Using a Dietetic Care Process (DCP) can lead to improved application of evidence-based guidelines and critical thinking in dietetics. One aim of the project Improvement of Education and Competences in Dietetics (IMPECD) is to develop a unified DCP for international educational purposes. Therefore, a comparison of European DCPs was needed.A concise literature search and semi-structured interviews with experts representing the full EFAD (European Federation of the Associations of Dietitians) member states were conducted from June to October 2017.16 out of 23 EFAD member states responded (70%) from which 13 indicated to use a DCP. Eight different DCPs were found, with four to six core steps and three graphical representations. In one country the use of a dietetic process is indicated by law. The DCPs have more similarities than differences as they follow the same principles. Differences in language or form may not limit the improvement in collaboration and international exchange in dietetic practice. These results provide a good basis for the development of a unified DCP for educational purposes.
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Introduction: Different models of frameworks for dietetic care are used in Europe. There is a substantial need for a consistent framework to compare research results and to cooperate on an international level. Therefore, one of the goals of the EU-funded project IMPECD was the development of a unified framework Dietetic Care Process (DCP) in order to foster a shared understanding of process-driven dietetic counselling. Materials and Methods:: Based on a literature review and in-depth analysis of different frameworks an iterative and incremental development process of finding solutions for decision-making within the consortium consisting of dietetic experts from 5 European HEI was passed. The developed DCP model was integrated in an online training course including 9 clinical cases (MOOC) to train students. The draft versions and the concluding final version DCP model were evaluated and re-evaluated by teachers and 25 students at two Intensive Study Programmes. Results:: The DCP model consists of five distinct, interrelated steps which the consortium agreed on: Dietetic Assessment, Dietetic Diagnosis, Planning Dietetic Intervention, Implementing Dietetic Intervention, Dietetic Outcome Evaluation. A standardized scheme was developed to define the process steps: dedication, central statement, aim and principles, and operationalization. Discussion:: Existing different process models were analyzed to create a new and consistent concept of a unified framework DCP. The variety within the European countries represented by the consortium proved to be both a challenge in decision-making and an opportunity to integrate multinational perspectives and intensify the scientific discourse. The development of a standardized scheme with precise definitions is a prerequisite for planning study designs in health services research. Besides, clarification is essential for establishing process-guided work in practice. The evaluated MOOC is now implemented in study programmes used by 5 European HEI in order to keep approaches and process-driven action comparable. The MOOC promotes the exchange of ideas between future professionals on an international level.
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BACKGROUND & AIMS: Dietetic interventions contribute to certain health objectives and other outcomes, but are mostly part of a multimodal and multidisciplinary approach what makes evaluating the actual effects of dietitians' involvement rather complex. Although monitoring and outcome evaluation (M&OE) can provide routine data to prove the effectiveness of dietetic interventions, this has not been established yet in different dietetic settings.METHODS: A comprehensive framework for M&OE in dietetics was developed by dietetic experts from five European higher education institutes for dietetics in the course of the EU sponsored project "Improvement of Education and Competences in Dietetics (IMPECD)".RESULTS: Firstly, clear definitions on M&OE are proposed to facilitate the use of consistent terminology, with a specific emphasis on the term "impact" covering macro-level outcomes such as cost-effectiveness. Secondly, the Dietetic Care Process (DCP) was merged into a logic model to demonstrate the position of M&OE in relation to intervention planning and implementation, in both group and individual settings. Thirdly, selecting the appropriate indicators is indispensable to monitor and evaluate outcomes, and requires a high level of dietitians' critical reasoning. A categorized overview of indicators is provided to support this process. Lastly, the consortium developed a checklist to give dietitians a handle on what elements could be included in their M&OE plan and trigger them to perform M&OE in practice.CONCLUSIONS: Innovative M&OE models may help dietitians to demonstrate their effectiveness in improving clinical outcomes and justify their role in health care.
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