effect models adjusted for pre-pregnancy Body Mass Index (BMI) and recent GDM. Secondary analyses explored associations between maternal characteristics, depressive symptoms, diet quality, fibre and saturated fat intake.

Results

The intervention group had significantly (p < 0.05) higher diet quality, greater intakes of core food groups, fibre, prebiotic, and monounsaturated fat and lower saturated fat than usual care at 12 weeks postpartum. More women in the intervention group met recommendations for fibre, magnesium, iron and folate, and core food group serves of vegetables, fruit and meat/meat alternatives. Mixed-effect models showed sustained improvements postpartum in the intervention group. Antenatal depressive symptoms were associated with lower postpartum diet quality (p = 0.01), and lower income was associated with lower saturated fat intakes.

Conclusions

Well-designed, behaviourally informed antenatal interventions can support sustained dietary improvements postpartum. Addressing social and psychological factors is essential for maximising their impact.

Introduction

Mealtime experience is a multidimensional concept extending beyond meal satisfaction. Many existing patient meal satisfaction tools fail to capture this complexity. This study examines the internal consistency, test–retest reliability and validity of the Austin Health Patient Mealtime Experience Tool.

Methods

The Austin Health Patient Mealtime Experience Tool was developed through a literature review and stakeholder input. Participants from acute, sub-acute and rehabilitation wards at Austin Health completed the tool (Test 1) alongside the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire on Day 1. A follow-up assessment was conducted 7 days later (Test 2). Factor analysis assessed construct validity. Concurrent and convergent validity were determined by correlating scores with the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire. Internal consistency was assessed using Cronbach's coefficient α, and test–retest reliability was evaluated through correlation analysis.

Results

A total of 143 completed surveys were collected from participants aged 19–101 years (mean age: 72.1 ± 17.6 years), with 48.3% identifying as female. The Austin Health Patient Mealtime Experience Tool demonstrated strong internal consistency (Cronbach's coefficient α = 0.75) and test–retest reliability (correlation coefficient = 0.73, p < 0.001, n = 94). Concurrent validity (correlation coefficient = 0.67, p < 0.001, n = 126) and convergent validity were also supported.

Conclusion

The Austin Health Patient Mealtime Experience Tool is a valid and reliable tool for assessing patient mealtime experience beyond meal satisfaction. It enables efficient data collection on key factors influencing mealtime experience, supporting informed decision-making to enhance patient care.

Objectives

This review aimed to synthesise current evidence on the effects of gastrostomy in Parkinson's disease (PD) and parkinsonism, Multiple Sclerosis (MS) and Huntington's disease (HD).

Purpose

Evidence regarding the risks and benefits of gastrostomy insertion and use in progressive neurological diseases, excluding Motor Neurone Disease (MND), is lacking, causing gastrostomy decision-making discussions to arise as a matter of debate in practice.

Methods

Three databases (Web of Science, Ovid Medline and Embase) were searched for research on the impacts of gastrostomy, including survival, complication rates, nutrition changes, in adults with progressive neurological diseases, excluding MND. Quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist: Primary Research, and a narrative synthesis was conducted.

Results

Twelve (n = 12) studies were eligible for inclusion, with either retrospective cohort (n = 12) or cross-sectional (n = 1) design, examining the effects of percutaneous endoscopic gastrostomy (PEG) (n = 8), radiologically inserted gastrostomy (RIG) (n = 1) or gastrostomy not further defined (n = 4) in adults with PD (n = 6), parkinsonism (n = 3), MS (n = 3), or HD (n = 3). There was variability in outcomes and comparators with inconclusive results. Quality was assessed as positive (n = 3) or neutral (n = 9). Gastrostomy appears to be associated with increased care needs in the population of interest.

Conclusions

Gastrostomy insertion and use in this cohort is poorly investigated. High-quality prospective studies, especially with well-defined nutrition-related outcome measures, and robust statistical analyses are needed to determine the potential benefits of gastrostomy in this population.

Trial Registration: PROSPERO: CRD42024604136.