Bakgrund NCP är en systematisk, problemlösande metod med ett unikt standardiserat språk som används av yrkesverksamma dietister för dokumentation. Det bidrar till att dietisten agerar utifrån ett kritiskt tänkande där besluten för att hantera patientens nutritionsproblem sker utifrån kunskap av evidensbaserad erfarenhet. Dietisternas Riksförbund (DRF) uppmanar legitimerade dietister att arbeta enligt NCP. Syfte Studiens syfte var att studera svenska dietisters arbete med att ställa nutritionsdiagnoser enligt NCP. Metod En webbaserad enkät utformades. Yrkesverksamma dietister rekryterades via det sociala mediet Facebook samt via DRF:s hemsida. Insamlad data bearbetades i SPSS Statistics 22, och analyserades med Chi-2-test och Correlate Bivariate Spearman. Signifikansnivån bestämdes till p-värde < 0.05. Resultat 119 dietister deltog i studien varav 103 (87 %) skrev nutritionsdiagnoser. I genomsnitt hade dietisterna arbetat i 2 år (1-3 år) med NCP, och över hälften arbetade inom akutsjukvård. Analysen visade att det fanns ett samband mellan antal år dietisterna arbetat med NCP och hur många nutritionsdiagnoser de skrev (r=-0.197, p=0.046). Ett samband visades även mellan tiden dietisterna arbetat med NCP och tiden det tog att skriva nutritionsdiagnoser (r=-0.226, p=0.022). Av de 103 dietisterna som använde NCP ansåg 60 % att deras kunskap och erfarenhet kunde förbättras, 89 % tyckte att nutritionsdiagnoser var användbara. Engelskan i referensbladen tyckte 48 % till viss del var svårtolkad och (n=13) angav att översättning till svenska kunde underlätta arbetet. Det framgick att mer än hälften (53 %) av dietisterna ibland utformade PES-meningar utan att ha funnit passande tecken/symtom i referensbladet. Slutsats Svenska dietister önskar mer kunskap och utbildning i NCP och översättning av referensbladen till svenska skulle sannolikt kunna öka användandet av nutritionsdiagnoser. En vidare implementering av NCP i Sverige behövs. / Background The Nutrition care process is a systematic, problem-solving approach with a standardized language used by dietitians for documentation. It stimulates dietitians to critically appraise and take evidence-based decisions on a patient's nutritional problems. The Swedish Association of Clinical Dietitians (DRF) appeals qualified dietitians to work according the NCP. Objective The aim was to study Swedish dietitians’ work with nutrition diagnosis according to the NCP. Method(s) A web-based questionnaire was developed. Dietitians was recruited through the social media Facebook and the DRF website. The collected data were processed in SPSS, analyzed by Chi-2-test and Correlate Bivariate Spearman, with significance level at p < 0.05. Results A total of 119 dietitians responded to the questionnaire and 103 (87 %) of the respondents wrote nutrition diagnosis. The respondents had on average worked with the NCP for 2 years (range 1-3 years), and over half worked in hospitals. There was a correlation between years working according to the NCP and the number of written diagnosis (r=-0.197, p=0.046). Also, the time for writing a nutritional diagnosis was reduced as the experience of working with NCP increased (r=-0.226, p=0.022). It was 60 % that thought their knowledge and experience in NCP could be improved, 89 % stated that the NCP was useful. The English in the reference sheets 48 % of the respondents said partly was difficult to understand and (n=13) wanted them to be translated into Swedish. It showed that more than half (53 %) of the dietitians sometimes composed PES-statements without finding the appropriate signs/symptoms in the reference sheet. Conclusion Swedish dietitians consider themselves to be in need of more knowledge and training in the NCP, and translations of the reference sheets would possibly increase the use of nutrition diagnosis. A further implementation of the NCP is needed in Sweden.

Submitted by Erika Demachki (erikademachki@gmail.com) on 2015-02-03T19:15:25Z No. of bitstreams: 2 Tese - Cláudia Fabiana Alves Rezende - 2014.pdf: 6705012 bytes, checksum: 1b40d2350a1c7203675ff54a47f37246 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Erika Demachki (erikademachki@gmail.com) on 2015-02-03T19:15:52Z (GMT) No. of bitstreams: 2 Tese - Cláudia Fabiana Alves Rezende - 2014.pdf: 6705012 bytes, checksum: 1b40d2350a1c7203675ff54a47f37246 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-02-03T19:15:52Z (GMT). No. of bitstreams: 2 Tese - Cláudia Fabiana Alves Rezende - 2014.pdf: 6705012 bytes, checksum: 1b40d2350a1c7203675ff54a47f37246 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-02-19 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / One of the most competitive and growth potential of the agribusiness sector is the citrus industry. Citrus nurseries grown in protected cultivation, constitutes one of the foundations of this growth. To achieve high productivity in any culture, there are a number of factors, among which the supply of nutrients, in the manner and in adequate quantity becomes paramount. The Diagnosis and Recommendation Integrated System (DRIS) was developed to provide a diagnosis of the nutritional status of cultivated plants, helping the decision on fertilizer recommendation for crops, being based on the balance of essential nutrients to plants. The objective of this study aimed to obtain a database of foliar analysis for establishment of DRIS and assess the nutritional status of two rootstocks (Rangpur lime and Swingle Citrumelo) and two combinations of citrus seedlings (Orange Pear/Rangpur lime and Orange Christmas /Swingle Citrumelo) grown in ‘Goiás’ collections hundred twenty leaf samples for rootstocks and one hundred and twenty leaf samples for ready seedlings were performed . With the data obtained organized a database. The database was analyzed by the tracks or Critical Levels of Concentration and DRIS method by method. Bands Concentration diagnosed for the Rangpur Lime rootstock , the most limiting nutrient deficiency were Mg and Zn and excess P and Fe. For Citrumelo Swingle, limiting disability K, S, Mn, Cu and Zn, excess Fe and N. For the citrus nurseries K, S and Zn were the nutrients most limiting nutrient deficiency and P, Fe, Mg and N in excess. Zn is the nutrient most often deficiency and Fe excess among rootstocks and citrus nurseries. The DRIS diagnosed S as the most limiting disability and N as the most limiting for excess, and still showed higher sensitivity for diagnosing nutritional problems. / Um dos setores mais competitivos e com potencial de crescimento do agronegócio é a citricultura. As mudas cítricas, cultivadas em cultivo protegido, constitui um dos alicerces desse crescimento. Para se obter alta produtividade em qualquer cultura, existem um conjunto de fatores, dentre os quais o fornecimento de nutrientes, de maneira e em quantidade adequada se torna primordial. O Sistema Integrado de Diagnose e Recomendação (DRIS) foi desenvolvido para fornecer um diagnóstico do estado nutricional de plantas cultivadas, auxiliando na decisão sobre a recomendação de adubação para culturas agrícolas, sendo baseado no balanço de nutrientes essenciais aos vegetais. Este trabalho teve por objetivo obter um banco de dados de análise foliar para estabelecimento do DRIS e avaliar o estado nutricional de dois porta-enxertos (Limão Cravo e Citrumelo Swingle) e duas combinações de mudas cítricas (Laranja Pera/Limão Cravo e Laranja Natal/Citrumelo Swingle) cultivados em Goiás. Foram realizados coletas de cento e vinte amostras de folhas para porta-enxertos e cento e vinte amostras de folhas para as mudas prontas. Com os dados obtidos organizou-se um banco de dados. O banco de dados foi analisado pelo método dos Níveis Críticos ou Faixas de Concentração e pela metodologia DRIS. As Faixas de Concentração diagnosticaram, para o porta-enxerto Limão Cravo, os nutrientes mais limitantes por deficiência foram Mg e Zn e por excesso P e Fe. Para o Citrumelo Swingle, limitante por deficiência K, S, Mn, Cu e Zn e por excesso Fe e N. Para as mudas cítricas os nutrientes K, S e Zn foram os nutrientes mais limitantes por deficiência e o P, Fe, Mg e N por excesso. O Zn é o nutriente com maior frequência de deficiência e o Fe de excesso entre os porta-enxertos e as mudas prontas. O método DRIS diagnosticou o S como o mais limitante por deficiência e o N como o mais limitante por excesso, e ainda apresentou maior sensibilidade para diagnosticar problemas nutricionais.