Volume 55 Number 4 December 1998

Nutrition screening practices in Australian hospitals

Maree Ferguson and Sandra Capra

Abstract Malnourished patients may be remaining unrecognised as many Australian hospitals have no formal mechanism for identifying patients at risk of malnutrition. The aim of this study was to identify current nutrition screening practices in Australian hospitals. A survey designed to ascertain nutrition screening practices and dietitians' perceived barriers to the implementation of nutrition screening was sent to all members of the Dietitians Association of Australia in December 1995. Five hundred and eighty of 1382 members responded to the survey. Fifty-three per cent (310) of the respondents were hospital clinical dietitians representing 124 Australian hospitals. There was apparent confusion amongst professionals as to the definition of nutrition screening, with many dietitians perceiving nutrition screening and nutrition assessment to be the same process. Less than 5% of hospitals were conducting nutrition screening, and screening practices between hospitals varied widely. The most frequently cited barriers to the implementation of nutrition screening were related to insufficient time and staffing levels. This study confirms that nutrition screening is not routine in many Australian hospitals. (Aust J Nutr Diet 1998;55:157-161).

An omnibus survey of the Australian rural health dietetic workforce

Roger Hughes

Abstract Workforce issues specific to rural and remote dietitians have received little research attention in Australia despite widespread recognition of issues such as high dietetic staff turnover and recruitment difficulties. This omnibus survey of the Dietitians Association of Australia (DAA) membership sought to identify the features of the rural dietetic workforce and the nature and prevalence of a number of rural workforce issues, including incentives and disincentives for recruitment and retention and participation and satisfaction with professional and managerial support. A total of 140 rural and remote dietitians responded to a postal survey of the total DAA membership, representing an estimated response rate of 30% of rural dietitians. The results identify a number of positive attributes of rural and remote practice worth marketing to the broader profession. Almost all respondents to the survey enjoyed their work, in particular the diversity of roles and extent of responsibilities, and the opportunities to gain a range of skills and experiences otherwise not easily gained in metropolitan practice. The results and limitations of this study illustrate the need for a more detailed and rigorous investigation of the rural dietetic workforce in order to be able to respond efficiently to the challenges of rural nutrition and dietetic workforce development. Recommendations have been made to help progress the development and support of this important section of the Australian dietetic workforce. (Aust J Nutr Diet 1998;55:163-169).

An Australian study using weighed dietary records: response rates and respondent characteristics

Malcolm Riley and Ingrid Rutishauser

Abstract Population-based studies which include measurement of dietary intake by weighed dietary records typically do not achieve a high response. This will decrease confidence in the generalisability of study findings. Investigation of the characteristics of the respondents relative to those of the non-respondents, however, will assist in drawing valid inferences from the data. In a study requiring weighed dietary records of 1361 Tasmanian adults (aged 20 to 65 years) selected from the electoral roll, we examined the variation in response rate by selected personal and residential characteristics and by month of approach. After removal of those ineligible for the study, the overall response rate for complete participation was 63%, with 75% completing at least some requirements of the study, and 21% declining to participate. Only 4% could not be located. The response rate varied by socioeconomic status of the suburb of residence (advantaged, 69.5%; middle, 62.7%; disadvantaged, 53.2%; P = 0.005). The response rate was higher in rural areas than in urban areas (67 versus 60%; P = 0.02), and the refusal rate increased with age (20 to 34 years, 18.2%; 50 years or more, 25.5%; P = 0.02). Response rate did not vary by gender or by month of initial approach over a 12-month period. Although the potentially serious effect of non-response cannot be fully alleviated, in presenting findings from population studies involving weighed dietary records it would be prudent to stratify or otherwise control for SES, for rural or urban residence and for age. (Aust J Nutr Diet 1998;55:172-178).

Determinants of food choices among hospitality management students

Jane L. Allen, Fiona J. Cumming and David W. Woodward

Abstract This cross-sectional study aimed to explore linkages between usage frequency and food perceptions of 188 Australian undergraduate hospitality management students. For ten individual foods, multiple linear regression analyses indicated that personal consumption frequency was significantly predicted by liking for nine foods, by perceived parental usage for five foods, by perceived healthfulness of the food for one food, and by perceived friends' usage for none. For the five higher fat foods collectively, perceived healthfulness was the only significant predictor of usage for the higher fat group of foods, and liking the only significant predictor for the five lower fat foods collectively. We conclude from the former result that tertiary hospitality students make food decisions in similar ways to secondary students. From the latter result, we conclude that health concerns may provoke avoidance of higher fat foods, but that usage of lower fat foods depends on their being liked. Implications for the nutrition education of hospitality management students are discussed. (Aust J Nutr Diet 1998;55:180-186).

Nutrient intake at meals in residential care facilities for the aged: validated visual estimation of plate waste

Alice Jane Sherwin, Caryl Anne Nowson, Joan McPhee, Jo L. Alexander, John D. Wark
and Leon Flicker

Abstract This study aimed to validate visual plate waste estimation against weighed waste as a method of dietary assessment of nursing home and hostel residents. Assessment of nutrient intake is integral to safeguarding minimal nutrition standards for aged residential care. A pilot study was conducted of residents from six institutions to validate a quick, reliable visual plate waste method. Comparing observed and weighed waste for 1368 food items, a difference of only 1.5 to 1.7% was found in assessed waste. Inter-observer difference in assessed waste was only 0.21%. The method was equally valid for different institution types, diet textures and most food types. Estimation of nutrient intake from meals using weighed waste assessment indicated that those taking texture modified diets were at risk of lower energy, protein and fibre intakes. Therefore visual assessment of plate waste provides a valid means of assessing intake in groups of elderly persons in residential care, where dietary intake may be suboptimal. (Aust J Nutr Diet 1998;55:188-193).

Nutritional knowledge, food-related and body-related attitudes among preadolescent children

Wendy Roncolato, Gail Huon, Chantal Braganza and Jan Ritchie

Abstract This study investigated the nutritional knowledge among a sample of primary school children, and examined their attitudes toward eating and their bodies. Participants included 129 girls and 56 boys (mean age 10.6 years), who were drawn from schools across a range of socioeconomic status (SES) areas. Measures included the nutritional knowledge questionnaire, children's attitudes towards eating scale, children's body mapping questionnaire, and drive for thinness and body dissatisfaction subscales of the eating disorders inventory. Children knew the sources and functions of calcium, but not those of iron, protein, carbohydrates and vitamins. Both genders were aware of weight management issues, although girls showed lower body liking and higher body dissatisfaction. Higher SES was associated with more positive eating attitudes, and lower SES with less nutritional knowledge, higher body mass index, higher drive for thinness, and a greater desire to weigh less. Attempts to improve children's food-related choices need to address their nutritional knowledge and attitudes. (Aust J Nutr Diet 1998;55:195-202).