| What is dietetic competence? Competency standards, competence and competency explained
Susan Ash and Susan Phillips
Abstract Competency standards for entry level dietitians have been published since 1993. To determine their currency they were reviewed in 1998, by interviews with new graduates and surveys of stakeholders. The methodology used to develop the competency standards and the terminology used to describe them has not been published widely and this became clear during the review process. This paper explains the research methodology used, by a task force of members of the Dietitians Association of Australia, to develop the competency standards. It then defines in detail the underlying units, elements, performance criteria, range variables and evidence guide used to describe the standards. The issues surrounding the assessment of competence and competence of assessors is also discussed, and leads to the concept that competence is not relevant only to entry level practitioners. It is relevant to all professionals through the principle of lifelong learning. Our profession’s future is dependent upon competent professionals actively engaging in professional development programs such as the Accredited Practising Dietitian program. (Aust J Nutr Diet 2000;57:147-151)
Nutritional risk factors and dietary intake in older adults with Parkinson's disease attending community-based therapy groups
Michelle Miller and Lynne Daniels
Abstract Parkinson’s disease (PD) is a chronic, progressive neurological condition, primarily occurring in late adulthood. The aims of this study were, firstly, to determine the prevalence of nutritional risk factors using a screening tool and estimate of nutrient intake in a sample of older Australians with PD, and, secondly, to compare these results with recommended dietary intakes (RDIs) and intake data from an Australian reference group. Forty-five community-living adults (aged 65 years and over) with PD were recruited. Demographics and medical history were collected using a self-administered questionnaire. Height and weight were measured and body mass index (BMI) calculated. The Australian Nutrition Screening Initiative (ANSI) tool was administered and nutrient intake assessed using diet history methodology. Total ANSI score classified 27, 11 and seven of the sample as being at high, moderate and low risk, respectively, of developing health or nutritional problems. No difference in mean intake of selected nutrients between the PD sample and the reference group was observed and nutrient intake of the sample generally exceeded the RDIs. The mean BMI was 24.0 ± 3.7 kg/m2 and 23.6 ± 5.1 kg/m2 for males and females respectively, and are within the normal range, but BMI was below 22 kg/m2 for 12 of the PD subjects. No correlation was observed between total ANSI scores and nutrient intake or total ANSI scores and self-reported weight loss. No correlation was observed for selected nutrients and weight with the exception of protein (r = -0.37, P = 0.010). This study highlights the need for further research to examine the consequences of symptoms and drug therapy on nutritional intake and risk of poor nutritional status. More sensitive and specific screening tools and investigations that target nutritional status of older frail adults are required. (Aust J Nutr Diet 2000;57:152-158)
Evaluation of iron-related nutrition resources for women
Siobhan C. Hickling, Greg D. Blight and Jill L. Sherriff
Abstract Five focus groups were conducted in the Perth metropolitan area with women aged 15 to 30 years in order to evaluate iron-related nutrition resources for young women. The aim was to provide information on the interpretation, likes, dislikes and the influence on self-reported dietary behaviour of these resources. The resources being evaluated were the iron resources of Meat and Livestock Australia. The five groups were selected to represent the socioeconomic range within the target population. The sessions were conducted using a semi-structured guide relating to the nutrition resources. Resources perceived by participants as simple, bright, practical and easy to follow were most liked and were reported as most likely to make them change their dietary behaviour. Some reported making dietary changes after seeing the iron-related nutrition resources. However, many perceived barriers to change were identified, namely lack of information, motivation and time; perceived cost; and some women did not feel the issue was important or relevant to them. (Aust J Nutr Diet 2000;57:159-162,174)
Viewpoint:
Nutrition screening for older Australians
A. Stewart Truswell
Abstract Between 1995 and 2000 the Australian Nutrition Screening Initiative (ANSI) questionnaire was available and used in Australia to screen mostly older people for risk of nutritional insufficiency. The checklist consists of 12 statements, half of them associated with good nutrition (e.g. ‘I eat at least three meals per day’), half associated with poor nutrition (e.g. ‘without wanting to I have lost or gained 5 kg in the last 6 months’). Most statements are single but one is double and two are triple. Members of the public, or their carers, are required to answer ‘yes’ or ‘no’ to all these questions and the answers are allocated scores. A high score indicates high nutritional risk. In elderly patients coming into a rehabilitation unit the ANSI checklist gave ‘low risk’ scores in some patients with cachexia or protein energy malnutrition. In other older people from the community the checklist gave more ‘high risk’ scores not confirmed by a full nutritional examination. Some of the questions in the ANSI checklist are ambiguous or confusing. While the ANSI checklist has value as an educational tool, the diagnosis of poor nutrition cannot be accurately achieved by a lay person filling in a questionnaire. It requires that their history be checked by a health professional and some examination made, starting with weight measurement. (Aust J Nutr Diet 2000;57:163-165,174)
Insight:
An electronic mail network to bring tertiary nutrition students and expert practitioners together – report of a pilot program
Malcolm Riley
Abstract In second semester 1999, a simple electronic mail (email) network was set up for students undertaking a second year undergraduate subject titled ‘Nutrition through the life cycle’ at the University of Queensland. There were three purposes for the network. The first was to introduce a novel learning interaction that engaged students and teaching staff. The second purpose was to provide a convenient information conduit between staff and students who were located at different campuses. The third purpose was to encourage discussion between students and practising nutritionists in a way that did not require the physical presence of the invited nutritionists or make excessive demands on their time. The email network was maintained throughout the semester and was evaluated positively by the students. The use of Internet-based technologies is likely to increase in tertiary education and in the professional lives of nutritionists. Early encouragement of appropriate and efficient uses of email and email networks allows students to take advantage of the opportunities offered by the technology. This pilot program was popular with participating students, easy to manage and provided useful professional contact for the students. It is planned to continue and expand this program. (Aust J Nutr Diet 2000;57:166-168) |
Australian Journal of Nutrition and Dietetics, Volume 57, Number 3, September 2000