Research and dietetic practice: An inevitable linkage
Research and dietetic practice: An inevitable linkage
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DOI：
10.1111/j.1747-0080.2008.00321.x
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发表时间：
2008-12-01
影响因子：
3.1
通讯作者：
Allman-Farinelli, Margaret
中科院分区：
文献类型：
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作者：
Allman-Farinelli, Margaret
在这个以证据为基础的指南和系统评价的时代，该行业越来越意识到研究的重要性，以告知我们的营养和营养学实践。然而，就在不久前，实践还可以被更多地看作是由我们权威的专业长老教授的一门手艺，少数营养师接受了为营养学“科学”提供信息的研究的责任。营养和饮食实践不可避免地与研究有关。实践引导我们必须探索的研究问题，研究为我们作为营养和饮食专业人员的日常实践提供信息。20世纪90年代初，医生开始将医学范式转向循证实践。1营养师似乎已经接受了千年之交的转变。循证实践要求营养师有能力对文献中发表的证据的质量做出判断。营养师必须能够批判性地分析所采用的研究方法并评估结论。他们必须辨别出由于不良的研究设计和进行而产生的积极关联，并接受由于样本量不足而产生的无效假设。营养师必须理解孤立的研究和一系列表明因果关系的证据之间的区别。这种技能的重要性在我们的入门级能力中得到认可，并在高级APD计划中得到加强。所有执业营养师都有职业责任来培养这些技能。研究和实践之间的联系远远超出了饮食文学的批评。本文作者并不是第一个反思研究对营养学实践的重要性的人，也不是第一个支持研究的所有权应该属于营养学家的人。美国饮食协会承认，研究是职业的基础。[2]这一信息对这一专业来说是如此重要，因此这一主题值得重申。正如丹尼尔斯在2002年所反映的那样，饮食研究是一种“不断提出问题，评估已经做了什么的实践方法”，3.研究不应被视为属于大学的、仅限于全职研究人员的专业的外围工作。相反，它是所有营养师实践的基本方式。许多营养师仍然问他们可能从事什么类型的研究，但几乎每一个方面的做法回避质疑。与科学背景，营养师精通定量研究的性质。使用数字来评估患者的电解质水平或比较不同诊断类别之间的服务情况完全在我们的舒适区内。我们承认，关于医院和老年人营养不良的比例，
In this era of evidence-based guidelines and systematic reviews, the profession is increasingly aware of the importance of research to inform our practice of nutrition and dietetics. However, it is not so long ago that practice could be viewed more as a craft taught by our authoritative professional elders and with a minority of dietitians accepting responsibility for the research that informed the ‘science’of dietetics. Nutrition and dietetic practice are inevitably linked to research. Practice leads us to the research questions that must be explored and research informs our everyday practice as a nutrition and dietetic professional. A shift in the paradigm for medicine towards evidencebased practice began in the early 1990s for physicians. 1 Dietitians appear to have embraced the shift around the change of millennium. Evidence-based practice requires dietitians to have the skills to make judgment about the quality of the evidence published in the literature. Dietitians must be able to critically analyse the research methods employed and evaluate the conclusions. They must discern positive associations because of poor study design and conduct and acceptance of null hypotheses because of insufficient sample size. Dietitians must appreciate the difference between isolated studies and a body of evidence indicating causation. The importance of such skill is recognised in our entry-level competencies and built upon in the advanced APD program. All practicing dietitians have a professional responsibility to develop these skills. The link between research and practice goes considerably beyond critique of the dietetic literature. The current author is not the first to reflect on the importance of research for the practice of dietetics; nor the first to espouse that ownership of the research should belong to dietitians. The American Dietetic Association has acknowledged that research is the foundation of the profession. 2 The message is so central to the profession that the theme deserves reiteration. As Daniels reflected in 2002, dietetic research is an ‘approach to practice that is about constantly asking questions, evaluating what is already being done...’, 3 and research must not be viewed as something peripheral to the profession that belongs to universities and is restricted to full-time researchers. Rather, it is fundamental to the way that all dietitians practise. Many dietitians still ask what type of research they could possibly engage in, but almost every facet of practice begs questioning.With a scientific background, dietitians are well versed in the quantitative nature of research. Use of numbers to assess electrolyte levels of patients or compare occasions of service among the different diagnostic categories is well within our comfort zone. We acknowledge that there is still much to be discovered about rates of malnutrition in hospitals and aged