Challenges in delivering nutrition care perceived by hospital dietitians in the Czech Republic: a qualitative study.

Abstract

Nutrition care is a crucial component of healthcare, with dietitians playing a key role in patient outcomes. However, their integration into interdisciplinary teams remains limited. While there are countries where dietitians are well situated, in the Czech Republic, the profession of a dietitian was established in 2004 and is still undergoing a transformation. Hence, this study aims to explore the experiences and challenges in delivering nutrition care that Czech dietitians encounter while working in a hospital setting. Data were collected through semistructured interviews with hospital dietitians. Participants were recruited purposefully via professional associations, social media and chain referrals. Interviews were transcribed and analysed using applied thematic analysis with an inductive coding approach. Interviews were held with hospital dietitians from across the Czech Republic. All interviews were conducted online via ZOOM. A total of 15 hospital dietitians took part in the study, predominantly female, covering a wide range of formal level of dietetics education, years of practice and professional roles. Three main themes were identified: (1) unclear professional role and identity, (2) marginalisation of nutrition care and (3) tension between professional aspirations and legal boundaries. The professional identity of dietitians remains fragmented, especially in the matter of what constitutes the role of a dietitian. Participants reported limited recognition by other healthcare professionals and insufficient organisational support. Barriers such as inadequate staffing, lack of autonomy and absence of strategic prioritisation of nutrition care were perceived as key obstacles to effective interprofessional collaboration and delivery of nutrition care. Hospital dietitians in the Czech Republic face systemic, organisational and team-based challenges that may limit their ability to deliver effective nutrition care. The findings suggest that clarifying professional roles, improving awareness among healthcare staff and exploring supportive institutional practices could help strengthen their integration into interprofessional teams. Further research is needed to examine how changes in educational structures, staffing policies and management approaches would influence the delivery of nutrition care and the evolving role and professional identity of dietitians.