Proximal and Distal Influences on Dietary Change Among a Diverse Group with Prediabetes Participating in a Pragmatic, Primary Care Nurse-Led Intervention: a Qualitative Study

2021 ◽  
pp. 1-28
Author(s):  
Sally L. Abel ◽  
Lisa C. Whitehead ◽  
David C. Tipene-Leach ◽  
Kirsten J. Coppell
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Dietary Intervention ◽  
Ecological Model ◽  
Dietary Change ◽  
Dietary Interventions ◽  
Care Nurse ◽  
Socioeconomic Environment ◽  
Primary Care Nurse ◽  
Stratified Sample

Abstract Objective: To understand motivators, facilitators and challenges to dietary change amongst a diverse sample of New Zealanders with prediabetes participating in a primary care nurse-led individualised dietary intervention. Design: A qualitative study involving semi-structured, face-to-face interviews with a stratified sample of adults with prediabetes and body mass index ≥25kg/m2, purposefully selected from a larger 2-year primary care-based prediabetes dietary intervention study. Thematic analysis was undertaken. A socio-ecological model guided interpretation. Setting: Hawke’s Bay, Aotearoa/New Zealand, April 2018-March 2020. Participants: Fifty-eight people aged 28-69 years, with similar numbers of men and women, indigenous Māori and non-Māori, and those who had and had not regressed to normoglycaemia at 6-months. Results: Motivators for wanting to make dietary changes were determination not to progress to diabetes; wanting to be healthy and contribute to others; and encouragement by others. Facilitators for adopting and maintaining changes were a strong desire to be healthy; personal determination; and feeling supported. Challenges were compromised control over life and environmental factors; feeling unsupported by others; social occasions; financial constraints; and living with other health conditions. Developing their own strategies to overcome challenges was empowering, enabling a sense of control. These factors were similar across demographic and glycaemic outcome groups. Conclusions: Influences on dietary change involved personal, interpersonal, organisational, environmental, and policy factors. Although findings appeared similar across groups, dietary interventions need to address the specific ways motivators, facilitators and challenges manifest for individuals and social groups, and be tailored accordingly within the context of the wider obesogenic and socioeconomic environment.

scholarly journals What predicts regression from pre-diabetes to normal glucose regulation following a primary care nurse-delivered dietary intervention? A study protocol for a prospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033358 ◽  
Author(s):  
Kirsten Coppell ◽  
Trish Freer ◽  
Sally Abel ◽  
Lisa Whitehead ◽  
David Tipene-Leach ◽  
...  
Keyword(s):  
Primary Care ◽  
New Zealand ◽  
Dietary Intervention ◽  
Glycated Haemoglobin ◽  
Structured Interview ◽  
Post Intervention ◽  
Potential Cost ◽  
Care Nurse ◽  
Primary Care Nurse ◽  
Study Results

IntroductionPre-diabetes is a high-risk state for the development of type 2 diabetes mellitus (T2DM) and cardiovascular disease. Regression to normoglycaemia, even if transient, significantly reduces the risk of developing T2DM. The primary aim of this mixed-methods study is to determine if there are clinically relevant differences among those with pre-diabetes and excess weight who regress to normoglycaemia, those who have persistent pre-diabetes and those who progress to T2DM following participation in a 6-month primary care nurse-delivered pre-diabetes dietary intervention. Incidence of T2DM at 2 years will be examined.Methods and analysisFour hundred participants with pre-diabetes (New Zealand definition glycated haemoglobin 41–49 mmol/mol) and a body mass index >25 kg/m2 will be recruited through eight primary care practices in Hawke’s Bay, New Zealand. Trained primary care nurses will deliver a 6-month structured dietary intervention, followed by quarterly reviews for 18 months post-intervention. Clinical data, data on lifestyle factors and health-related quality of life (HR-QoL) and blood samples will be collected at baseline, 6 months, 12 months and 24 months. Sixty participants purposefully selected will complete a semi-structured interview following the 6-month intervention. Poisson regression with robust standard errors and clustered by practice will be used to identify predictors of regression or progression at 6 months, and risk factors for developing T2DM at 2 years. Qualitative data will be analysed thematically. Changes in HR-QoL will be described and potential cost savings will be estimated from a funder’s perspective at 2 years.Ethics and disseminationThis study was approved by the Northern A Health and Disability Ethics Committee, New Zealand (Ethics Reference: 17/NTA/24). Study results will be presented to participants, published in peer-reviewed journals and presented at relevant conferences.Trial registration numberACTRN12617000591358; Pre-results.

A Primary Care Nurse Clinic

1998 ◽  
Vol 29 (7) ◽  
pp. 50???51
Author(s):  
LAURA STOBER LARSEN ◽  
GLORIA A. CARNELL ◽  
RICHARD F. LARSEN
Keyword(s):  
Primary Care ◽  
Care Nurse ◽  
Primary Care Nurse

scholarly journals Open Mouth, Open Mind: Expanding the Role of Primary Care Nurse Practitioners

2016 ◽  
Vol 30 (5) ◽  
pp. 480-488 ◽  
Author(s):  
Carol A. Clark ◽  
Kathleen A. Kent ◽  
Richard D. Jackson
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Care Nurse ◽  
Open Mouth ◽  
Primary Care Nurse ◽  
Open Mind

scholarly journals Clinical practice guidelines and principles of care for people with dementia: a protocol for undertaking a Delphi technique to identify the recommendations relevant to primary care nurses in the delivery of person-centred dementia care

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044843
Author(s):  
Caroline Gibson ◽  
Dianne Goeman ◽  
Mark William Yates ◽  
Dimity Pond
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Dementia Care ◽  
Care Nurse ◽  
Primary Care Nurse ◽  
People With Dementia ◽  
Primary Care Nurses

IntroductionNationally and internationally it is well recognised that dementia is poorly recognised and suboptimally managed in the primary care setting. There are multiple and complex reasons for this gap in care, including a lack of knowledge, high care demands and inadequate time for the general practitioner alone to manage dementia with its multiple physical, psychological and social dimensions. The primary care nurse potentially has a role in assisting the general practitioner in the provision of evidence-based dementia care. Although dementia-care guidelines for general practitioners exist, evidence on resources to support the primary care nurse in dementia care provision is scarce. The ‘Australian Clinical Practice Guidelines and Principles of Care for People with Dementia’ provides 109 recommendations for the diagnosis and management of dementia. This protocol describes a Delphi study to identify which of the 109 recommendations contained in these multidisciplinary guidelines are relevant to the primary care nurse in the delivery of person-centred dementia care in the general practice setting.Methods and analysisUsing a Delphi consensus online survey, an expert panel will grade each of the recommendations written in the ‘Clinical Practice Guidelines and Principles of Care for People with Dementia’ as high-to-low relevance with respect to the role of the primary care nurse in general practice. To optimise reliability of results, quality indicators will be used in the data collection and reporting of the study. Invited panel members will include Australian primary care nurses working in general practice, primary care nursing researchers and representatives of the Australian Primary Health Care Nurses Association, the peak professional body for nurses working in primary healthcare.Ethics and disseminationThis study has been approved by The University of Newcastle Human Research Ethics Committee (HREC) (H-2019-0029).Findings will be published in a peer-reviewed journal and presented at scientific conferences.

Exploring the actual and potential role of the primary care nurse in the prevention of cancer: a mixed methods study

2013 ◽  
Vol 23 (3) ◽  
pp. 288-299 ◽  
Author(s):  
S. McIlfatrick ◽  
S. Keeney ◽  
H. McKenna ◽  
N. McCarley ◽  
G. McIlwee
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Potential Role ◽  
Mixed Methods Study ◽  
Care Nurse ◽  
Primary Care Nurse ◽  
Prevention Of Cancer
Sign in / Sign up

Export Citation Format

Share Document