Nutritional Workforce Wellness: Case Study of Hospital Staff Dietitians

Thesis Abstract

Dietitians in hospital settings face escalating work demands, high-life-work conflict, and evolving clinical responsibilities that may compromise their personal wellbeing and professional performance. This study investigates nutritional workforce wellness among hospital staff dietitians, addressing the problem that occupational stress, burnout, and suboptimal well-being can undermine clinical judgment, job satisfaction, and retention. The aim is to evaluate the determinants, manifestations, and outcomes of wellness within this professional group, with specific objectives to (1) assess levels of burnout, job satisfaction, physical health indicators, and psychological wellbeing; (2) examine organizational, workload, and psychosocial factors associated with wellness; (3) explore coping strategies and perceived institutional support; (4) determine the relationship between wellness indicators and job performance metrics; and (5) propose evidence-based interventions to enhance wellbeing and workforce sustainability. The study adopts a mixed-methods design anchored in the Job Demands-Resources (JD-R) model and Self-Determination Theory to illuminate how job demands, resources, autonomy, competence, and relatedness shape wellbeing and work outcomes among hospital dietitians. A purposive sampling approach targets staff dietitians employed at three tertiary-referral hospitals in a metropolitan health network, with a total eligible population of 112 individuals. A stratified random sample of 84 dietitians will be selected to participate in the quantitative strand, complemented by 20 in-depth qualitative interviews to enrich interpretation. Quantitative data will be collected via a structured survey incorporating validated instruments the Maslach Burnout Inventory (MBI) for burnout, the WHO-5 Well-Being Index, the Copenhagen Psychosocial Questionnaire (COPSOQ) for psychosocial risks, the Perceived Stress Scale (PSS), and organizational measures including the Utrecht Work Engagement Scale (UWES) and the Practice Environment Scale-Nursing Work Index (PES-NWI) adapted for dietetics. Clinical health indicators such as body mass index (BMI), resting heart rate, and self-reported sleep quality will be self-reported, with optional biometric data from occupational health records where available. Qualitative data will be obtained through semi-structured interviews focusing on perceived drivers of wellness, coping mechanisms, perceived organizational support, and recommendations for workplace interventions. Descriptive statistics, reliability analyses (Cronbach’s alpha), and multivariate techniques including multiple regression and structural equation modeling (SEM) will test the relationships among job demands, resources, wellness outcomes, and job performance. The thematic analysis of interview transcripts will use an explicit coding framework aligned with JD-R and Self-Determination Theory constructs. Expected findings include (a) moderate-to-high burnout levels in the presence of excessive administrative load and limited control; (b) positive associations between job resources (supervisory support, autonomy, schedule flexibility) and wellbeing, engagement, and retention intentions; (c) significant correlations between wellbeing indicators and clinical job performance metrics such as accuracy in nutrient prescription, compliance with dietary protocols, and patient satisfaction scores; and (d) identification of effective coping strategies and organizational practices that strengthen resilience. The study contributes to knowledge by operationalizing the wellness construct within hospital dietetics, validating the applicability of JD-R and Self-Determination Theory to a non-nursing allied health group, and offering a context-specific, evidence-based intervention framework for improving wellbeing and workforce sustainability. The conclusion will synthesize how organizational policy, leadership practices, and resource allocation can create a healthier work environment that supports professional autonomy and quality patient care. Recommendations include (1) implementing workload management and flexible scheduling, (2) enhancing supervisor support and multidisciplinary collaboration, (3) establishing wellness programs and confidential counseling services, and (4) integrating wellness metrics into annual performance and retention strategies to reduce burnout and improve patient-centered outcomes. The study also outlines directions for longitudinal follow-up to assess the impact of targeted interventions over time.