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SCI: Role of the Registered Dietitian (2007)

Citation:

Croes-Barone SJ, Rolnick RH, Durante D, Zaunbrecher MM, Hackell V, Farias Y. Medical nutrition therapy is recognized as an important element in complete rehabilitation. Rehab Manag. 1998;56, 59-60, 63.

 
Study Design:
Narrative Review
Class:
R - Click here for explanation of classification scheme.
Quality Rating:
Negative NEGATIVE: See Quality Criteria Checklist below.
Research Purpose:

Not described by author.

Inclusion Criteria:

Not described by author

Exclusion Criteria:

Not described by author

Description of Study Protocol:

Recruitment

 Methods for study inclusion were not described.

Design

 A review of the roles of health care professionals working with Spinal Cord Injured  (SCI) patients and how medical nutrition therapy is valued as an important element of rehabilitation.

Blinding used (if applicable)

 Not applicable

Intervention (if applicable)

 Not applicable

Statistical Analysis

 Not performed.

Data Collection Summary:

Timing of Measurements

 Oragnized as:

  • Role of the physician
  • Role of the nurse
  • Role of the speech pathologist
  • Role of the occupational therapist
  • Role of the physical therapist
  • Role of the registered dietitian as a wellness advocate 

Dependent Variables

Original data was not included in the narrative

Independent Variables

 Control Variables

 

Description of Actual Data Sample:

 

Initial N: Not applicable

Attrition (final N): Not applicable

Age: Not applicable

Ethnicity: Not applicable

Other relevant demographics: Not applicable

Anthropometrics Not applicable

Location:

 Not noted

Summary of Results:

 

 

  • Physicians are the bridge builders in the efforts aimed at achieving nutritional stability and the re-establishment of related functional abilites.
  • Nurses' support, documentation, and consistent communication are integral to the success of medical nutrition therapy. 
  • The dietitian can coordinate efforts with food service to adjust consistencies according to the speech pathologist's recommendation and monitor the patient's acceptance of these modifications.
  • Occupational therapists can impact the success of nutritional intervention through the teaching of new skills and approaches in achieving independent feeding. This can allow improved p.o. intake, weight gain, and an improved appetite along with an improved sense of confidence and well-being.
  • The physical therapist supports the compliance to diet by encouraging appropriate snacks and beverages during and after therapy sessions.  They can alert the dietitian to diet or food issues, which the patient may have expressed during therapy sessions.
  • The dietitan can support therapies through development and implementation of a therapeutic nutrition plan to teach and motivate the patient to enhance or change life habits toward a healthier approach to eating and living.

Other Findings

 

Author Conclusion:

Working within a treatment team with a commitment to prevention and wellness is a motivator to SCI patients. Patients tend to remain committed to their medical nutrition therapy (MNT) while in the hospital so hopefully they will remain committed to MNT after discharge. The optimal rehabilitation of each patient requires a multidisciplinary approach in all aspects of care including nutrition.

Funding Source:
University/Hospital: Memorial Rehabilitation Hospital Houston, Baylor College of Medicine
Reviewer Comments:
  • Purpose of the study was not stated.
  • Search strategy was not included
  • Methods to select studies were not included.
  • Comparative studies were not included
  • Limitations of the review and individual studies was not described.
Quality Criteria Checklist: Review Articles
Relevance Questions
  1. Will the answer if true, have a direct bearing on the health of patients? Yes
  2. Is the outcome or topic something that patients/clients/population groups would care about? Yes
  3. Is the problem addressed in the review one that is relevant to dietetics practice? Yes
  4. Will the information, if true, require a change in practice? Yes
 
Validity Questions
  1. Was the question for the review clearly focused and appropriate? No
  2. Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described? No
  3. Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased? No
  4. Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible? N/A
  5. Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined? No
  6. Was the outcome of interest clearly indicated? Were other potential harms and benefits considered? Yes
  7. Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described? No
  8. Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included? No
  9. Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed? No
  10. Was bias due to the review's funding or sponsorship unlikely? Yes