Facilitators and barriers for promoting healthy eating among primary care patients: results of a qualitative study among practice nurses

2021 ◽  
Author(s):  
Geertruida J Groenendijk-van Woudenbergh ◽  
Marlies C van Hell-Cromwijk ◽  
Ytje J J van der Veen ◽  
Hylkje F Algra ◽  
Willemieke Kroeze
Keyword(s):  
Primary Care ◽  
Communication Skills ◽  
Healthy Eating ◽  
Patient Encounter ◽  
Structured Interviews ◽  
Good Communication ◽  
Practice Nurses ◽  
Professional Characteristics ◽  
Primary Care Patients ◽  
Facilitators And Barriers

Abstract Background Practice nurses have an important role in promoting healthy eating to prevent or delay long-term complications from chronic lifestyle-related diseases. Objective To identify the facilitators and barriers encountered by practice nurses at a professional level when promoting healthy eating among patients. Methods Face-to-face semi-structured interviews were conducted with 21 Dutch practice nurses. Data were recorded, transcribed and analysed using inductive thematic analysis. Results Two main themes were determined: professional characteristics and professional–patient encounter. Professional characteristics included good communication skills and experience facilitated the successful promotion of healthy eating, while a lack of communication skills and lack of knowledge about diet were perceived as barriers. The most frequently identified facilitators for professional–patient encounter included ensuring a personal connection with patients, creating food awareness, focussing on small changes, adopting a tailored approach, motivating and arranging extra consultations. Barriers included lack of skills to raise the topic, lack of persistence, inability to find a common understanding, lack of competence in handling patients’ own choices and underuse of existing educational materials. Conclusions Further research using the identified facilitators and barriers for promoting healthy eating in primary care patients with chronic diseases could assist in the development of future training programmes for practice nurses.

scholarly journals Correlates, Facilitators and Barriers of Healthy Eating Among Primary Care Patients with Prediabetes in Singapore—A Mixed Methods Approach

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1014 ◽  
Author(s):  
Raymond Boon Tar Lim ◽  
Wei Keong Wee ◽  
Wei Chek For ◽  
Jayalakshmy Aarthi Ananthanarayanan ◽  
Ying Hua Soh ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Healthy Eating ◽  
Healthy Food ◽  
Family Influence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Primary Care Patients ◽  
Eating Out ◽  
Facilitators And Barriers

Healthy diet remains the primary means to prevent chronic diseases among those with prediabetes. We conducted a mixed methods study, consisting of a cross-sectional survey and in-depth interviews to assess factors associated with fulfilling the healthy plate recommendation, and to explore reasons for the behaviour among primary care patients with prediabetes in Singapore. The prevalence of meeting the recommendation was 57.3%. This was positively associated with being married and negatively associated with being Malay, frequency of eating out weekly and frequency of deep-fried food consumption weekly. The recurrent themes for not meeting the recommendation included family influence, perception of healthy food being not tasty, lack of skills to prepare or choose healthy food, difficulty in finding healthier options when eating out, and healthy food being costly. The recurrent themes for meeting the recommendation included family influence, self-discipline, fear of disease complications, education by healthcare professionals, mass media influence and health promotion campaigns. Much more remains to be done to promote healthy eating among these patients. There were different levels of facilitators and barriers to healthy eating. Apart from the individual and interpersonal levels, practitioners and policy makers need to work together to address the organisational, community and policy barriers to healthy eating.

scholarly journals Process evaluation of a stepped-care program to prevent depression in primary care: patients’ and practice nurses’ experiences

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Alide D. Pols ◽  
Karen Schipper ◽  
Debbie Overkamp ◽  
Susan E. van Dijk ◽  
Judith E. Bosmans ◽  
...  
Keyword(s):  
Primary Care ◽  
Process Evaluation ◽  
Care Program ◽  
Stepped Care ◽  
Practice Nurses ◽  
Primary Care Patients

scholarly journals Nasal balloon autoinflation for glue ear in primary care: a qualitative interview study

2018 ◽  
Vol 69 (678) ◽  
pp. e24-e32
Author(s):  
Jane Vennik ◽  
Ian Williamson ◽  
Caroline Eyles ◽  
Hazel Everitt ◽  
Michael Moore
Keyword(s):  
Primary Care ◽  
Low Cost ◽  
Daily Routine ◽  
Structured Interviews ◽  
Early Management ◽  
Practice Nurses ◽  
Holistic Treatment ◽  
Qualitative Interview Study ◽  
Cost Treatment ◽  
Glue Ear

BackgroundNasal balloon autoinflation is an effective, non-surgical treatment for symptomatic children with glue ear, although uptake is variable and evidence about acceptability and feasibility is limited.AimTo explore parent and healthcare professional views and experiences of nasal balloon autoinflation for children with glue ear in primary care.Design and settingQualitative study using semi-structured interviews with a maximum-variety sample of parents, GPs, and practice nurses. The study took place between February 2013 and September 2014.MethodSemi-structured face-to-face and telephone interviews were audiorecorded, transcribed verbatim, and analysed using inductive thematic analysis.ResultsIn all, 14 parents, 31 GPs, and 19 nurses were included in the study. Parents described the nasal balloon as a natural, holistic treatment that was both acceptable and appealing to children. GPs and nurses perceived the method to be a low-cost, low-risk strategy, applicable to the primary care setting. Good instruction and demonstration ensured children mastered the technique and engaged with the treatment, but uncertainties were raised about training provision and potential impact on the GP consultation. Making nasal balloon autoinflation part of a child’s daily routine enhances compliance, but difficulties can arise if children are unwell or refuse to cooperate.ConclusionNasal balloon autoinflation is an acceptable, low-cost treatment option for children with glue ear in primary care. Provision of educational materials and demonstration of the method are likely to promote uptake and compliance. Wider use of the nasal balloon has the potential to enhance early management, and may help to fill the management gap arising from forthcoming changes to care pathways.

scholarly journals Correlates, facilitators and barriers of physical activity among primary care patients with prediabetes in Singapore – a mixed methods approach

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Raymond Boon Tar Lim ◽  
Wei Keong Wee ◽  
Wei Chek For ◽  
Jayalakshmy Aarthi Ananthanarayanan ◽  
Ying Hua Soh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Mixed Methods ◽  
Peer Influence ◽  
Vigorous Physical Activity ◽  
Family Members ◽  
Well Being ◽  
Primary Care Patients ◽  
Facilitators And Barriers ◽  
Barriers To Physical Activity

Abstract Background Primary care patients with prediabetes is a priority group in the clinical, organisational and policy contexts. Engaging in regular physical activity is crucial to prevent diabetes for this group. The objectives of the study were to assess factors associated with meeting the recommendation of at least 150 min of moderate/vigorous physical activity weekly, and to explore facilitators and barriers related to the behaviour among primary care patients with prediabetes in Singapore. Methods This was a mixed methods study, consisting of a cross-sectional survey involving 433 participants from 8 polyclinics, and in-depth interviews with 48 of them. Adjusted prevalence ratios (aPR) were obtained by mixed effects Poisson regression model. The socio-ecological model (SEM) was applied, and thematic analysis performed. Results The prevalence of meeting the recommendation was 65.8%. This was positively associated with being male (aPR 1.21, 95%CI 1.09–1.34), living in 4–5 room public housing (aPR 1.19, 95%CI 1.07–1.31), living in executive flat/private housing (aPR 1.26, 95%CI 1.06–1.50), having family members/friends to exercise with (aPR 1.57, 95%CI 1.38–1.78); and negatively associated with a personal history of osteoarthritis (aPR 0.75, 95%CI 0.59–0.96), as well as time spent sitting or reclining daily (aPR 0.96, 95%CI 0.94–0.98). The recurrent themes for not meeting the recommendation included lacking companionship from family members/friends, medical conditions hindering physical activity (particularly osteoarthritis), lacking knowledge/skills to exercise properly, “no time” to exercise and barriers pertaining to exercise facilities in the neighbourhood. The recurrent themes for meeting the recommendation included family/peer influence, health/well-being concerns and education by healthcare professionals. Conclusions Much more remains to be done to promote physical activity among primary care patients with prediabetes in Singapore. Participants reported facilitators and barriers to physical activity at different levels of the SEM. Apart from the individual and interpersonal levels, practitioners and policy makers need to work together to address the organisational, community and policy barriers to physical activity.

Patient preferences for treatment for angina: An overview of findings from three studies

2008 ◽  
Vol 13 (3_suppl) ◽  
pp. 104-108 ◽  
Author(s):  
Ann Bowling ◽  
Barnaby Reeves ◽  
Gene Rowe
Keyword(s):  
Primary Care ◽  
Older People ◽  
Artery Bypass ◽  
Age Groups ◽  
Treatment Preferences ◽  
Structured Interviews ◽  
Negative Attitudes ◽  
Coronary Syndrome ◽  
Positive Attitudes ◽  
Primary Care Patients

Background: Access to cardiac treatments has been documented to vary with patients’ age. It is unknown whether these variations reflect patients’ treatment preferences. We aimed to investigate patients’ preferences for cardiology treatments and develop a Patients’ Preferences Questionnaire. Methods: Semi-structured interviews with primary care patients with diagnosed angina with postal follow-up. The resulting Patients’ Preferences Questionnaire was tested with newly admitted inpatients with acute coronary syndrome and with patients in primary care. Results: The Patients’ Preferences Questionnaire was psychometrically sound. Analyses of preference subscale scores showed that the most positive preference scores were for medication. Angioplasty scored highest at the negative end of the scale. Detailed analyses showed that older people and women were less likely to prefer coronary artery bypass surgery (CABG), reflecting its greater level of invasiveness. Older people (aged over 75 years, compared to people aged under 75 years), but not women, were also more cautious in their strength of preference for angioplasty. More positive attitudes towards CABG surgery, and more negative attitudes towards medication, were associated with greater impact of the condition on life. Conclusions: The research resulted in a psychometrically sound Patients’ Preferences Questionnaire. There was some evidence to support the view that older people's weaker preferences for CABG may contribute slightly to variations in the provision of re-vascularization. There was also variation in preferences within age groups, cautioning against the assumption that all or most older people are more reluctant than younger people to undergo invasive procedures.

Patient’s experience with comorbidity management in primary care: a qualitative study of comorbid pain and obesity

2015 ◽  
Vol 17 (01) ◽  
pp. 33-41 ◽  
Author(s):  
E. Amy Janke ◽  
Michelle L. Ramirez ◽  
Brittany Haltzman ◽  
Megan Fritz ◽  
Andrea T. Kozak
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Comparative Method ◽  
Holistic Approach ◽  
Structured Interviews ◽  
Primary Care Settings ◽  
Lack Of Information ◽  
Motivation Enhancement ◽  
Primary Care Patients ◽  
Clinical Interactions

AimThe aim of this research is to examine perceptions of those with comorbid chronic pain and obesity regarding their experience of comorbidity management in primary care settings.BackgroundChronic pain and obesity are common comorbidities frequently managed in primary care settings. Evidence suggests individuals with this comorbidity may be at risk for suboptimal clinical interactions; however, treatment experiences and preferences of those with comorbid chronic pain and obesity have received little attention.MethodsSemi-structured interviews conducted with 30 primary care patients with mean body mass index=36.8 and comorbid persistent pain. The constant comparative method was used to analyze data.FindingsParticipants discussed frustration with a perceived lack of information tailored to their needs and a desire for a personalized treatment experience. Participants found available medical approaches unsatisfying and sought a more holistic approach to management. Discussions also focused around the need for providers to initiate efforts at education and motivation enhancement and to show concern for and understanding of the unique difficulties associated with comorbidity. Findings suggest providers should engage in integrated communication regarding weight and pain, targeting this multimorbidity using methods aligned with priorities discussed by patients.

scholarly journals Exploring the barriers and facilitators of psychological safety in primary care teams: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ridhaa Remtulla ◽  
Arwa Hagana ◽  
Nour Houbby ◽  
Kajal Ruparell ◽  
Nivaran Aojula ◽  
...  
Keyword(s):  
Primary Care ◽  
Interpersonal Relationships ◽  
Psychological Safety ◽  
Multidisciplinary Teams ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Authoritarian Leadership ◽  
Shared Beliefs ◽  
Primary Care Teams ◽  
Facilitators And Barriers

Abstract Background Psychological safety is the concept by which individuals feel comfortable expressing themselves in a work environment, without fear of embarrassment or criticism from others. Psychological safety in healthcare is associated with improved patient safety outcomes, enhanced physician engagement and fostering a creative learning environment. Therefore, it is important to establish the key levers which can act as facilitators or barriers to establishing psychological safety. Existing literature on psychological safety in healthcare teams has focused on secondary care, primarily from an individual profession perspective. In light of the increased focus on multidisciplinary work in primary care and the need for team-based studies, given that psychological safety is a team-based construct, this study sought to investigate the facilitators and barriers to psychological safety in primary care multidisciplinary teams. Methods A mono-method qualitative research design was chosen for this study. Healthcare professionals from four primary care teams (n = 20) were recruited using snowball sampling. Data collection was through semi-structured interviews. Thematic analysis was used to generate findings. Results Three meta themes surfaced: shared beliefs, facilitators and barriers to psychological safety. The shared beliefs offered insights into the teams’ background functioning, providing important context to the facilitators and barriers of psychological safety specific to each team. Four barriers to psychological safety were identified: hierarchy, perceived lack of knowledge, personality and authoritarian leadership. Eight facilitators surfaced: leader and leader inclusiveness, open culture, vocal personality, support in silos, boundary spanner, chairing meetings, strong interpersonal relationships and small groups. Conclusion This study emphasises that factors influencing psychological safety can be individualistic, team-based or organisational. Although previous literature has largely focused on the role of leaders in promoting psychological safety, safe environments can be created by all team members. Members can facilitate psychological safety in instances where positive leadership behaviours are lacking - for example, strengthening interpersonal relationships, finding support in silos or rotating the chairperson in team meetings. It is anticipated that these findings will encourage practices to reflect on their team dynamics and adopt strategies to ensure every member’s voice is heard.

scholarly journals Family Practice Nursing in Newfoundland and Labrador: Are Reported Roles Reflective of Professional Competencies for Registered Nurses in Primary Care?

2021 ◽  
Vol 7 ◽  
pp. 237796082110534
Author(s):  
Maria Mathews ◽  
Dana Ryan ◽  
Richard Buote ◽  
Sandra Parsons ◽  
Julia Lukewich
Keyword(s):  
Primary Care ◽  
Registered Nurses ◽  
Family Practice ◽  
Newfoundland And Labrador ◽  
Secondary Analysis ◽  
Family Physicians ◽  
Scope Of Practice ◽  
Professional Competencies ◽  
Structured Interviews ◽  
Practice Nurses

Background Family practice nurses are Registered Nurses who work collaboratively in primary care and deliver a range of services. Professional competency statements have been developed to describe the skills and knowledge of family practice nurses as a distinct field. Purpose We conducted a secondary analysis of qualitative interview data to examine how family practice nurse roles/activities relate to recently developed professional competencies. Methods Family physicians and family practice nurses in Newfoundland and Labrador (NL) participated in semi-structured interviews, during which they discussed roles/activities and scope of practice surrounding family practice nursing. For this secondary analysis, we used competency statements to inform thematic coding of the transcribed interviews. Results For the initial study, a total of 8 participants (5 family practice nurses; 3 family physicians) were interviewed from diverse practices. All transcripts from the original study (n = 8) were included in the secondary analysis and analysed across 47 competencies encompassing 6 domains (Professionalism; Clinical Practice; Communication; Collaboration and Partnership; Quality Assurance, Evaluation and Research; Leadership). Roles/activities reported by participants were reflective of the competencies, but with substantial variation in expression. Conclusions Family practice nursing competency statements reflect the actual activities of family practice nurses in NL. The professional competencies can serve as a framework to examine contributions of family practice nurses and identify areas warranting further training. The use of competencies to explore family practice nurses’ roles and activities can assist with optimizing scope of practice.

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