{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T20:46:34Z","timestamp":1792356394791,"version":"4.4.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2009,7,24]],"date-time":"2009-07-24T00:00:00Z","timestamp":1248393600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hum Resour Health"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Food handlers have a very important role in preventing food contamination during its preparation and distribution. This responsibility is even greater in hospitals, since a large number of patients have low immunity and consequently food contamination by pathogenic bacteria could be particularly harmful. Therefore, a good working environment and periodic training should be provided to food handlers by upper management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This study is qualitative research by means of focus group and thematic content analysis methodologies to examine, in detail, the statements by food handlers working in the milk and specific-diet kitchens in a hospital to understand the problems they face in the workplace.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>We found that food handlers are aware of the role they play in restoring patients' health; they consider it important to offer a good-quality diet. However, according to their perceptions, a number of difficulties prevent them from reaching this aim. These include: upper management not prioritizing human and material resources to the dietetic services when making resource allocation decisions; a perception that upper management considers their work to be of lesser importance; delayed overtime payments; lack of periodic training; managers lacking administrative skills; insufficient dietitian staff assistants, leading to overwork, at the same time as there is an excess of dietitians; unhealthy environmental working conditions \u2013 high temperature, high humidity, loud and constant noise level, poor ventilation; lack of food, and kitchen utensils and equipment; and relationship conflicts with chief dieticians and co-workers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>From these findings, improvement in staff motivation could be achieved by considering non-financial incentives, such as improvement in working conditions and showing appreciation and respect through supervision, training and performance appraisal. Management action, such as investments in intermediary management so that managers have the capacity to provide supportive supervision, as well as better use of performance appraisal and access to training, may help overcome the identified problems.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1478-4491-7-63","type":"journal-article","created":{"date-parts":[[2009,7,25]],"date-time":"2009-07-25T06:13:25Z","timestamp":1248502405000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Hurdles at work: perceptions of hospital food handlers"],"prefix":"10.1186","volume":"7","author":[{"given":"Cilce Helena Figueiredo Preza","family":"Bertin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magda Andrade","family":"Rezende","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirce Maria","family":"Sigulem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania Beninga","family":"Morais","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2009,7,24]]},"reference":[{"key":"187_CR1","unstructured":"Food and Agriculture Organization of the United Nations: Food Quality and Safety Systems \u2013 A Training Manual on Food Hygiene and the Hazard Analysis and Critical Control Point (HACCP) System. [http:\/\/www.fao.org\/docrep\/w8088e\/w8088e04.htm]"},{"key":"187_CR2","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1177\/0148607100024005296","volume":"24","author":"MLR Carvalho","year":"2000","unstructured":"Carvalho MLR, Morais TB, Amaral DF, Sigulem DM: Hazard analysis and critical control point system approach in the evaluation of environmental and procedural sources of contamination of enteral feedings in three hospitals. JPEN J Parenter Enteral Nutr. 2000, 24: 296-302. 10.1177\/0148607100024005296.","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"187_CR3","doi-asserted-by":"crossref","first-page":"2439","DOI":"10.4315\/0362-028X-68.11.2439","volume":"68","author":"MLS Vaz","year":"2005","unstructured":"Vaz MLS, Novo NF, Sigulem DM, Morais TB: A training course on food hygiene for butchers: Measuring its effectiveness through microbiological analysis and the use of an inspection checklist. 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J Am Diet Assoc. 2003, 103: 566-569. 10.1053\/jada.2003.50129.","journal-title":"J Am Diet Assoc"},{"key":"187_CR6","doi-asserted-by":"publisher","DOI":"10.4135\/9781412984287","volume-title":"Focus Groups as Qualitative Research","author":"D Morgan","year":"1997","unstructured":"Morgan D: Focus Groups as Qualitative Research. 1997, Thousand Oaks, CA: Sage Publications, 2","edition":"2"},{"key":"187_CR7","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1136\/bmj.311.7000.299","volume":"311","author":"J Kitzinger","year":"1995","unstructured":"Kitzinger J: Qualitative research: introducing focus groups. BMJ. 1995, 311: 299-302.","journal-title":"BMJ"},{"key":"187_CR8","volume-title":"L'Analyse de contenu","author":"L Bardin","year":"1977","unstructured":"Bardin L: L'Analyse de contenu. 1977, Paris: Presses Universitaires de France"},{"key":"187_CR9","unstructured":"Ministry of Planning: [Brasil. Minist\u00e9rio do Planejamento, Or\u00e7amento e Gest\u00e3o. Secretaria de Or\u00e7amento Federal]. [http:\/\/www.planejamento.gov.br]"},{"key":"187_CR10","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/1478-4491-1-10","volume":"1","author":"M Dieleman","year":"2003","unstructured":"Dieleman M, Cuong PV, Anh LV, Martineau T: Identifying factors for job motivation of rural health workers in North Viet Nam. Hum Resour Health. 2003, 1: 10-10.1186\/1478-4491-1-10.","journal-title":"Hum Resour Health"},{"key":"187_CR11","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1080\/09603120120110031","volume":"12","author":"DA Clayton","year":"2002","unstructured":"Clayton DA, Griffith CJ, Price P, Peters AC: Food handlers' beliefs and self-reported practices. 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