RESEARCH QUESTIONNAIRE

Name

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* 1. Name

Gender

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* 2. Gender

Qualification

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* 3. Qualification

Where do you work?

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* 4. Where do you work?

Name of hospital/clinic

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* 5. Name of hospital/clinic

Town

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* 6. Town

District

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* 7. District

For how many years you have been in this profession

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

What type of diet and foods you usually advice your patients in following conditions.

a) Celiac Disease

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

a) Celiac Disease

b)Hypertension

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* 10. b)Hypertension

c) Diabetes

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* 11. c) Diabetes

d) Lactose Intolerance

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* 12. d) Lactose Intolerance

e) Coronary Heart Disease

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* 13. e) Coronary Heart Disease

f) GERD (Gastro Esophageal Reflux Disease)

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* 14. f) GERD (Gastro Esophageal Reflux Disease)

g) Iron Deficiency Anemia

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* 15. g) Iron Deficiency Anemia

h) Crohn's Disease

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* 16. h) Crohn's Disease

i) Gastritis

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* 17. i) Gastritis

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

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

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

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

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

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

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

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

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

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

What is your source of information for diet recommendation?

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

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

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

Do you ever refer a patient to a dietitian?

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

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

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* 26. 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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