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Biomedical subjects

M B Foltz

Publications and source records attributed to M B Foltz.

11 recordsLinked to original sources
PubMed1994

Nutrition support, supplementation, and replacement.

Nutrition support in acute, chronic, or home care settings can be implemented successfully by the well-informed primary care physician, who often is the first to identify poor nutritional health in his or her patients. Using established protocols for the identification or of risk factors and indicators of malnutrition, specific alerts to the need for nutrition support are presented. The logical approach to nutrition support interventions through four stages representing the gradual increase in complexity and cost, paralleling the progressive inability to use regular foods and the gastrointestinal tract are discussed. Specific, practical measures that can be recommended and implemented by the primary care physician managing the older person are presented. The ethical, legal, and home health aspects of nutrition support in the care of the older American by the primary care physician are also reviewed.

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PubMed1993

Dietitians' self-perceptions: implications for leadership.

This article reports usual modes of thinking and behavior as measured by the Life Styles Inventory--Level 1, Self-Description (LSI--Level 1), which was completed by 893 dietitians who attended at least one invitational leadership seminar during 1986 through 1989. The LSI--Level 1 measures 12 lifestyles, both positive and negative, and there is a score for each style. On a scale of 1 to 40, mean scores of the study sample were highest for Affiliative (32.0), Humanistic-Helpful (31.6), Achievement (31.1), and Self Actualize (28.8) styles. These are positive styles that characterize creative thinkers who have been described as good leaders: confident and energetic with balanced concern for both tasks and people. When mean scores of the study sample were plotted on a scaled circumplex to give a visual profile of the scores, the Dependent and Self Actualize styles were dominant; the study sample means were above the 75th percentile of the general population sample. Dependency is described as a self-defeating style characterized by insecurity, indecision, meekness, and acquiescence. chi 2 Analysis showed that study respondents who had high scores in positive styles were significantly more likely to hold graduate degrees, publish articles, conduct research, hold offices, initiate projects, and serve as mentors. High scores in self-defeating styles were associated with the bachelor's degree level and less involvement in research and continuing education programs. These results indicate that many dietitians possess attributes associated with strong leadership skills; nevertheless, a substantial number reported self-defeating, dependent behaviors.(ABSTRACT TRUNCATED AT 250 WORDS)

Dependency, Psychological↗
PubMed1993

Nutrition screening and assessment: current practices and dietitians' leadership roles.

OBJECTIVE: To ascertain hospital nutrition screening and assessment practices and the need for additional resources to facilitate these processes. DESIGN: A survey questionnaire was developed to ascertain screening protocols, assessment procedures and tools, relevant training and research needs, and respondent characteristics. SAMPLE: The survey was sent to 988 members of Dietitians in Nutrition Support, a dietetic practice group of The American Dietetic Association; 388 (39.3%) responses were used for analysis. STATISTICAL ANALYSIS: Descriptive statistics were used to calculate response frequency. chi 2 Statistics were used to test associations between nutrition assessment practices and association membership, nutrition support team activity, patient load, time allocations, and type and size of hospital. RESULTS: Most institutions had policies for screening (90.2%); 68.7% of dietitians were involved in screening either alone or with others. Assessment practices within hospitals varied widely: 45.9% used a standard form; 66.8% assessed patients at risk; and 10.6% assessed all patients. Typical assessments included height and weight, diagnosis, weight history, albumin, food intolerance, and allergies. Social histories and sophisticated methods such as indirect calorimetry were used infrequently. Most assessments (54.5%) took 31 to 59 minutes; 35.0% of the dietitians spent more than half their time doing assessments. A large percentage (48.7%) of respondents viewed the dietitian as having greatest influence on assessment policies; others thought physicians (23.2%), administrators (15.7%), nurses (6.2%), or pharmacists (6.5%) had the greatest influence. APPLICATIONS/CONCLUSIONS: Recommended improvements include improved standards of practice, development of written protocols and practice guidelines, better use of human resources, standardization of assessment procedures throughout the profession, and empowerment of dietitians to assume a stronger leadership role in this dimension of dietetics practice.

Anthropometry↗
PubMed1991

Image and role of the consultant dietitian in long-term care: results from a survey of three Midwestern States.

Consultant dietitians and other health care professionals in three states were surveyed to determine the image and role of consultant dietitians in long-term care. Data were derived from telephone interviews with nursing home personnel in Illinois, Indiana, and Ohio. Chi 2 Analysis was used to determine whether health professionals' perceived image and job functions of consultant dietitians were significantly different from the perceptions of consultant dietitians. Overall, respondents held positive views of consultant dietitians. More than half of the respondents said the image of consultant dietitians had improved over the past 5 years. More than half of nursing directors, dietitians, dietary managers, and medical directors responded that consultant dietitians spent adequate time in facilities to do their jobs. Results of the study indicate that consultant dietitians believe that they are viewed by other health professionals as they actually are: competent, knowledgeable, well-respected, and involved in direct patient care functions. The next challenge is for more consultant dietitians to build on this base and become proactive, developing strong franchises and more opportunities for the profession.

Attitude of Health Personnel↗
PubMed1990

Health care innovations from the internal marketing perspective.

This paper presents an opportunity to apply the marketing concept internally to the diffusion and implementation of innovative services which can help organizations to achieve an advantageous external market position. An internal marketing communications model is discussed in this paper to identify factors and relationships influencing the internal diffusion and implementation of innovative services. Three case studies are presented to demonstrate the applicability of the model to a specific innovation in the health care industry. The notion of marketing innovative services from the inside out also is critical for other service firms. Further operational models are needed to present opportunities for marketing of innovative services.

Diffusion of Innovation↗
PubMed1988

The role of the clinical dietitian: I. Present professional image and recent image changes.

This study was designed to assess the image of dietitians in the hospital setting. Fifty persons in each of six health professions responded to a telephone questionnaire. The six health professions were nutrition support dietitians, general clinical dietitians, directors of nursing, hospital administrators, chief dietitians, and physicians. Respondents were selected from relatively large hospitals (greater than 200 beds) that were distributed geographically across the United States. Results indicated that nutrition support dietitians had a more positive view of how their profession was viewed by others than did general clinical dietitians. A larger proportion of nutrition support dietitians than of general clinical dietitians believed that they were viewed as working with specialized patients (14% vs. 9%), as an important part of the hospital team (20% vs. 6%), and as acting as a resource person for the medical staff (30% vs. 13%). Physicians and chief dietitians held the strongest opinions concerning the image of the nutrition support and general clinical dietitians; both held a more positive view of the nutrition support dietitian. A greater number of physicians expressed the view that nutrition support dietitians were more competent and knowledgeable than were general clinical dietitians (24% vs. 9%) and were an important part of the hospital team (36% vs. 15%). A greater percentage of chief dietitians said that nutrition support dietitians, in comparison with general clinical dietitians, were competent and knowledgeable (40% vs. 19%) and professional, well respected, expert, and more specialized (65% vs. 44%). In comparison with 5 years ago, 76% and 69% of nutrition support and general clinical dietitians, respectively, thought that they are now viewed as more professional and as having abilities that are recognized.

Attitude of Health Personnel↗
PubMed1988

The role of the clinical dietitian: II. Staffing patterns and job functions.

On the basis of responses to a telephone questionnaire, this study evaluated--from the viewpoint of nutrition support dietitians, general clinical dietitians (dietitians who are not members of a nutrition support team and who provide general clinical dietetic services), and other health professionals--the current job functions that nutrition support and general clinical dietitians perform in hospitals. Anticipated staffing needs and desired job functions were also assessed. For the nutrition support and general clinical dietitians, as viewed by themselves and other health professionals, there was considerable overlap in many job activities. However, a significantly larger proportion of directors of nursing thought that nutrition support dietitians were more involved than general clinical dietitians in the evaluation of nutritional status (42% vs. 14%) and in contributing expertise to medical team discussions (48% vs. 12%). A significantly larger proportion of physicians viewed the nutrition support dietitian as more involved than the general clinical dietitian in in-service programs for medical and nursing staffs (32% vs. 6%). A large proportion of directors of nursing (62%), hospital administrators (34%), and physicians (56%) believed that dietetic involvement in the supervision of food preparation, especially by general clinical dietitians, was much greater than did the dietetic staff. The outlook for the future suggests a greater participation by both the nutrition support and the general clinical dietitian in direct patient care functions and less involvement in food preparation and clerical tasks.

Dietetics↗
PubMed1985

How to deliver specialized nutritional support.

Integrating specialized nutritional support into long term care facilities will continue to be a multidisciplinary process, involving the education and training of a number of members of the health care team. And as the dynamics of the current health care environment shape the way in which specialized nutritional therapy is provided, standards and protocols for nutritional assessment, enteral and parenteral therapy and staff education will be essential for cost-effective, quality patient care. Specific issues relating to these standards have been discussed--each facility should then develop its own framework for nutritional support, based on individual needs.

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