Distribución de nutricionistas en el sistema de salud peruano: un panorama por niveles de atención

La prestación de servicios para la atención integral de la salud requiere la participación de diversos profesionales con competencias específicas para brindar la mejor atención posible a la población. La inclusión del nutricionista en los diferentes niveles del sistema de salud es crucial para garantizar una atención integral en las diversas etapas de la vida. Una distribución inequitativa de nutricionistas en los niveles de atención puede conducir a una fragmentación de la atención y la pérdida de oportunidades para abordar los problemas relacionados con la alimentación y nutrición. Por ello, se desarrolló un estudio con el objetivo de describir la distribución de nutricionistas en los establecimientos de salud según el nivel de atención, y evaluar el cumplimiento de las recomendaciones de recursos humanos establecidas por la norma técnica de las UPSS de Nutrición y Dietética. Se desarrolló un estudio descriptivo y transversal, mediante el análisis de fuentes secundarias. Se utilizaron los datos de recursos humanos por IPRESS de SUSALUD, del año 2022. Se consideró la Norma técnica de UPSS de Nutrición y Dietética para evaluar el cumplimiento de las recomendaciones de recursos humanos. Entre los principales resultados, se identificó que el 7.93% de los establecimientos de salud del primer nivel de atención tienen al menos un nutricionista. En el segundo nivel de atención, el 96.35% de los establecimientos de salud no cumplen con las recomendaciones de recursos humanos de la norma técnica, y ningún establecimiento del tercer nivel de atención cumplió esta recomendación. La distribución de nutricionistas en los diversos niveles de atención del sistema de salud peruano es desigual. Es necesario mejorar la planificación de recursos humanos en el sistema de salud peruano para garantizar una atención integral de la salud a la población.

The provision of services for comprehensive healthcare requires the involvement of various professionals with specific competencies to provide the best possible care to the population. The inclusion of nutritionists at different levels of the healthcare system is crucial to ensure comprehensive care at various stages of life. An unequal distribution of nutritionists across healthcare levels can lead to fragmented care and missed opportunities to address nutrition-related issues. Therefore, a study was conducted with the aim of describing the distribution of nutritionists in healthcare facilities according to the level of care and evaluating compliance with the human resources recommendations established by the technical standard of Nutrition and Dietetics UPSS. A descriptive and cross-sectional study was conducted using the analysis of secondary sources. Human resources data from SUSALUD for the year 2022 were used. The Technical Standard of UPSS of Nutrition and Dietetics was considered to assess compliance with human resources recommendations. Among the main findings, it was identified that 7.93% of first-level healthcare facilities have at least one nutritionist. In the second level of care, 96.35% of healthcare facilities do not comply with the human resources recommendations of the technical standard, and no third-level healthcare facility met this recommendation. The distribution of nutritionists across various levels of care in the Peruvian healthcare system is unequal. It is necessary to improve human resources planning in the Peruvian healthcare system to ensure comprehensive healthcare for the population..

Análisis cualitativo de los perfiles de egreso en procesos de aseguramiento de la calidad de carreras de Nutrición y Dietética en Chile

Antecedentes: La evaluación de los perfiles de egreso es uno de los aspectos centrales en la acreditación de carreras en Chile, por cuanto su formulación y aplicación en los procesos formativos influyen en sus niveles de pertinencia y calidad. Objetivo: Evidenciar las fortalezas y debilidades del diseño y aplicación de los perfiles de egreso de las carreras de Nutrición y Dietética en Chile, a partir de los resultados de sus procesos de acreditación. Materiales y métodos: Estudio transversal, descriptivo, cualitativo. Se identificaron, en las resoluciones de acreditación entre los años 2004 y 2016, las fortalezas y debilidades de los perfiles de egreso y las contradicciones entre lo declarado y lo ejecutado por los programas. Las carreras se ordenaron en dos grupos según el tiempo de acreditación: i) de dos a cuatro años y ii) de 5 o más años. Usando el software Atlas.ti 7.0 se determinaron los patrones y diferencias conceptuales en los juicios evaluativos de los perfiles de egreso. Resultados: Existe una alta variabilidad entre carreras en los contenidos y aplicación de los perfiles de egreso. Ella se asocia a las capacidades instaladas en las instituciones y a los tiempos de acreditación de la carrera. Existen carreras con déficit en el cumplimiento de competencias, conocimientos y habilidades. Conclusiones: Los contenidos y aplicación de perfiles de egreso son muy heterogéneos y su aplicación se asocia al tiempo de acreditación de la carrera. Es necesario limitar la alta dependencia a la demanda y estimular mayores compromisos institucionales.

Background: Assessment of the graduate profiles is one of the key aspects of program accreditation in Chile, therefore, their development and application in training processes have an impact on their relevance and quality. Objective: To demonstrate the strengths and weaknesses of the design and application of graduate profiles of Nutrition and Dietetics degree programs in Chile, on the basis of the outcomes of their accreditation processes. Materials and methods: Cross-sectional, descriptive, qualitative study. Strengths and weaknesses of graduate profiles, and inconsistencies between what was stated and what was actually implemented in the programs were identified in the accreditation resolutions issued between 2004 and 2016. Degree programs were classified in two groups, according to accreditation years: i) two to four years, and ii) five or more years The Atlas.ti 7.0 software was used to determine patterns and conceptual differences in the evaluative judgement of graduate profiles. Results: There was a high variability in the content and application of graduate profiles between degree programs. This was associated with the institutions' installed capacities and with accreditation years awarded to the program. Some programs were not compliant with the required competencies, knowledge and skills. Conclusions: The content and application of graduate profiles are highly heterogeneous, and its application is associated to accreditation years of the program. It is necessary to limit high dependency on demand to encourage stronger institutional commitments.

Análisis cualitativo de los procesos regulatorios de la calidad en los programas de Nutrición y Dietética en Chile

RESUMEN Introducción. El objetivo de este estudio es establecer patrones positivos y negativos de los resultados de los procesos de acreditación de las carreras. Asimismo, identificar desde una perspectiva cualitativa, variables relevantes y relaciones entre los criterios usados en su evaluación. Materiales y métodos. El estudio es transversal, descriptivo y cualitativo. Se analizaron veinte resoluciones de acreditación de las carreras de Nutrición y Dietética en Chile, emitidas entre los años 2004 y 2016 por la Comisión Nacional de Acreditación mediante el software ATLAS ti. Se consideraron las tres dimensiones; Propósitos e Institucionalidad; Condiciones de Operación y Resultados; y Capacidad de Autorregulación para establecer una matriz de relaciones con la identificación de patrones positivos y negativos entre criterios. Resultados. Se evidencian fuertes diferencias entre las carreras. Las relaciones positivas y negativas entre los códigos de los criterios perfil de egreso y plan de estudio indican que solo algunas de ellas proveen una formación adecuada. Del mismo modo, las relaciones entre la calificación del cuerpo docente y la investigación revelan casos de docentes sin niveles suficientes. Otros aspectos deficitarios son el nivel con que ingresan los estudiantes y el uso efectivo de diagnósticos y autoevaluaciones. Conclusiones. El estudio provee información relevante para la toma de decisiones y procesos de retroalimentación orientados al urgente mejoramiento y aseguramiento de la calidad de carreras, en particular de sus planes de estudio, calificación de docentes y efectividad de los procesos de aseguramiento de la calidad, dada la creciente importancia de estos profesionales en la salud pública.

ABSTRACT Introduction. The objective of this study is to establish positive and negative patterns based on the results of accreditation processes of degree programs. Similarly, its aim is to identify, from a qualitative perspective, relevant variables and relationships among the criteria used in their evaluation. Materials and methods. This is a cross-sectional, descriptive and qualitative study. Twenty accreditation resolutions of Chilean Nutrition and Dietetics degree programs were analyzed using the software ATLAS ti. Resolutions were issued between 2004 and 2016 by the National Accreditation Commission. Three dimensions were considered in order to establish a matrix of relationships associated with the identification of positive and negative patterns among criteria: Purpose and Institutionalism; Operating Conditions and Results; and Self-Regulatory Ability. Results. Major differences were found among the degree programs. Positive and negative relationships between criteria codes, graduate profile and curriculum, indicate that only some degree programs provide an appropriate training. In the same way, the relationship between the teaching staff qualification and research work revealed cases of teachers who were not sufficiently qualified. Other weak aspects were the level of knowledge that students have when they enter university and the effective use of diagnostics and self-assessment tests. Conclusions. This study provides relevant information for decision making and feedback processes oriented at the urgent improvement and quality assurance of degree programs, particularly of curricula, teaching staff qualifications, and effectiveness of the quality assurance processes, given the increasing importance of nutrition professionals in the public health area.

¿Qué pasa con la formación de nutricionistas en Chile? / What happening with nutritionist training in Chile?

RESUMEN El propósito de este artículo es analizar la evolución de las carreras y programas de Nutrición y Dietética en Chile. Se verifica un incremento sostenido de la oferta formativa, particularmente en los últimos veinte años, asociado a procesos de mercantilización de la Educación Superior. El aseguramiento de la calidad ha operado a través de la acreditación voluntaria y sus resultados son congruentes con el contexto nacional. La creciente importancia de la alimentación y nutrición en la salud pública del país exige formular cambios en la formación en Nutrición y Dietética, para lo cual se plantean diversas recomendaciones para lograr mayores niveles de pertinencia y el mejoramiento continuo de la calidad.

ABSTRACT The purpose of this article is to analyze the evolution of Nutrition and Dietetics degree programs and majors in Chile. This research demonstrated a sustained increase in the number of training programs, particularly during the last twenty years, due to the process of commodification of higher education. Quality assurance has been implemented by voluntary accreditation, which has shown results consistent with the national context. The growing importance given to food and nutrition in the national public health scenario requires changes in Nutrition and Dietetics academic programs. To this end, different recommendations are made in order to achieve improved relevance standards and continuous quality improvement.

Caracterización de estudiantes de nutrición de la Universidad del Mar de Talca según composición de capital cultural y social / Characterization of nutrition students of the Universidad del Mar of Talca according to cultural and social capital composition

Considering the increase in higher education institutions that offer the Nutrition program and the paradigm shift in the healthcare area oriented to a bio psychosocial approach, which can be understood as a holistic look at the principal actors in the educational process and whose development is not only technical and professional, but also educational. The aim of this article was to describe the composition of the cultural and social capital of the students enrolled in the Nutrition and Dietetics program at the University del Mar of Talca. This was a quantitative, non-experimental, cross-sectional and descriptive study; a survey with close ended question was applied to 45 students. The descriptive statistics results were analyzed using SPSS v.20 and indicated the composition of cultural and social capital of the universe of this study, allowing characterization of each individual whose program training implies a search for social mobility, security, notions of self-expression, and valoric composition proper to modernity.

Considerando el incremento de instituciones de educación superior que ofertan la Carrera de Nutrición, y el cambio paradigmático en el área de salud orientado a un enfoque biopsicosocial, el que podemos entender como una mirada holística hacia los actores en este proceso educativo, cuyo desarrollo no es sólo técnico y profesional, sino también formativo; el presente artículo pretende describir la composición del capital cultural y social de estudiantes de la carrera de Nutrición y Dietética de la Universidad del Mar de Talca. Estudio cuantitativo, no experimental, transversal y descriptivo, con muestra de 45 estudiantes a quienes se les aplicó un cuestionario con preguntas cerradas. Los resultados analizados con estadística descriptiva y utilizando el programa SPSS v.20, indican que la composición del capital cultural y social de los sujetos, permite caracterizar a un estudiante cuya formación disciplinar implica una búsqueda de movilidad social, seguridad, generando nociones de autoexpresión, y una composición valórica muy propia de la modernidad.

Assessing the Value of a Nutrition and Dietetic Service Website.

Background: The Leicestershire dietetic service developed a website (www.lnds.nhs.uk) in 2004 with three levels of access; for the public, health care professionals (HCPs) and dietitians. Over 450 resources are available on the site. The website has never been evaluated, though is perceived as being used frequently by dietitians. Access to nutrition websites has increased over recent years. Marquis et al. and Buttriss [1,2] have discussed how nutrition websites are used by dietitians and the public and how and why their popularity has increased. The study aimed to explore the value attached to the department website, the costs of running it and make recommendations for future development of the website. Methods: The researcher developed a Survey Monkey (www.surveymonkey.com) questionnaire, containing 12 questions to assess how visitors used the website and what they viewed. This was attached to the website for 6 weeks in spring 2013. Local Health Information Services (HIS) and Google Analytics information was available to look at retrospective website activity. Information on departmental printing costs was available to see if this had reduced over the time the website had been live. Results: Fifty four website users responded to the online questionnaire and indicated that this sample of users visited the website regularly and could find the information they were looking for. On a scale of 1-5, with 5 being a very positive response, the average rating for useful information was 4.19 and the average rating from users for the quality of the information was 4.27. The retrospective information showed that users, repeat users and pages viewed had increased steadily over the last 3 years. Unique visitors had increased from 7986 in 2011 to 10641(predicted in 2013) and return visitors had increased from 50.9% in 2011 to 57.6% (predicted) in 2013. The website users were a range of patients/public, HCPs and dietitians and although most users were from the UK there was an increasing worldwide audience. The printing budget had reduced over recent years while the number of dietetic staff employed and patients seen had increased between 2010 and 2012. Discussion: The results of the online questionnaire and Google Analytics data provided information that indicated the range of visitors valued the website and could mostly find what they were looking for. Improvements were identified e.g. a better search facility and consideration given to setting up Facebook/Twitter accounts to allow user experience to be captured on an on-going basis. The website was a very cost effective way of providing, accessible, evidence based, patient centred resources when compared with other ways of providing dietary information to patients and HCPs in Leicestershire. Conclusions: The website was valued and should be maintained with consideration given to the improvements recommended.

A ciência da nutrição em trânsito: da nutrição e dietética à nutrigenômica / The science of nutrition in transit: from nutrition and dietetics to nutrigenomics

No cenário mundial, a emergência do campo da Nutrição foi um fenômeno característico do início do século XX. No Brasil, a emergência da Nutrição localizou-se na área das Ciências da Saúde (ou Ciências da Vida), caracterizando-se, à primeira vista, como uma ciência de natureza biológica. Este artigo tem por objetivo analisar a trajetória do processo de produção do conhecimento científico que garantiu especificidade ao campo da Nutrição no Brasil, da emergência aos dias atuais. Os pressupostos teóricos que norteiam o artigo são: o conceito de campo científico, desenvolvido por Pierre Bourdieu e os conceitos de paradigma e comunidade científica, introduzidos por Thomas Samuel Kuhn. A análise histórica evidencia que desde o seu nascimento, além da natureza biológica, a Nutrição brasileira assumiu dimensões sociais e ambientais, caracterizando-se como um campo de conhecimento multidisciplinar, constituído a partir da integração de Ciências Biológicas, Ciências Sociais e Ciências dos Alimentos e Nutrição. Nas últimas décadas, com o intenso desenvolvimento da comunicação e informática, da genética e das teorias sobre a sustentabilidade ecológica do planeta Terra, importantes mudanças paradigmáticas têm ocorrido no campo da Nutrição. Portanto, pode-se afirmar que a Nutrição estaria vivenciando a era pós-genômica, constituindo-se uma ciência multidisciplinar, caracterizada pela integração das dimensões biológica, social e ambiental.

In the world scenario, the emergence of nutrition science was a phenomenon characteristic of the early Twentieth Century. In Brazil, its emergence occurred in the health sciences area (or life sciences) and was characterized, at first, as a science of biological nature. This article aims to analyze the trajectory of the process of producing scientific knowledge which ensured specificity to the field of nutrition in Brazil, from its emergence to the present. The theoretical assumptions that guide the article are: the concept of scientific field, developed by Pierre Bourdieu, and the concepts of paradigm and scientific community, introduced by Thomas Samuel Kuhn. Historical analysis shows that, from birth and in addition to its biological nature, Brazilian nutrition assumed social and environmental dimensions, being characterized as a multidisciplinary field of knowledge formed from the integration of the biological sciences, social sciences and food and nutrition sciences. In the last decades, with the intensive development of communication and information technology, genetics and sustainability theories, major paradigmatic changes have occurred in the field of nutrition. Therefore, one can say that nutrition is experiencing a post-genomic era and becoming a multidisciplinary science, characterized by the integration of the biological, social and environmental dimensions.