DIET PRESCRIPTION DECISION AUTONOMY AND PERCEPTIONS OF LEGAL RESPONSIBILITY OF NEW YORK STATE END STAGE RENAL-DISEASE CLINICAL DIETITIANS (NURSING, MEDICINE).
Contributors: New York University.
Published: 1984
Number of pages: 229
Subjects: Health Sciences, Nutrition.
Description: The purpose of this study was to examine the decision making contribution of the clinical dietitian working in New York State End-Stage Renal Disease (ESRD) Facilities and to investigate the degree of perceived legal responsibility of the dietitian for selected hypothetical diet prescription errors. Mail questionnaires were sent to the sample population of 90 New York State-ESRD facility medical directors, head nurses and clinical dietitians. The research instrument was developed for this study and included nine diet prescription decision situations and four hypothetical incidents of diet prescription error. In addition, there were three subjects considered by the research to be essential to diet prescription formulation--these were self-rated by participants as well as one question on knowledge level of legal risks of professional responsibilities. The instrument was tested for construct validity and produced acceptable Cronbach alpha coefficients.

Role expectations of the dietitians showed statistically significant intergroup and intragroup differences (p < .05). Five of the questions were directed at assessing the level of dietitian decision contribution in the diet prescription and included decisions ranging from bran to feeding the comatose patient with renal shut-down. The next four questions were directed at analyzing the level of initiative expected of the dietitian while validating the content of the diet prescription, and ranged from situations of "vague diet order" to "non-individualized protein" prescription.

The second focus of the questionnaire inquired into the dietitian's degree of perceived legal responsibility for four hypothetical incidents in which different members of the triad--physician, nurse or dietitian--make a mistake in formulating, transcribing or interpreting the potassium level of the diet. The culmination of this error sequence was depicted as death of the patient. The dietitian plays a different role in each incident, but is the professional in all incidents who executes the final error of excess dietary potassium for the ESRD patient.

The nine decision items were measured on a tri-level professionalism scale of: low, intermediate or high decision autonomy, or initative by the dietitian. Results indicated that there was a heavy concentration among the three occupational groups in rating the dietitian, in actual practice, as performing at the intermediate or consultant level of decision contribution. Dietitians had a higher self-image than the physicians and nurses who held similar lower opinions of the dietitian's level of performance. . . . (Author's abstract exceeds stipulated maximum length. Discontinued here with permission of author.) UMI.
Notes: Source: Dissertation Abstracts International, Volume: 45-08, Section: B, page: 2503.

Thesis (PH.D.)--NEW YORK UNIVERSITY, 1984.

School code: 0146.