scholarly journals General practitioners’ views on providing nutrition care to patients with chronic disease: a focus group study

2016 ◽  
Vol 8 (4) ◽  
pp. 357 ◽  
Author(s):  
Jennifer Crowley ◽  
Lauren Ball ◽  
Anne-Thea McGill ◽  
Stephen Buetow ◽  
Bruce Arroll ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Focus Groups ◽  
General Practitioners ◽  
Nutrition Knowledge ◽  
Focus Group Study ◽  
Knowledge And Skills ◽  
Practice Nurses ◽  
Nutrition Care ◽  
Descriptive Approach ◽  
Consultation Time

ABSTRACT INTRODUCTION Nutrition care refers to practices conducted by health professionals to support patients to improve their dietary intake. General practitioners (GPs) are expected to provide nutrition care to patients for prevention and management of chronic disease. AIM This study explores GPs’ opinions regarding nutrition care provision to patients with chronic disease. METHODS An interpretive descriptive approach to qualitative research using seven semi-structured focus groups with 48 GPs in Auckland was used. Focus groups investigated how GPs felt about providing nutrition care; the perceived barriers to and support required for this care; the development of further nutrition knowledge and skills; and possible roles for Practice Nurses. Recorded interviews were transcribed verbatim and analysed using a thematic approach. RESULTS GPs indicated routine provision of basic nutrition care to patients with chronic disease, but perceived their limited consultation time and nutrition competence constrained their capacity to provide nutrition care. GPs felt they needed further information to provide culturally, socially and economically sensitive nutrition care. GPs displayed variable opinions on the benefits of developing their nutrition knowledge and skills, and the idea of Practice Nurses providing nutrition care. CONCLUSIONS Despite perceiving that nutrition care is important for patients with chronic disease and facing barriers to providing nutrition care, GPs appear reluctant to further develop their knowledge and skills and for Practice Nurses to provide this care. Strategies to enhance GPs’ nutrition-related self-efficacy, nutrition cultural competence and attitudes towards further training care may be warranted.

scholarly journals Nutrition competence of primary care physicians in Saudi Arabia: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033443 ◽  
Author(s):  
Osamah Al-gassimi ◽  
Hassan Bin Usman Shah ◽  
Rawan Sendi ◽  
Heba A Ezmeirlly ◽  
Lauren Ball ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Nutrition Knowledge ◽  
Sectional Study ◽  
Cross Sectional ◽  
Knowledge And Skills ◽  
Nutrition Care ◽  
Dietary Behaviours

ObjectivesPrimary care physicians have an opportunity to support healthy dietary behaviours of patients by providing nutrition care. However, it is unclear whether primary care physicians in the Kingdom of Saudi Arabia (KSA) are sufficiently competent in nutrition. This study aimed to assess the nutrition competence of primary care physicians in KSA and identify whether nutrition competence is associated with the provision of nutrition care to patients living with diet-related chronic disease.DesignA cross-sectional study.SettingChronic disease clinics across 48 primary care centres under the Ministry of Health in the city of Jeddah, KSA.Participants90 primary care physicians completed the survey (response rate: 98%). General practitioners and family medicine residents, specialists, and consultants actively working in chronic disease clinics between February and May 2019 were included.Primary and secondary outcome measuresPrimary outcome measure was nutrition competence of primary care physicians measured via the validated nutrition competence (NUTCOMP) questionnaire.ResultsPrimary care physicians perceived themselves as competent in nutrition care but their reported provision of nutrition care was limited. Confidence in their nutrition knowledge and skills elicited the lowest mean scores of 25.8 (±5.4) out of 35 and 29 (±5.2) out of 40, respectively. The reported provision of nutrition care was closely correlated with physicians’ confidence in their nutrition knowledge (r=0.57) and communication (r=0.52). Three factors were identified as predicting whether physicians provide nutrition care to patients: confidence in counselling about nutrition (p<0.001), having previous nutrition education (p=0.005) and a higher professional qualification (p=0.008).ConclusionsPrimary care physicians felt confident in providing nutrition care to patients living with diet-related chronic disease. Primary care physicians would benefit from higher levels of nutrition knowledge and skills to effectively support patients to improve their dietary behaviours and health conditions, leading to a positive impact on public health.

Experiences of general practitioners, practice nurses, psychologists and patients with stepped collaborative care for depression: a focus group study in a large primary healthcare organization

2014 ◽  
Vol 2 (2) ◽  
pp. 170 ◽  
Author(s):  
Luc Gidding ◽  
Mark Spigt ◽  
Emmaline Brouwer ◽  
Jessica De Snoo ◽  
Katinka Mijnheer ◽  
...  
Keyword(s):  
Primary Care ◽  
Focus Group ◽  
General Practitioners ◽  
Primary Healthcare ◽  
Collaborative Care ◽  
Diagnostic Tools ◽  
Initial Symptom ◽  
Focus Group Study ◽  
Diagnostic Uncertainty ◽  
Practice Nurses

Rationale, aims and objectives: Depression is a major and complex problem in primary care. Stepped Collaborative Care (SCC) models for depression have been developed to support primary care in diagnostic and therapeutic procedures. This study aimed to compare barriers and facilitators experienced by general practitioners (GPs), practice nurses for psychosocial care, primary care psychologists and patients working with SCC for depression and to discuss possible solutions for barriers in daily practice.Method: Conventional content analysis of focus group data. Nine mono-disciplinary focus groups including 16 general practitioners (GPs), 4 practice nurses, 6 psychologists and 23 patients.Results: All 4 participant groups appeared to perceive a need for more skills, support and time for GPs to adequately assess symptoms and initiate psychosocial management accordingly. Psychologists often ignore a GP’s diagnosis. The GPs’ diagnostic uncertainty and their unfamiliarity with psychological therapies can result in inappropriate treatments, incorrect referrals and long waiting lists. To improve stepped collaborative care programs for psychosocial symptoms, improving initial symptom assessment by the GP, seems the most important aspect. All participants agreed that diagnostic tools/questionnaires should be used in primary care, but such activities should not be complicated and should not add to the GPs’ workload. Patients need more information to share decisions with their care providers.Conclusion: There is a need for a diagnostic-therapeutic tool to support GPs in regulating the influx of patients in SCC models and enhancing the effect of SCC in daily practice in order to improve the person-centeredness and efficiency of primary healthcare.

scholarly journals Australian practice nurses’ perceptions of their role and competency to provide nutrition care to patients living with chronic disease

2014 ◽  
Vol 20 (2) ◽  
pp. 203 ◽  
Author(s):  
Sarah Cass ◽  
Lauren Ball ◽  
Michael Leveritt
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Nutrition Education ◽  
Care Setting ◽  
Primary Care Setting ◽  
Practice Nurses ◽  
Nutrition Care ◽  
Nurses Perceptions ◽  
Basic Level

Nutrition is important in the management of chronic disease, and practice nurses in the Australian primary care setting are increasingly providing nutrition care to patients living with chronic disease. The aim of the present study was to investigate practice nurses’ perceptions of their role and competency to provide nutrition care to patients living with chronic disease in Australia. Twenty practice nurses currently employed in general practice participated in an individual semi-structured telephone interview. Interviews were transcribed verbatim and thematically analysed. Practice nurses perceived themselves to be in a prime position to provide opportunistic nutrition care to patients. Participants perceived that the ideal role of a practice nurse is to advocate for nutrition and provide a basic level of nutrition care to patients; however, the interpretation of the term ‘basic’ varied between participants. Participants perceived that practice nurses are highly trusted and approachable, which they valued as important characteristics for the provision of nutrition care. Barriers to providing nutrition care included time constraints, lack of nutrition knowledge and lack of confidence. Participants were concerned about the availability and accessibility of nutrition education opportunities for practice nurses. The present study has demonstrated that practice nurses perceive themselves as having a significant role in the provision of nutrition care to patients with chronic disease in the Australian primary care setting. Further investigation of strategies to enhance the effectiveness of nutrition care provision by practice nurses is warranted.

scholarly journals Strengths and weaknesses in the diagnostic process of endometriosis from the patients’ perspective: a focus group study

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Moniek van der Zanden ◽  
Laura de Kok ◽  
Willianne L. D. M. Nelen ◽  
Didi D. M. Braat ◽  
Annemiek W. Nap
Keyword(s):  
Focus Groups ◽  
General Practitioners ◽  
Health Care Providers ◽  
Medical Staff ◽  
Public Awareness ◽  
Diagnostic Delay ◽  
Diagnostic Process ◽  
Care Providers ◽  
Knowledge And Skills ◽  
Patients Perspective

Abstract Objectives Endometriosis is characterized by a long interval between onset of symptoms and diagnosis. Detailed information about the patients’ perspective on the diagnostic delay of endometriosis is scarce. The aim of this study was to identify strengths and weaknesses in the diagnostic process of endometriosis from the patients’ perspective. Methods Qualitative study with semi-structured focus groups. Participants were women between 18 and 45 years old with a recently confirmed diagnosis. The focus groups were audio recorded and fully transcribed. Grounded theory methodology was applied for data analysis. Results Six focus groups were organized, in which 23 women participated. Mean time from start of symptoms to diagnosis was 8.5 years. Dominant themes were knowledge about normal menstruation and endometriosis, being believed and acknowledged by medical staff, and collaboration between health care providers including fast referral to a gynaecologist. Barriers to a timely referral and diagnosis were young age, normalization of symptoms and a lack of awareness in general practitioners. Facilitating factors included adequate knowledge and skills of the general practitioner, a desire for pregnancy and persisting in a request for specialist consultation by the patient. Conclusions The diagnostic process of endometriosis is hampered by delayed consultation, inadequate appraisal of symptoms by general practitioners and the interaction between patients and medical professionals. Efforts should be made to increase public awareness and to provide medical staff with sufficient knowledge and skills to adequately acknowledge presented symptoms.

scholarly journals General practitioners can offer effective nutrition care to patients with lifestyle-related chronic disease

2013 ◽  
Vol 5 (1) ◽  
pp. 59 ◽  
Author(s):  
Lauren Ball ◽  
Cristina Johnson ◽  
Ben Desbrow ◽  
Michael Leveritt
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
General Practice ◽  
Chronic Disease ◽  
General Practitioners ◽  
Vegetable Intake ◽  
Cochrane Library ◽  
Nutrition Care ◽  
Randomised Controlled ◽  
Nutrition Behaviour

INTRODUCTION: Nutrition is a key priority for the management of lifestyle-related chronic disease, and the demand on general practitioners (GPs) to provide nutrition care is increasing. AIM: The aim of this systematic review was to investigate the effectiveness of nutrition care provided by GPs in improving the nutrition-related behaviour and subsequent health outcomes of individuals with lifestyle-related chronic disease. METHODS: A systematic literature review was conducted using the Cochrane Library, MEDLINE and ISI Web of Knowledge databases. Randomised controlled trials that investigated a nutrition care intervention feasible within general practice consultations, and that utilised outcome measures relevant to nutritionrelated behaviour or indicators of health, were included in the review. RESULTS: Of the 131 articles screened for inclusion, nine studies, totalling 9564 participants, were included in the review. Five interventions observed improvements in the nutrition behaviour of participants, such as a reduction of energy consumption, reduction of meat consumption, increase in fruit and vegetable intake, increase in fish intake and increase in fibre intake. Seven interventions observed improvements in risk factors, including in weight, serum lipid levels and blood pressure. Some inconsistencies in findings were observed in the reviewed studies. DISCUSSION: This systematic review demonstrates that GPs have the potential to provide nutrition care that improves the nutrition behaviour and risk factors in individuals with lifestyle-related chronic disease. However, the consistency and clinical significance of the intervention outcomes are unclear. Further investigation regarding the development of nutrition care protocols and the attributes of nutrition care that result in improved outcomes are required. KEYWORDS: Chronic disease; general practice; general practitioners; nutritional management

Nutrition beyond drugs and devices: a review of the approaches to enhance the capacity of nutrition care provision by general practitioners

2012 ◽  
Vol 18 (2) ◽  
pp. 90 ◽  
Author(s):  
Jennifer Crowley ◽  
Lauren Ball ◽  
Clare Wall ◽  
Michael Leveritt
Keyword(s):  
Medical Education ◽  
Chronic Disease ◽  
Nutrition Education ◽  
Continuing Medical Education ◽  
Best Practice ◽  
Care Delivery ◽  
Nutrition Knowledge ◽  
Practice Setting ◽  
Care Provision ◽  
Nutrition Care

The prevention and management of chronic disease is a key priority for primary care services. Nutrition-related care is an integral feature of several best practice guidelines for management of chronic disease in the general practice setting. This paper critically reviews the international literature to enhance the nutrition knowledge, skills and overall capacity of GPs to provide nutrition care using examples from nutrition in medical education, continuing medical education, GP-centred and practice-setting approaches. The medical nutrition education approach provides an opportunity for linear translation between desired nutrition competencies and curriculum learning objectives, while that of continuing medical education allows for tailored nutrition education to increase nutrition competencies once a learning need is identified. The GP-centred approach focuses on the determinants of nutrition care provision by GPs as strategies for enhancing nutrition care delivery, whereas the practice setting approach aims to increase the nutrition-related exposure to patients through avenues independent of the GP. In the Australian and New Zealand context, the potential appropriateness of these approaches requires judicious consideration, as it is unlikely that one approach will comprehensively address this topic. Ongoing multifaceted evaluation of each approach is needed to ensure enhancement of GPs’ capacity to provide nutrition care by increasing nutrition knowledge and skills, and improving patient health outcomes.

scholarly journals Current nut recommendation practices differ between health professionals in New Zealand

2017 ◽  
Vol 21 (6) ◽  
pp. 1065-1074 ◽  
Author(s):  
Rachel C Brown ◽  
Andrew R Gray ◽  
Lee Ching Yong ◽  
Alex Chisholm ◽  
Sook Ling Leong ◽  
...  
Keyword(s):  
New Zealand ◽  
Chronic Disease ◽  
General Practitioners ◽  
Health Professionals ◽  
Disease Risk ◽  
Population Level ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Practice Nurses ◽  
Study Participants

AbstractObjectiveDespite evidence linking regular nut consumption with reduced chronic disease risk, population-level intakes remain low. Research suggests nut-promoting advice from doctors facilitates regular nut consumption. However, there is no information on current nut recommendation practices of health professionals. The aim of the present study was to examine the advice provided by health professionals regarding nut consumption.DesignIn this cross-sectional study, participants were invited to complete a survey including questions about their nut recommendation practices.SettingNew Zealand (NZ).SubjectsThe NZ Electoral Roll was used to identify dietitians, general practitioners and practice nurses.ResultsIn total 318 dietitians, 292 general practitioners and 149 practice nurses responded. Dietitians were more likely (82·7 %) to recommend patients increase consumption of nuts than general practitioners (55·5 %) and practice nurses (63·1 %; both P<0·001). The most popular nuts recommended were almonds, Brazil nuts and walnuts, with most health professionals recommending raw nuts. The most common recommendation for frequency of consumption by dietitians and practice nurses was to eat nuts every day, while general practitioners most frequently recommended 2–4 times weekly, although not statistically significantly different between professions. Dietitians recommended a significantly greater amount of nuts (median 30 g/d) than both general practitioners and practice nurses (20 g/d; both P<0·001).ConclusionsDietitians were most likely to recommend consumption of nuts in accordance with current guidelines, but there are opportunities to improve the adoption of nut consumption recommendations for all professions. This may be a viable strategy for increasing population-level nut intakes to reduce chronic disease.

scholarly journals Australian and New Zealand Medical Students’ Attitudes and Confidence towards Providing Nutrition Care in Practice

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 598 ◽  
Author(s):  
Breanna Lepre ◽  
Jennifer Crowley ◽  
Dineo Mpe ◽  
Harsh Bhoopatkar ◽  
Kylie J. Mansfield ◽  
...  
Keyword(s):  
New Zealand ◽  
Medical Students ◽  
Focus Groups ◽  
Nutrition Education ◽  
Undergraduate Students ◽  
Nutrition Knowledge ◽  
Medical Practitioners ◽  
Nutrition Care ◽  
Students Attitudes

The prevalence of lifestyle-related chronic disease is increasing. Doctors in primary care are ideally placed to support patient nutrition care, but recent reviews show education is still lacking. This study aimed to identify medical students’ attitudes towards the role of nutrition in health, nutrition knowledge, and perceptions of nutrition education, in postgraduate (Australia) and undergraduate (New Zealand) programs in order to identify gaps in nutrition knowledge and skills to better inform future education. Second-year graduate and third-year undergraduate students participated in semi-structured focus groups and interviews. A general inductive approach was used to investigate students’ (1) attitudes toward the role of nutrition in health, (2) nutrition knowledge based on nutrition-specific competencies and (3) perceived adequacy of nutrition education received. Interviews (nine) and focus groups (seven) identified four common themes: (1) role of medical practitioners in nutrition care, (2) barriers to nutrition education, (3) nutrition knowledge, and (4) nutrition-related skills. Students perceive that doctors are well-placed to provide some level of nutrition care, but poor translation of nutrition knowledge to clinical contexts is a key limitation in nutrition education. In summary, nutrition education may be insufficient to support the nutrition-related competency development of the undergraduate and postgraduate student participants in this study. Focusing on the integration of these skills into the curriculum may be a priority.

scholarly journals How often should general practitioners provide nutrition care to patients? A forecasting activity to determine the target frequency for chronic-disease management in Australia

2016 ◽  
Vol 22 (5) ◽  
pp. 383 ◽  
Author(s):  
Lauren Ball ◽  
Patricia Lee ◽  
Gina L Ambrosini ◽  
Kyra Hamilton ◽  
Haitham Tuffaha
Keyword(s):  
Chronic Disease ◽  
General Practitioners ◽  
Health Professionals ◽  
Chronic Disease Management ◽  
Support Staff ◽  
Policy Makers ◽  
Nutrition Care ◽  
Dietary Behaviours ◽  
Disease Outcomes ◽  
Primary Health

Supporting patients to have healthy dietary behaviours contributes significantly to preventing and managing lifestyle-related chronic diseases. ‘Nutrition care’ refers to any practice provided by a health professional to support a patient to improve their dietary behaviours and subsequent health outcomes. Approximately 3% of consultations by Australian general practitioners (GPs) involve the provision of nutrition care. The aim of the present paper was to forecast the potential implications of a higher frequency of nutrition care by GPs. Evidence on the effect of improved dietary behaviours on chronic disease outcomes, number of Australian adults estimated to have poor dietary behaviours and effectiveness of GPs providing nutrition care were taken into consideration. Using hypertension as a case example, for GPs to provide nutrition care to all hypertensive adults who would benefit from improved dietary behaviours, GPs would need to provide nutrition care in a target rate of 4.85% of consultations or 4.5 million different patients each year. The target aligns with the existing priorities for supporting chronic-disease prevention and management in Australia by increasing the rate that brief lifestyle interventions are provided by primary health professionals. This conservative target presents a considerable challenge for GPs, support staff, researchers and policy makers, but can be used to inform future interventions to support nutrition care by GPs.

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