RESEARCH QUESTIONNAIRE

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* 1. Name

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* 2. Gender

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* 3. Qualification

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* 4. Where do you work?

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* 5. Name of hospital/clinic

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* 6. Town

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* 7. District

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* 8. For how many years you have been in this profession

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* 9. What type of diet and foods you usually advice your patients in following conditions?
CELIAC DISEASE
Type of diet?

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* 10. 1.Foods to be eaten?

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* 11. 2.Foods to be eaten?

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* 12. 3.Foods to be eaten?

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* 13. 1.Foods to avoid?

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* 14. 2.Foods to avoid?

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* 15. 3.Foods to avoid?

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* 16. 1.Any vitamin ,mineral supplement?

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* 17. 2.Any vitamin ,mineral supplement?

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* 18. 3.Any vitamin ,mineral supplement?

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* 19. HYPERTENSION
Type of diet?

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* 20. 1.Foods to be eaten?

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* 21. 2.Foods to be eaten?

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* 22. 3.Foods to be eaten?

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* 23. 1.Foods to avoid?

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* 24. 2.Foods to avoid?

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* 25. 1.Foods to avoid?

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* 26. 1.Any vitamin and mineral supplement?

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* 27. 2.Any vitamin and mineral supplement?

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* 28. 3.Any vitamin and mineral supplement?

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* 29. DIABETES
Type of diet?

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* 30. 1.Foods to be eaten?

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* 31. 2.Foods to be eaten?

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* 32. 3.Foods to be eaten?

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* 33. 1.Foods to avoid?

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* 34. 2.Foods to avoid?

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* 35. 3.Foods to avoid?

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* 36. 1.Any vitamin and mineral supplement?

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* 37. 2.Any vitamin and mineral supplement?

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* 38. 3.Any vitamin and mineral supplement?

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* 39. Lactose Intolerance
Type of diet?

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* 40. 1.Food to be eaten?

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* 41. 2.Food to be eaten?

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* 42. 3.Food to be eaten?

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* 43. 1.Foods to avoid?

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* 44. 2.Foods to avoid?

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* 45. 3.Foods to avoid?

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* 46. 1.Vitamin/mineral supplements?

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* 47. 2.Vitamin/mineral supplements?

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* 48. 3.Vitamin/mineral supplements?

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* 49. CORONARY HEART DISEASE
Type of diet?

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* 50. 1.Foods to be eaten?

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* 51. 2.Foods to be eaten?

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* 52. 3.Foods to be eaten?

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* 53. 3.Foods to avoid?

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* 54. 1.Vitamins/Minerals Supplements

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* 55. 2.Vitamins/Minerals Supplements

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* 56. 3.Vitamins/Minerals Supplements

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* 57. GERD (Gastro Esophageal Reflux Disease)
Type of diet?

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* 58. 1.Foods to be eaten?

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* 59. 2.Foods to be eaten?

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* 60. 3.Foods to be eaten?

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* 61. 1.Foods to avoid?

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* 62. 2.Foods to avoid?

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* 63. 3.Foods to avoid?

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* 64. 1.Vitamins/minerals supplements?

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* 65. 2.Vitamins/minerals supplements?

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* 66. 3.Vitamins/minerals supplements?

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* 67. IRON DEFICIENCY ANEMIA
Type of diet?

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* 68. 1.Foods to be eaten?

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* 69. 2.Foods to be eaten?

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* 70. 3.Foods to be eaten?

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* 71. 1.Foods to avoid?

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* 72. 2.Foods to avoid?

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* 73. 3.Foods to avoid?

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* 74. 1.Vitamins/mineral supplements?

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* 75. 2.Vitamins/mineral supplements?

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* 76. 3.Vitamins/mineral supplements?

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* 77. CROHN'S DISEASE
Type of diet?

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* 78. 1.Foods to be eaten?

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* 79. 2.Foods to be eaten?

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* 80. 3.Foods to be eaten?

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* 81. 1.Foods to be avoided?

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* 82. 2.Foods to be avoided?

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* 83. 3.Foods to be avoided?

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* 84. 1.Vitamin/mineral supplements

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* 85. 2.Vitamin/mineral supplements

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* 86. 3.Vitamin/mineral supplements

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* 87. GATRITIS
Type of diet?

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* 88. 1.Foods to be eaten?

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* 89. 2.Foods to be eaten?

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* 90. Foods to be avoided?

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* 91. Vitamins/minerals supplements?

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* 92. Who do you think plays the major role in patients' health care?

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* 93. During the patients assessment, do you assess the nutrition status of the patient

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* 94. If yes, how do you assess the nutritional status of the patients?

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* 95. If you find any nutritional disorder, how do you treat it?

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* 96. What do you think is the role of dietitian in health care?

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* 97. What is your source of information for diet recommendation?

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* 98. Do you ever feel the need for additional support of a dietitian?

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* 99. Do you ever refer a patient to a dietitian?

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* 100. Please mention whether you agree or disagree with the following statements.

  AGREE DISAGREE
Eating right is just a matter of common sense.
Nutrition education is not the responsibility of physicians.
Nutrition is important only in certain medical specialties.
In many cases medication could be reduced or eliminated if patient is followed by recommended diet.
It is important to have an understanding of food composition and preparation to provide reliable nutritional counseling.
Physicians are well prepared for nutritional counseling in different diseases.
Dietary counseling is the waste of time because people don't change their habits anyway.
Medical institute should place greater emphasis on nutrition education.

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