Dietitian

from Wikipedia, the free encyclopedia

Dietician is the protected name for a medical profession . The previous two-year and now three-year training takes place at state-approved schools or private schools and ends with an examination. In Austria the dietitians are called diaetologists and in Switzerland they are qualified nutritionists HF / FH .

Definition of dietician / diaetologist

The definition of "dietician" ( English dietitian ) was carried out by the International Congress of Dietetic Associations (ICDA) and was approved by the European Federation of the Associations of Dietitians taken (EFAD):

"A dietitian is a person with a qualification in nutrition & diets recognized by national authority (s). The dietitian applies the science of nutrition to the feeding and education of groups of people and individuals in health and disease. "

The job title diaetologist is made up of the Greek terms δίαιτα (díaita, diet) and λόγος (lógos, teaching). The term diet was originally used in the sense of "lifestyle" or "way of life". The dietetics deals still scientifically with the "right" diet and lifestyle in health and disease. Diaetologists have scientifically sound expertise and guarantee a guideline-compliant, evidence-based therapy.

The EFAD subdivides dietitians according to specialization and field of work in which dietitians work in Europe:

  • Administrative Dietitian: "a dietitian who focuses and works primarily within food service management with responsibility for providing nutritionally adequate, quality food to individuals or groups in health and disease in an institution or a community setting."
  • Clinical Dietitian: "a dietitian who has responsibility for planning, education, supervision and evaluation of a clinically devised eating plan to restore the client / patient to functional nutritional health. Clinical dietitians can work in primary care as well as in institutions. "
  • Public Health or Community Dietitian: "a dietitian directly involved in health promotion and policy formulation that leads to the promotion food choice amongst individuals and groups to improve or maintain their nutritional health and minimizes risk from nutritionally derived illness."

If a dietician covers several fields of work, the EFAD speaks of the General Dietitian.

The dietitian is the only health profession in the field of dietetics and nutrition that can be recognized in other European countries on the basis of EU Directive 2005/36 / EC. Recognition abroad is necessary for exercising the profession.

Professional history and associations

The professional history of dietitians in Germany begins in the 1920s. Nurses prepared medically prescribed diets in the kitchenette of the wards in the hospitals. In the mid-1920s, a further professional qualification as a diet nurse was introduced, which was expanded a short time later to an independent two-year training as a diet nurse. In the 1930s, the professional title of dietitian was established and the first diet schools emerged, for example at the Kaiserin Augusta Hospital in Berlin under the doctor Carl Schlayer and the diet nurse Johanna Kunath. In 1937 the profession received state recognition. Due to the Second World War , many schools were discontinued and resumed after the war. Initially, the profession developed further in both the Federal Republic of Germany and the GDR . In the 1950s, the training of dietitians in the GDR was increased to three years. In the Federal Republic of Germany, the training was initially increased to three and then to four years (including the year of recognition). In the 1970s it was cut back to two years. Only after the fall of the Wall will the training be set for three years across the country and the applications of the West German Association of Dieticians for an extension of the training will be granted. Since 1974, the training to become a state-approved dietician has been regulated nationwide in the Diet Assistance Act (DietAssG). The professional title is also protected in the same law. The dietician is one of the health professions. In the current classification of occupations of the German employment agency, dietitians are listed in group 8176 - occupations in diet and nutrition therapy - as the only therapy occupation for the nutrition and dietetics sector. In the International Standard Qualification of Professions ( ISCO88 ) the dietitians can be found in main group 3 "Technicians and non-technical professions of equal rank" in sub-item 322 "Modern medical professions (excluding nursing)" under item 3223. The same group also includes the professional group of physiotherapists, medical technical assistants and occupational therapists.

With the support of the German Nutrition Society (DGE), founded in 1954, the “Association of State-Recognized Dieters and Nutritionists in Germany” was founded in Mainz in 1957 , from which today's “ Association of Dieters - Deutscher Bundesverband e. V. “(VDD) was created. In the same year the VDD becomes a member of the ICDA, which is still in existence today . In 1972 the VDD is a founding member of the CADEC (Committee of Dietetic Associations in the European Community) , today's EFAD.

education

The training of dietitians is regulated in the dietician training and examination ordinance (DietAss APrV). Admission requirements for the training are physical and psychological suitability for the exercise of the profession and an intermediate level of education (upper secondary level). The training ends after three years with an oral, written and practical exam. After successfully passing the exam, you must apply for permission to use the professional title " Dietician " ( Diet AssG §1 ). The professional title “dietician” may only be used after it has been issued by the competent authority in the federal state of the training facility. Without this permission, significant penalties are possible. ( DietAssG §10 )

The training comprises a total of 4,450 hours, of which 3,050 are theoretical and 1,400 hours are practical. The course content and the state examination are specified in the DietAss APrV. With 1000 (presence) hours, the subject of dietetics is the main focus of the lesson. The training of dietitians, like that of the other state-recognized non-academic medical professions (e.g. physiotherapists , midwives and occupational therapists ), is regulated by federal law. The training has a special status, as it cannot be assigned to either the Vocational Training Act (BBiG) or higher education.

In Germany around 700 dietitians are trained in 60 schools every year. In the EC Directive 2005/36 / EC on the regulation for the recognition of professional qualifications of September 7, 2005, the training to become a dietitian is listed in the "specially structured training courses". This list also includes other health professions such as physiotherapists , speech therapists , occupational therapists and pediatric nurses .

After training as a dietitian, there is the possibility of professional training. These further qualification measures are carried out by various specialist societies such as the DGE ( German Society for Nutrition ), DDG ( German Diabetes Society ) and the Association of Dieters - Deutscher Bundesverband e. V. (VDD) and enable specialization in certain areas of activity such as nutrition and diet advice and catering management.

In Austria about 100 diaetologists are trained at 5 training centers (FHs) every year. The training locations are Innsbruck, Bad Gleichenberg, Linz, St. Pölten and Vienna. Since 2006, the profession of diaetologist has been based on a recognized academic training and is regulated both by the University of Applied Sciences Studies Act and by the FH-MTD Training Ordinance [4]. The training at universities of applied sciences lasts 6 semesters and ends with a Bachelor of Science in Health Studies (BSc). There are also offers for part-time master’s courses in Graz, Innsbruck and Vienna.

Education

In Switzerland and Austria the training for dipl. Nutritionist HF / FH or diaetologist has been held exclusively at universities for several years.

In Germany, the current principles of professional law do not allow training to be carried out at university level. However, there are also academic training opportunities in Germany in the form of a dual course at the Fulda University and a shortened, additive course at the Neubrandenburg University.

At the Fulda University of Applied Sciences, the degree in dietetics is dovetailed with training at a cooperating training facility. The Fulda University of Applied Sciences cooperates with the training centers for dieticians in Gießen, Marburg, Würzburg, Bad Hersfeld and Mainz. The four-semester dietetics course at the Neubrandenburg University of Applied Sciences builds on the completed training as a dietician. It cooperates with the college for dietitians in Quakenbrück.

Both courses conclude with a Bachelor of Science in dietetics. The aim of both courses is to make dietetics more scientific as well as the professionalization and academization of the professional group of dieticians in Germany. Since both courses take into account the legal bases for training as dietitians, professional recognition in (European) countries is simplified.

tasks

Dietitians are the only legally protected, federally regulated profession for the subject of dietetics and nutrition. Essentially, dietitians work in the following areas:

  • Clinical dietetics and nutrition: These include in particular diet and nutritional advice in the clinical and outpatient sector as well as the diet therapy settings of patients (e.g. enteral nutrition or parenteral nutrition and special diets ).
  • Administration (catering management): This includes monitoring the practical implementation of diet therapy measures in the kitchen as well as managing the (diet) kitchen and instructing staff.
  • Public Health ( prevention and health promotion): This includes the development, implementation, implementation and evaluation of measures in the field of prevention and health promotion.
  • Teaching and research: These include the training of health professions (e.g. dietitians, health and nurses) as well as the collaboration and implementation of studies.

The therapeutic measures range from oral nutrition to enteral to parenteral care. Therapy goals are an optimal supply of energy, nutrients and fluids and the best possible quality of life in all situations. As part of the interdisciplinary collaboration, dieticians bring their expertise to therapeutic measures in the following medical fields:

  • Endocrinology and Metabolism (Diabetes Mellitus)
  • Gastroenterology and hepatology
  • Immunology and allergology
  • oncology
  • Nephrology
  • Pediatrics
  • geriatrics
  • Intensive care
  • surgery
  • Psychiatry, eating disorders
  • Clinical nutrition

Diaetologists are involved in health promotion:

  • Healthy nutrition at all ages
  • Diet during pregnancy and breastfeeding
  • Sports nutrition
  • food industry
  • Community catering

employment

Diet assistants are mostly employed in hospitals , rehabilitation clinics and similar institutions, but they are also increasingly working independently and in doctor's offices or with health insurance companies. The therapeutic area and health tourism offer further possibilities.

In Germany in 2008, according to the health reports (GBE), 14,000 dietitians were employed in Germany subject to social security contributions. Since in Germany - in contrast to other countries - working dietitians are not registered, the number of self-employed dietitians is not known. The estimates range from 2000 to 5000 self-employed. The only professional association of dieticians (Verband der Dietassistenten - Deutscher Bundesverband e.V., VDD) represents around 4500 dieticians and thus around 1/3 of the dieticians in Germany. Dietitians show a comparably high degree of organization. In 2009, the VDD commissioned a professional field analysis, which was carried out by the Berlin School of Public Health at the Charité . Accordingly, the job description of dietitians is diverse and the fields of work are wide-ranging. Most dietitians in Germany are employed (65%), followed by freelance work (15%) and a mixture of these, “employed and freelance” (20%). Employed dietitians mainly work in clinics (54.5%) and rehabilitation facilities (17.6%) and other facilities such as doctors' offices, schools, pharmacies (25%). Care facilities play a subordinate role, with only 2.9% of dietitians working here. Due to the demographic change, however, it is to be expected that the activities in care and senior facilities will increase. The implementation of the “Expert Standard on Nutrition” of the DNQP (German Network for Quality in Care) could also lead to an increase in employment figures - not only in care and senior citizens' facilities. The predominant activity of dietitians is patient-related, i. i.e., they work directly with the patient or client (63.5%).

The majority of dietitians are involved in diet therapy and nutritional advice (85.4%), followed by activities in catering management (54%). But also research (29%), public relations (13%) and teaching (11%) are frequent fields of work for dietitians. About 2/3 (62.9%) of all dieticians work in one or more interprofessional teams, which mostly consist of other dieticians (80%) as well as doctors (66%), nurses (35%), psychologists (35%) and (dieters -) cooks (39%) pass. The interprofessional teams vary greatly depending on whether dietitians work in clinics or independently. With dietitians in clinics, nurses and (diet) cooks are much more often members of the team. In the case of the self-employed, on the other hand, other health professions, such as physiotherapists or psychotherapists. The activities of dietitians in a team indicate the many interfaces to other professional groups that are necessary to carry out holistic diet and nutritional therapy measures. Dietitians often do further training. 73.5% of all dietitians have taken part in at least one training course - that speaks for a high quality of professional activity.

As a specialist, the dietitian is an important link between doctor , patient and relatives. However, in Germany there is also the professional title of diet cook . In contrast to the dietitian, however, this is a commercial profession with an examination by the Chamber of Commerce and Industry .

Web links

Individual evidence

  1. ^ Rhein-Neckar-Wiki: Diet nurse Johanna Kunath Johanna Kunath
  2. ↑ DietAssG - unofficial table of contents. Retrieved June 29, 2020 .
  3. ↑ a b FH JOANNEUM range of courses. Retrieved on August 15, 2018 (German).
  4. ^ Dietetics - St. Pölten University of Applied Sciences. Retrieved August 15, 2018 .
  5. ^ FH Campus Wien: Dietetics. Retrieved August 15, 2018 .
  6. ↑ Bachelor course in dietetics in cooperation with the University of Neubrandenburg. In: ckq-gmbh.de. Quakenbrück Christian Hospital, accessed on August 18, 2017 .