title: Registered dietitians' roles in decision-making processes for PEG placement in the elderly.
abstract: OBJECTIVE
  The role of registered dietitians (RDs) in decision-making for percutaneous endoscopic gastrostomy (PEG) placement was explored. The ethical climate in their workplace and the relationship between decision-making and the ethical climate were examined.
  
  
  METHODS
  The survey included 67 RDs in complex continuing care and long-term care settings in Ontario. Descriptive statistics were used to describe roles, ethical climate, and professional characteristics. Pearson's and nonparametric correlations were used to examine relationships between roles, ethical climate, and professional characteristics.
  
  
  RESULTS
  Among the respondents, 97% thought RDs had a role in decision-making processes. The majority of RDs were usually or always involved in two roles: identifying relevant nutrition issues (91.2%) and discussing feeding options and alternatives (80.7%). Dietitians' roles in decision-making processes were more extensive when their relationship with physicians was positive (r=0.321, P=0.016), they had adequate knowledge (r=0.465, P<0.001) and adequate skills (r=0.520, P<0.001), and they were more satisfied with their role (r=0.554, P<0.001).
  
  
  CONCLUSIONS
  Registered dietitians performed a variety of roles in decision-making processes concerning PEG placement in the elderly. A positive working relationship with physicians, knowledge, skills, and role satisfaction significantly increase RDs' involvement with patients and families.
authors.affiliation: Mackenzie Health.
authors.forename: Maria O P
authors.initials: MO
authors.lastname: Szeto
authors.affiliation: Rutgers, The State University of New Jersey-School of Health Related Professions.
authors.forename: Julie O'Sullivan
authors.initials: JO
authors.lastname: Maillet
authors.affiliation: Rutgers, The State University of New Jersey-School of Health Related Professions.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Brody
authors.affiliation: Rutgers, The State University of New Jersey-School of Health Related Professions.
authors.forename: J Scott
authors.initials: JS
authors.lastname: Parrott
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000066491:Clinical Decision-Making; D058620:Elder Nutritional Physiological Phenomena; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data*; D005774:Gastrostomy / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D064686:Nutritionists; D009864:Ontario; D024382:Professional Role