scholarly journals Direct observation of the nutrition care practices of Australian general practitioners

2014 ◽  
Vol 6 (2) ◽  
pp. 143 ◽  
Author(s):  
Lauren Ball ◽  
Ben Desbrow ◽  
Michael Yelland ◽  
Michael Leveritt

INTRODUCTION: Nutrition care refers to nutrition-related advice or counselling provided by health professionals in an attempt to improve the nutrition behaviour of patients. AIM: The aim of this study was to describe the practices of a sample of Australian general practitioners (GPs) when providing nutrition care to adult patients. METHODS: Eighteen GPs (13 male, 5 female) were observed by fourth-year medical students during their general practice rotation. Each GP was observed for five consultations that included nutrition care, totalling 90 observed consultations. In each consultation, students completed a 31-item nutrition care checklist of nutrition care practices that could feasibly occur in a standard consultation. Each practice was marked with either a ‘yes’ (completed), ‘no’ (did not complete) or ‘completed by practice nurse prior to or after the consultation’. RESULTS: Twenty-eight nutrition care practices were observed at least once. The most frequently observed practices were measuring and discussing blood pressure (76.7%; n=69), followed by general questions about current diet (74.4%; n=67). Approximately half of the consultations included a statement of a nutrition-related problem (52.2%; n=47), and the provision of nutrition advice that focused on a nutrient (45.6%; n=41) or food group (52.2%; n=47). Consultations with male GPs, as well as GPs with more than 25 years of experience, were associated with an increased number of nutrition care practices per consultation. DISCUSSION: The GPs performed nutrition care practices in varying frequencies. Further research is required to identify the most effective GP nutrition care practices to improve the nutrition behaviour of patients. KEYWORDS: Chronic disease; family practice; general practitioners, nutrition therapy

2015 ◽  
Vol 7 (3) ◽  
pp. 244 ◽  
Author(s):  
Jennifer Crowley ◽  
Lauren Ball ◽  
Dug Yeo Han ◽  
Anne-Thea McGill ◽  
Bruce Arroll ◽  
...  

INTRODUCTION: Improvements in individuals' nutrition behaviour can improve risk factors and outcomes associated with lifestyle-related chronic diseases. AIM: This study describes and compares New Zealand medical students, general practice registrars and general practitioners' (GPs') attitudes towards incorporating nutrition care into practice, and self-perceived skills in providing nutrition care. METHODS: A total of 183 New Zealand medical students, 51 general practice registrars and 57 GPs completed a 60-item questionnaire investigating attitudes towards incorporating nutrition care into practice and self-perceived skills in providing nutrition care. Items were scored using a 5-point Likert scale. Factor analysis was conducted to group questionnaire items and a generalised linear model compared differences between medical students, general practice registrars and GPs. RESULTS: All groups indicated that incorporating nutrition care into practice is important. GPs displayed more positive attitudes than students towards incorporating nutrition in routine care (p<0.0001) and performing nutrition recommendations (p<0.0001). General practice registrars were more positive than students towards performing nutrition recommendations (p=0.004), specified practices (p=0.037), and eliciting behaviour change (p=0.024). All groups displayed moderate confidence towards providing nutrition care. GPs were more confident than students in areas relating to wellness and disease (p<0.0001); macronutrients (p=0.030); micronutrients (p=0.010); and women, infants and children (p<0.0001). DISCUSSION: New Zealand medical students, general practice registrars and GPs have positive attitudes and moderate confidence towards incorporating nutrition care into practice. It is possible that GPs' experience providing nutrition care contributes to greater confidence. Strategies to facilitate medical students developing confidence in providing nutrition care are warranted. KEYWORDS: General practitioner; health knowledge, attitudes, practice; medical education; nutrition therapy


2013 ◽  
Vol 5 (1) ◽  
pp. 59 ◽  
Author(s):  
Lauren Ball ◽  
Cristina Johnson ◽  
Ben Desbrow ◽  
Michael Leveritt

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


Author(s):  
Mary Beth Arensberg ◽  
Beth Besecker ◽  
Laura Weldishofer ◽  
Susan Drawert

AbstractThe Oncology Care Model (OCM) is a US Centers for Medicare & Medicaid Services (CMS) specialty model implemented in 2016, to provide higher quality, more highly coordinated oncology care at the same or lower costs. Under the OCM, oncology clinics enter into payment arrangements that include financial and performance accountability for patients receiving chemotherapy treatment. In addition, OCM clinics commit to providing enhanced services to Medicare beneficiaries, including care coordination, navigation, and following national treatment guidelines. Nutrition is a component of best-practice cancer care, yet it may not be addressed by OCM providers even though up to 80% of patients with cancer develop malnutrition and poor nutrition has a profound impact on cancer treatment and survivorship. Only about half of US ambulatory oncology settings screen for malnutrition, registered dietitian nutritionists (RDNs) are not routinely employed by oncology clinics, and the medical nutrition therapy they provide is often not reimbursed. Thus, adequate nutrition care in US oncology clinics remains a gap area. Some oncology clinics are addressing this gap through implementation of nutrition-focused quality improvement programs (QIPs) but many are not. What is needed is a change of perspective. This paper outlines how and why quality nutrition care is integral to the OCM and can benefit patient health and provider outcomes.


Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3588
Author(s):  
Jessica R. L. Lieffers ◽  
Amanda Gonçalves Troyack Vanzan ◽  
Janine Rover de Mello ◽  
Allison Cammer

Background: Oral health conditions, such as dental caries, pose a substantial burden worldwide. Although there are many risk factors for poor oral health, diet is often implicated as a cause of these issues. The purpose of this scoping review was to identify and map studies that have captured information on the “real-world” nutrition care practices of oral health professionals (OHPs) and dietitians to optimize oral health, and specifically the dentition and periodontium. Methods: A search of peer-reviewed articles was conducted using MEDLINE, CINAHL, and Embase. Articles that addressed the review objective and met the following criteria were included: English language, published since 2000, and study conducted in a high-income country. Results: Overall, 70 articles were included. Most articles reported on cross-sectional survey studies and provided self-reported data on OHP practices; few articles reported on dietitians. Most articles reported only general/unspecific information on assessment and intervention practices, such as dietary analysis, nutrition counselling, and diet advice, and lacked specific information about the care provided, such as the dietary assessment tools used, type of information provided, and time spent on these activities. Barriers to the provision of nutrition care by OHPs were common and included time and lack of remuneration. Few studies reported on collaboration between dietitians and OHPs. Conclusions: Several studies have captured self-reported information on nutrition care practices of OHPs related to oral health; however, there is limited information available on the details of the care provided. Few studies have examined the practices of dietitians.


2012 ◽  
Vol 29 (6) ◽  
pp. 719-725 ◽  
Author(s):  
L. Ball ◽  
R. Hughes ◽  
B. Desbrow ◽  
M. Leveritt

Author(s):  
Eram Albajri ◽  
Manal Naseeb

The proposed case will discuss irritable bowel syndrome. Individualized medical nutrition therapy is critical in the disease management. In this case, the learner will be provided with details to conceptualize the case and will be able to conduct a comprehensive nutrition assessment to evaluate the nutritional status. After identifying and prioritizing nutrition problems, the learner will determine the nutrition diagnoses and write proper statements. Based on the collected data, the learner will develop a nutrition care plan with appropriate goals, interventions, and strategies for monitoring and evaluation. Unspecified-IBS encounter challenges with food as it triggers the symptoms. Thus, the learner will evaluate the nutrient composition of dietary history and provide a substitute considering individual tolerance and severity of the symptoms. In addition, FODMAP will be applied. It also teaches patients what foods or eating patterns would be best (or best to avoid) for their day-to-day activities through self-awareness of symptoms and dietary food log.


2012 ◽  
Vol 31 (6) ◽  
pp. 995-1001 ◽  
Author(s):  
Ekta Agarwal ◽  
Maree Ferguson ◽  
Merrilyn Banks ◽  
Marijka Batterham ◽  
Judith Bauer ◽  
...  

2016 ◽  
Vol 8 (4) ◽  
pp. 357 ◽  
Author(s):  
Jennifer Crowley ◽  
Lauren Ball ◽  
Anne-Thea McGill ◽  
Stephen Buetow ◽  
Bruce Arroll ◽  
...  

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.


Author(s):  
Joshua Pearcy ◽  
Ekta Agarwal ◽  
Elizabeth Isenring ◽  
Ananya Somani ◽  
Charlene Wright ◽  
...  

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