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Knight A, Palermo C, Reedy G, Whelan K. Teaching and assessment of communication skills in dietetics: a scoping review. J Hum Nutr Diet 2024; 37:524-537. [PMID: 38206592 DOI: 10.1111/jhn.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Communication is a core element of dietetic practice, and although communication skills are a prominent feature of dietetic curricula, research suggests a need for more consistent approaches. The evidence on how communication skills are taught and assessed in dietetics has not been synthesised leaving uncertainty about best practice. This scoping review aimed to examine and map the research literature relating to the teaching and assessment of communication skills in dietetics. METHODS The review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. Five electronic databases, two theses databases and eight conference proceedings were systematically searched for research on how communication skills are taught and assessed in dietetics. The search had no geographical or time limits. Studies were independently screened by two authors, summarised thematically using the Kirkpatrick Model and narratively synthesised. RESULTS The 45 included studies were organised thematically into three categories: (i) the inclusion of communication skills education in dietetics, suggesting that dietitians have variable experiences; (ii) approaches to teaching communication skills in dietetics, characterised predominantly by a move away from didactic approaches in favour of experiential opportunities for learning such as simulation; and (iii) assessment of communication skills in dietetics, including the use of both dietetic-specific and generic tools. CONCLUSIONS The included studies demonstrate that although a variety of teaching strategies are used in the development of communication skills in dietetics, there is potential for more robust evaluation and more diverse approaches to support dietetic educators to prepare the dietetic workforce.
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Affiliation(s)
- Annemarie Knight
- Department of Nutritional Sciences, King's College London, London, UK
| | - Claire Palermo
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Gabriel Reedy
- Centre for Education, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Kevin Whelan
- Department of Nutritional Sciences, King's College London, London, UK
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2
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Knight A, Palermo C, Reedy G, Whelan K. Communication Skills: A Scoping Review of Experiences, Perceptions, and Use in Dietetics Practice. J Acad Nutr Diet 2023:S2212-2672(23)01762-8. [PMID: 38142740 DOI: 10.1016/j.jand.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Communication skills are a cornerstone of practice for dietitians. The field of dietetics is evolving and there is a need to synthesize the available literature on communication skills to improve the effectiveness of patient consultations and inform practitioner development. OBJECTIVE This scoping review aimed to identify the research literature relating to communication skills used in dietetics practice and perceptions and experiences of dietetics students, dietitians, and patients regarding communication skills. METHODS This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews and best practice guidance. Five databases (Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Center, and PsycInfo), two theses databases, and conference proceedings for 8 dietetics and health professions education associations were systematically searched for research on dietitians' communication skills. This included skills used in dietitian-patient communication, in communication interactions in different employment contexts, and diverse forms of communication (verbal, written, technological) and the views of dietetics students, dietitians, and patients, regarding communication skills. The search had no geographical or time limits. Studies were independently screened by two authors. RESULTS The 70 included studies spanned 45 years and were organized into four thematic categories: importance of communication skills in dietetics practice, development of communication skills, communication skills for dietitian-patient communication, and communication skills for wider dietetics practice. Sixty-five (92.9%) of the studies specifically explored the communication skills used for dietitian-patient consultations, including rapport building, questioning, listening, paraphrasing, and clarifying, whereas skills such as intercultural communication were less researched. CONCLUSIONS There is consensus between patients and dietitians regarding the skills that contribute to effective dietitian-patient communication. Areas less explored in the literature include the skills needed for intercultural communication and those needed for science communication. Greater understanding of the communication skills needed for contemporary nutrition and dietetics practice will guide education strategies for the development of dietitians.
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Affiliation(s)
- Annemarie Knight
- Department of Nutritional Sciences, King's College London, London, United Kingdom.
| | - Claire Palermo
- Monash University Clayton Campus, Clayton, Victoria, Australia
| | - Gabriel Reedy
- Centre for Education, King's College London, London, United Kingdom
| | - Kevin Whelan
- Department of Nutritional Sciences, King's College London, London, United Kingdom
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3
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Olufson HT, Ottrey E, Young AM, Green TL. An ethnographic study exploring person-centred nutrition care in rehabilitation units. Disabil Rehabil 2023:1-9. [PMID: 37776895 DOI: 10.1080/09638288.2023.2254230] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 08/25/2023] [Indexed: 10/02/2023]
Abstract
PURPOSE Person-centred care (PCC) is an essential component of high-quality healthcare across professions and care settings. While research is emerging in subacute nutrition services more broadly, there is limited literature exploring the person-centredness of nutrition care in rehabilitation. This study aimed to explore person-centred nutrition care (PCNC) in rehabilitation units, as described and actioned by patients, support persons and staff. Key factors influencing PCNC were also explored. MATERIALS AND METHODS An ethnographic study was undertaken across three rehabilitation units. Fifty-eight hours of field work were completed with 165 unique participants to explore PCNC. Field work consisted of observations and interviews with patients, support persons and staff. Data were analysed through the approach of reflexive thematic analysis, informed by PCC theory. RESULTS Themes generated were: (1) tensions between patient and staff goals; (2) disconnected moments of PCNC; (3) the necessity of interprofessional communication for PCNC; and (4) the opportunity for PCNC to enable the achievement of rehabilitation goals. CONCLUSIONS PCNC was deemed important to different stakeholders but was at times hindered by a focus on profession-specific objectives. Opportunities exist to enhance interprofessional practice to support PCNC in rehabilitation. Future research should consider the system-level factors influencing PCNC in rehabilitation settings.
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Affiliation(s)
- Hannah T Olufson
- School of Nursing, Midwifery & Social Work, Faculty of Health & Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia
- Dietetics & Food Services, Surgical, Treatment & Rehabilitation Service (STARS), Metro North Health, Herston, QLD, Australia
- STARS Education & Research Alliance, STARS, University of Queensland & Metro North Health, Herston, QLD, Australia
| | - Ella Ottrey
- Monash Centre for Scholarship in Health Education, Monash University, Clayton, VIC, Australia
| | - Adrienne M Young
- Dietetics & Food Services, Royal Brisbane & Women's Hospital, Metro North Health, Herston, QLD, Australia
- Centre for Health Services Research, University of Queensland, Brisbane, QLD, Australia
| | - Theresa L Green
- School of Nursing, Midwifery & Social Work, Faculty of Health & Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia
- STARS Education & Research Alliance, STARS, University of Queensland & Metro North Health, Herston, QLD, Australia
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Harvey A, Chu G, Lordly D, Arsenault JF, Conlan S, Laidlaw T, Wadsworth LA, Grant S. Evaluation of a Media Training Workshop for Nutrition Students and Trainees in Nova Scotia. CAN J DIET PRACT RES 2023; 84:112-118. [PMID: 36862844 DOI: 10.3148/cjdpr-2022-036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Gaps in communication training have been identified in Canadian and international academic and practicum dietetics programs. A workshop was developed to pilot supplementary media training to nutrition students/trainees studying in Nova Scotia. Students, interns, and faculty from two universities participated in the workshop. Data on perceived learning, media knowledge/skill use, and workshop feedback were collected immediately post-workshop using a mixed-form questionnaire. A modified questionnaire was administered eight months post-workshop to obtain information on utility of the perceived acquired knowledge/skills. Closed-ended responses underwent descriptive analysis, while open-ended responses underwent thematic analysis. Twenty-eight participants completed the questionnaire post-workshop, and six completed it at follow-up. All participants rated the workshop positively (7-point Likert scale) and reported learning something new (perceived). Perceived learning emphasized general media knowledge/skills and communication skills. Follow-up data suggested participants had applied perceived media knowledge/skills in message development and media and job interviews. These data suggest that nutrition students/trainees may benefit from supplementary communications and media training and provide a stimulus for ongoing curriculum review and discussion.
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Affiliation(s)
- Antonia Harvey
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
- Food and Nutrition Services, Nova Scotia Health, Halifax, NS
| | - Gillian Chu
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Daphne Lordly
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
- Fellow of Dietitians of Canada, Halifax, NS
| | | | - Sue Conlan
- School of Nutrition and Dietetics, Acadia University, Wolfville, NS
| | - Tess Laidlaw
- Department of Communication Studies, Mount Saint Vincent University, Halifax, NS
| | - Laurie A Wadsworth
- Department of Human Nutrition, St. Francis Xavier University, Antigonish, NS
- Fellow of Dietitians of Canada, Antigonish, NS
| | - Shannan Grant
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
- Departments of Pediatrics and Obstetrics and Gynaecology, Dalhousie University, Halifax, NS
- Departments of Pediatrics and Obstetrics and Gynaecology, IWK Health Centre, Halifax, NS
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Nagy A, McMahon A, Tapsell L, Deane F. The therapeutic relationship between a client and dietitian: A systematic integrative review of empirical literature. Nutr Diet 2022; 79:303-348. [PMID: 35324041 PMCID: PMC9543415 DOI: 10.1111/1747-0080.12723] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/11/2021] [Accepted: 01/01/2022] [Indexed: 01/03/2023]
Abstract
Aim Scientific evidence underpins dietetics practice; however, evidence of how the therapeutic relationship influences outcomes is limited. This integrative review aims to provide a comprehensive overview of the topic of the therapeutic relationship between clients and dietitians in the individual counselling context by summarising empirical literature into qualitative themes. Methods An electronic literature search of the Cumulative Index of Nursing and Allied Health Literature, PsychInfo, Scopus and Web of Science databases was conducted in October 2018 and repeated in February 2021. Studies were included if they explicitly referred to the therapeutic relationship (or associated terms), were based on study data and available in full text. Extracted data were checked by a second researcher and the methodological quality was evaluated independently by two researchers using the Mixed Methods Appraisal Tool. An iterative process of qualitatively coding, categorising and comparing data to examine recurring themes was applied. Results Seventy‐six studies met the inclusion criteria. Five themes were identified which showed the extent and nature of research in this area. Studies revealed the therapeutic relationship: (i) is valued within clinical dietetic practice, (ii) involves complex and multifactorial interactions, (iii) is perceived as having a positive influence, (iv) requires skills training and (v) is embedded in practice models and tools. Conclusion Studies show the therapeutic relationship is a valued and multifactorial component of clinical dietetic practice and is perceived to positively influence the client and dietitian. Observational data are needed to assess the extent to which the strength of the therapeutic relationship might contribute to clients' health outcomes.
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Affiliation(s)
- Annaliese Nagy
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Anne McMahon
- School of Health & Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Linda Tapsell
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Frank Deane
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
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Barnett A, Kelly JT, Wright C, Campbell KL. Technology-supported models of nutrition care: Perspectives of health service providers. Digit Health 2022; 8:20552076221104670. [PMID: 35677784 PMCID: PMC9168874 DOI: 10.1177/20552076221104670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/14/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To determine the perspectives to the adoption, scale-up, sustainability, and
spread of technology-supported models of nutrition care, in hospital and
ambulatory care settings. Methods Thirty-one health service providers participated in individual
semi-structured interviews from a tertiary health service in Queensland,
Australia. The Non-adoption, Abandonment, and challenges to the Scale up,
Spread and Sustainability (NASSS) framework, designed to evaluate
technology-supported models’ success, informed the qualitative design. Results Key findings were that technology-supported models of care could benefit many
chronic condition patient groups; dietitians are well suited to adopting
this technology: and the value proposition in creating efficiency gains in
the health service. However, challenges of transitioning and sustainability
were identified. Perceived enablers for technology supported models of care
included: previous intentions for technology supported models of care prior
to the 2019 novel coronavirus pandemic; opportunity for clinicians to
complete higher valued tasks; and integration of technology systems and
assisted staff roles. Perceived barriers included: suitability for patients
is dependent on experience and ability to use technology, varied confidence
by clinicians when conducting clinical assessments; high investment required
for set up and ongoing maintenance; and patients desire for adopting
face-to-face care over technology. Health service providers perceived that
embedding and adapting such models requires maintenance of high-quality
service and continued research. Conclusions Health service providers recognize adopting, scaling, and sustaining
technology-supported models of nutrition care benefits patients, clinicians,
and health services in general. Robust clinical trials and health service
evaluations of technology-supported models of care, across practice settings
are now needed.
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Affiliation(s)
- Amandine Barnett
- Centre for Online Health, The University of Queensland, Brisbane, QLD, Australia.,Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Jaimon T Kelly
- Centre for Online Health, The University of Queensland, Brisbane, QLD, Australia.,Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Charlene Wright
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Centre for Applied Health Economics, Griffith University, Brisbane, QLD, Australia
| | - Katrina L Campbell
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Healthcare Excellence and Innovation, Metro North Hospital and Health Service, Brisbane, QLD, Australia
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Whitehead K, Parkin T. UK Dietitians' views on communication skills for behaviour change: A 10 year follow-up survey. J Hum Nutr Diet 2021; 35:112-123. [PMID: 33829553 DOI: 10.1111/jhn.12903] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 03/29/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND In 2007, a survey of UK dietitians identified that dietitians were positive about the use of Communication Skills for Behaviour Change (CSBC) in practice, although barriers to the implementation of skills were acknowledged. This follow-up survey aimed to explore current perceptions of CSBC and compare them with the previous survey. METHODS A cross-sectional online survey of British Dietetic Association (BDA) members' views of CSBC was undertaken. The results for full members are presented. Quantitative data were analysed descriptively. Qualitative data were subject to either content, or inductive thematic analysis. RESULTS A response rate of 9.4% (n = 729) was achieved. Respondents were predominately female (n = 684; 95.1%) and worked in the National Health Service (n = 634; 87.4%). They were positive about the importance of CSBC in practice (n = 714; 99.5%). Pre-registration training had been completed by 346 respondents (48.7%). Post-registration training had been undertaken by 520 (74.7%) respondents and 514 of these (99.6%) had implemented training into practice, with few barriers identified. Perception of ability to use skills had increased, with 513 (83.6%) respondents rating their skills as excellent/very good compared to 62% previously. The majority (n = 594; 93.7%) reported that post-registration training was necessary, with the need for skills to be regularly reviewed (n = 456; 74.5%), and 235 (51.9%) respondents suggested this be mandatory. By contrast, some suggested that a skill review was not a priority, and would be difficult to administer and stressful. CONCLUSIONS Perception of the importance of CSBC remains high. Although the perceived ability to apply CSBC has increased, the perceived need for post-registration training is high, with respondents' favouring mandatory training.
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Affiliation(s)
- Kirsten Whitehead
- Division of Food, Nutrition and Dietetics, University of Nottingham, Loughborough, UK
| | - Tracey Parkin
- School of Health Professions, University of Plymouth, Plymouth, UK
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Are We Neglecting Nutrition in UK Medical Training? A Quantitative Analysis of Nutrition-Related Education in Postgraduate Medical Training Curriculums. Nutrients 2021; 13:nu13030957. [PMID: 33809505 PMCID: PMC8000414 DOI: 10.3390/nu13030957] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 03/10/2021] [Indexed: 12/28/2022] Open
Abstract
Suboptimal nutrition is a major cause of morbidity and mortality in the United Kingdom (UK). Although patients cite physicians as trusted information sources on diet and weight loss, studies suggest that the management of nutrition-related disorders is hindered by insufficient medical education and training. Objectives of this study were to: (1) Quantify nutrition-related learning objectives (NLOs) in UK postgraduate medical training curriculums and assess variation across specialties; (2) assess inclusion of nutrition-related modules; (3) assess the extent to which NLOs are knowledge-, skill-, or behaviour-based, and in which Good Medical Practice (GMP) Domain(s) they fall. 43 current postgraduate curriculums, approved by the General Medical Council (GMC) and representing a spectrum of patient-facing training pathways in the UK, were included. NLOs were identified using four keywords: 'nutrition', 'diet', 'obesity', and 'lifestyle'. Where a keyword was used in a titled section followed by a number of objectives, this was designated as a 'module'. Where possible, NLOs were coded with the information to address objective 3. A median of 15 NLOs (mean 24) were identified per curriculum. Eleven specialties (25.6%) had five or less NLOs identified, including General Practice. Surgical curriculums had a higher number of NLOs compared with medical (median 30 and 8.5, respectively), as well as a higher inclusion rate of nutrition-related modules (100% of curriculums versus 34.4%, respectively). 52.9% of NLOs were knowledge-based, 34.9% skill-based, and 12.2% behaviour-based. The most common GMP Domain assigned to NLOs was Domain 1: Knowledge, Skills and Performance (53.0%), followed by Domain 2: Safety and Quality (20.6%), 3: Communication, Partnership and Teamwork (18.7%), and 4: Maintaining Trust (7.7%). This study demonstrates considerable variability in the number of nutrition-related learning objectives in UK postgraduate medical training. As insufficient nutrition education and training may underlie inadequate doctor-patient discussions, the results of this analysis suggest a need for further evaluation of nutrition-related competencies in postgraduate training.
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Notaras S, Smythe K, Mak M, Whitehead K. Implementation of a peer review program using the validated DIET‐COMMS tool to assess dietitians' communication skills in the workplace. Nutr Diet 2020; 78:324-332. [DOI: 10.1111/1747-0080.12635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/16/2020] [Accepted: 07/19/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Stephanie Notaras
- Department of Dietetics Liverpool Hospital Liverpool New South Wales Australia
- School of Medicine Western Sydney University Campbelltown New South Wales Australia
- Dietetics Department South Western Sydney Local Health District Sydney New South Wales Australia
| | - Kylie Smythe
- Department of Dietetics Liverpool Hospital Liverpool New South Wales Australia
- Dietetics Department South Western Sydney Local Health District Sydney New South Wales Australia
| | - May Mak
- Department of Dietetics Liverpool Hospital Liverpool New South Wales Australia
- Dietetics Department South Western Sydney Local Health District Sydney New South Wales Australia
| | - Kirsten Whitehead
- Division of Nutritional Sciences University of Nottingham Nottingham UK
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Beck AK, Baker AL, Carter G, Wratten C, Bauer J, Wolfenden L, McCarter K, Britton B. Assessing Adherence, Competence and Differentiation in a Stepped-Wedge Randomised Clinical Trial of a Complex Behaviour Change Intervention. Nutrients 2020; 12:E2332. [PMID: 32759848 PMCID: PMC7469004 DOI: 10.3390/nu12082332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/24/2020] [Accepted: 08/01/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND A key challenge in behavioural medicine is developing interventions that can be delivered adequately (i.e., with fidelity) within real-world consultations. Accordingly, clinical trials should (but tend not to) report what is actually delivered (adherence), how well (competence) and the distinction between intervention and comparator conditions (differentiation). PURPOSE To address this important clinical and research priority, we apply best practice guidelines to evaluate fidelity within a real-world, stepped-wedge evaluation of "EAT: Eating As Treatment", a new dietitian delivered health behaviour change intervention designed to reduce malnutrition in head and neck cancer (HNC) patients undergoing radiotherapy. METHODS Dietitians (n = 18) from five Australian hospitals delivered a period of routine care and following a randomly determined order each site received training and began delivering the EAT Intervention. A 20% random stratified sample of audio-recorded consultations (control n = 196; intervention n = 194) was coded by trained, independent, raters using a study specific checklist and the Behaviour Change Counselling Inventory. Intervention adherence and competence were examined relative to apriori benchmarks. Differentiation was examined by comparing control and intervention sessions (adherence, competence, non-specific factors, and dose), via multiple linear regression, logistic regression, or mixed-models. RESULTS Achievement of adherence benchmarks varied. The majority of sessions attained competence. Post-training consultations were clearly distinct from routine care regarding motivational and behavioural, but not generic, skills. CONCLUSIONS Although what level of fidelity is "good enough" remains an important research question, findings support the real-world feasibility of integrating EAT into dietetic consultations with HNC patients and provide a foundation for interpreting treatment effects.
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Affiliation(s)
- Alison Kate Beck
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Gregory Carter
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Chris Wratten
- Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Waratah, NSW 2298, Australia
| | - Judith Bauer
- Centre for Dietetics Research, The University of Queensland, St Lucia, QLD 4072, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Kristen McCarter
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Ben Britton
- Hunter New England Health, New Lambton 2305, Australia
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11
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Lambert K, Lau TK, Davison S, Mitchell H, Harman A, Carrie M. Does a renal diet question prompt sheet increase the patient centeredness of renal dietitian outpatient consultations? PATIENT EDUCATION AND COUNSELING 2020; 103:1645-1649. [PMID: 32199691 DOI: 10.1016/j.pec.2020.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 02/29/2020] [Accepted: 03/03/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Effective communication is fundamental to helping patients change behaviour. Few studies have operationalised how to quantify and improve the patient centeredness of communication during the dietitian outpatient consultation. We sought to evaluate the impact of a renal diet question prompt sheet (QPS) on patient centeredness (PC) in dietitian outpatient clinics and describe the impact of a renal diet QPS on the volume and pattern of communication between dietitians (n = 4) and patients/carers (n = 24, n = 11). METHODS The Roter Interaction Analysis System was used to compute a PC index, the volume communication (number of questions and utterances) and categorise dietitian communication. RESULTS The QPS was associated with significant improvements in the PC of communication (p = 0.004 and p = 0.001), without increasing the volume of communication. The QPS was also associated with an increase in the total number of questions asked (p < 0.0001) especially from patients (p = 0.0009); and an increase in the volume of communication devoted to education and counselling (p < 0.0001). CONCLUSIONS This study describes a promising intervention to increase the patient centeredness of dietetic consultations in an outpatient setting. PRACTICE IMPLICATIONS Whilst simple in design, the use of a QPS had a large effect on how patients and carers interact with the dietitian in the outpatient setting.
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Affiliation(s)
- Kelly Lambert
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, 2522, Australia.
| | - Tsz Kwan Lau
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, 2522, Australia.
| | - Sarah Davison
- Department of Clinical Nutrition, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, 2500, Australia.
| | - Holly Mitchell
- Department of Clinical Nutrition, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, 2500, Australia.
| | - Alex Harman
- Department of Clinical Nutrition, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, 2500, Australia.
| | - Mandy Carrie
- Department of Clinical Nutrition, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, 2500, Australia.
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12
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Knight A, Baldwin C, Reidlinger DP, Whelan K. Communication skills teaching for student dietitians using experiential learning and simulated patients. J Hum Nutr Diet 2020; 33:601-613. [DOI: 10.1111/jhn.12743] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 11/29/2022]
Affiliation(s)
- A. Knight
- Department of Nutritional Sciences King’s College London London UK
| | - C. Baldwin
- Department of Nutritional Sciences King’s College London London UK
| | - D. P. Reidlinger
- Department of Nutritional Sciences King’s College London London UK
- Department of Nutrition and Dietetics Faculty of Health Sciences and Medicine Bond University Robina QLD Australia
| | - K. Whelan
- Department of Nutritional Sciences King’s College London London UK
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13
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Levey R, Ball L, Chaboyer W, Sladdin I. Dietitians' perspectives of the barriers and enablers to delivering patient-centred care. J Hum Nutr Diet 2019; 33:106-114. [PMID: 31218766 DOI: 10.1111/jhn.12684] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patient-centred care (PCC) is widely recognised as being important with respect to the delivery of quality health care. However, limited research has explored PCC in the dietetic context. In particular, dietitians' views of the barriers and enablers to delivering a patient-centred approach have not been investigated. Therefore, the present study aimed to explore primary care dietitians' perspectives of the barriers and enablers to delivering PCC. METHODS The present study was situated in a constructivist-interpretivist paradigm and used qualitative methods. Both convenience and snowball sampling were used to recruit Australian Accredited Practising Dietitians (APD) who were working in primary care. Individual semi-structured interviews explored dietitians' perspectives of the barriers and enablers to delivering PCC. Data were analysed thematically. RESULTS Twelve APDs were interviewed between March and April 2018. Seven themes were discovered: (i) challenges in defining PCC; (ii) valuing PCC; (iii) enacting PCC; (iv) requiring additional education in PCC; (v) evaluating one's own practice; (vi) workplace pressures and constraints; and (vii) keeping up with expectations. CONCLUSIONS These findings suggest that: (i) the meaning of PCC in dietetics should be clarified to ensure it is being practiced consistently; (ii) undergraduate curricula require a greater emphasis on PCC so that dietitians graduate with the necessary knowledge and skills; (iii) there is a need for more professional development training to facilitate uptake of PCC in practice; and (iv) quantitative measurement of PCC using validated instruments is needed to evaluate PCC in the dietetic setting. Addressing some of these factors may assist dietitians to adopt these practices.
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Affiliation(s)
- R Levey
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
| | - L Ball
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - W Chaboyer
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,School of Nursing and Midwifery, Griffith University, Gold Coast, QLD, Australia
| | - I Sladdin
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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14
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Notaras S, Conti J. A qualitative analysis of eating behaviour change for patients with diabetes and non-dialysis dependent chronic kidney disease stages 4-5. J Ren Care 2018; 44:219-228. [PMID: 30353696 DOI: 10.1111/jorc.12258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dietary changes recommended for chronic kidney disease (CKD) stages 4-5 and concurrent diabetes are difficult to follow given the multitude of food and fluid restrictions aimed at reducing the rate of CKD progression. Reduced adherence is commonplace and there is limited literature on patients' experiences with dietary changes and potential strategies to overcome this. OBJECTIVES Examine patients' experiences when adopting dietary changes recommended for CKD Stages 4-5 (pre-dialysis) and diabetes, and their perceptions of dietetic services and how they can be improved to assist them with dietary change. METHODS An exploratory qualitative study was undertaken using a purposive sampling method from a dietetic pre-dialysis clinic. Participants were interviewed using a semi-structured interview style. Data were analysed using an inductive thematic analysis from a constructivist perspective. RESULTS Three themes were identified: (1) Negative motivation to change eating behaviour to avoid dialysis; (2) sustaining motivation for change is challenging due to a sense of loss and confusion to incorporate the dietary changes recommended and (3) support is needed for eating behaviour change. CONCLUSION These findings have implications for dietitians to enhance their understanding of the patient experience and improve their skills in motivational counselling. Development of dietitian-specific communication and nutrition counselling programmes are recommended to equip dietitians with skills to better support patients. CKD Stage 3 nutrition education programmes could be beneficial to promote earlier access to dietetic services and dietary recommendations.
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Affiliation(s)
- Stephanie Notaras
- Department of Dietetics, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Janet Conti
- Western Sydney University, School of Social Sciences and Psychology, New South Wales, Australia
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15
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Lambert K, Mansfield K, Mullan J. Qualitative exploration of the experiences of renal dietitians and how they help patients with end stage kidney disease to understand the renal diet. Nutr Diet 2018; 76:126-134. [PMID: 29968271 DOI: 10.1111/1747-0080.12443] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/17/2018] [Accepted: 05/21/2018] [Indexed: 10/28/2022]
Abstract
AIM Dietary modification is integral to the management of end stage kidney disease. However, adherence to the renal diet is poor. Few studies have explored the perspectives of renal dietitians and how they work with patients to facilitate dietary change. The objectives of this study were to explore the experiences of renal dietitians about educating patients with end stage kidney disease; and to describe the strategies perceived to help patients understand the renal diet. METHODS Semi-structured interviews based on Sensemaking theory were conducted with renal dietitians (n = 27) working in Australia and New Zealand from a range of metropolitan, regional and remote areas. RESULTS Five major themes across two categories were derived from the data. The renal dietitians in this study experienced feelings of frustration, frequently worked in practice environments with limited or inadequate resources and perceived that establishing trust and demonstrating empathy were important to sense making. Renal dietitians helped patients make sense of and understand the diet by clarifying ambiguities and conflicting information; and simplifying complexity by using simple explanations, individualised advice and practical support. These strategies were considered critical to the renal diet sense making process. CONCLUSIONS The experience of providing renal diet advice to adults with end stage kidney disease was emotionally and professionally challenging. Alternative approaches to patient education may help dietitians to empower patients to better understand the renal diet. Further research exploring the experiences of learning about the renal diet from the patient and carer perspective would also help to inform future alternative approaches.
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Affiliation(s)
- Kelly Lambert
- Department of Clinical Nutrition, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, New South Wales, Australia
| | - Kylie Mansfield
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Judy Mullan
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.,Centre for Health Research Illawarra Shoalhaven Population (CHRISP), Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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16
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Notaras S, Mak M, Wilson N. Advancing practice in dietitians’ communication and nutrition counselling skills: a workplace education program. J Hum Nutr Diet 2018; 31:725-733. [DOI: 10.1111/jhn.12569] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- S. Notaras
- Department of Dietetics; Liverpool Hospital; Liverpool NSW Australia
| | - M. Mak
- Department of Dietetics; Liverpool Hospital; Liverpool NSW Australia
| | - N. Wilson
- Department of Dietetics; Liverpool Hospital; Liverpool NSW Australia
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17
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Hazzard E, Barone L, Mason M, Lambert K, McMahon A. Patient-centred dietetic care from the perspectives of older malnourished patients. J Hum Nutr Diet 2017; 30:574-587. [PMID: 28543671 DOI: 10.1111/jhn.12478] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Governing organisations for health services currently recommend a patient-centred (PC) approach to practice for all health professions, including dietetics. For the vulnerable older malnourished patient, this approach needs to be prioritised to improve outcomes. The paucity of patient experience data likely limits evidence-based, patient-centred care (PCC) from being implemented effectively. The present study aimed to identify quality indicators of dietetic services from the perspectives of older malnourished patients to inform evidence-based PC dietetic care. METHODS Surveys were completed by a sample of 28 females and 28 males (mean age 81 years) who had been seen by a dietitian for malnutrition assessment. In-depth, face-to-face, semi-structured interviews were undertaken with a sub-sample of four females and six males (mean age 81 years). Interviews were transcribed verbatim. Thematic analysis of transcripts and open-ended survey responses was conducted to determine patient-identified quality indicators. RESULTS Three structure indicators (continuity of care through regular contact and post-discharge dietetic follow-up; interdisciplinary coordination and collaboration; and high-quality hospital food services), five process indicators (addressing a patient's primary medical concern; involving the patient's family; providing clear and simple dietetic information; providing expert dietary knowledge; utilising interpersonal communication skills) and three outcome indicators (improvement in health status; improvement or maintenance of independence; weight gain) were identified. The experiences of older malnourished patients with dietetic services, as described in the present study, reinforce the importance of ensuring high-quality and tailored dietetic care as a key element of PC dietetic services. CONCLUSIONS The quality indicators of dietetic services identified in the present study may facilitate dietitians to provide evidence-based PCC for older malnourished patients.
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Affiliation(s)
- E Hazzard
- Nutrition and Dietetics, School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - L Barone
- Port Kembla Hospital, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia
| | - M Mason
- Port Kembla Hospital, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia
| | - K Lambert
- Nutrition and Dietetics, School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - A McMahon
- Nutrition and Dietetics, School of Medicine, University of Wollongong, Wollongong, NSW, Australia
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18
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Sladdin I, Ball L, Bull C, Chaboyer W. Patient-centred care to improve dietetic practice: an integrative review. J Hum Nutr Diet 2017; 30:453-470. [PMID: 28124489 DOI: 10.1111/jhn.12444] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Patient-centred care (PCC) is associated with significant improvements in patients' health outcomes and healthcare systems. There is an opportunity to better understand PCC in dietetics. Thus, the present integrative review aims to critically synthesise literature relating to PCC in dietetics. METHODS A systematic literature search was conducted between February and March 2016. Studies were included if they (i) involved dietitians and/or patients who had participated in an individual dietetic consultation; (ii) related to one or more components of PCC; and (iii) were empirical full-text studies in English, involving adult participants, published between 1997 and 2016. Following title and abstract screening, full texts were retrieved and independently assessed for inclusion by two of the investigators. Two independent investigators conducted data extraction and quality assessment using the Mixed Methods Appraisal Tool. Study findings were analysed thematically using meta-synthesis. Twenty-seven studies met the inclusion criteria. RESULTS Six themes were discovered inductively: (i) establishing a positive dietitian-patient relationship; (ii) displaying humanistic behaviours; (iii) using effective communication skills; (iv) individualising and adapting care; (v) redistributing power to the patient; and (vi) lacking time for PCC practices. The first three themes were closely related. Studies used a broad range of methodological designs. Limitations of the studies included a lack of reflexivity and a lack of representativeness of the study population. CONCLUSIONS It is apparent that dietitians require good communication skills and humanistic qualities to build positive relationships with patients. Patients strongly desire individualised nutrition care and greater involvement in care. Ensuring dietitians are able to incorporate patient-centred practises during care requires further research.
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Affiliation(s)
- I Sladdin
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
| | - L Ball
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
| | - C Bull
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
| | - W Chaboyer
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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McDermott MP, Tischler VA, Cobb MA, Robbé IJ, Dean RS. Veterinarian-Client Communication Skills: Current State, Relevance, and Opportunities for Improvement. JOURNAL OF VETERINARY MEDICAL EDUCATION 2015; 42:305-314. [PMID: 26315212 DOI: 10.3138/jvme.0115-006r] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Communication is increasingly recognized as a core skill for veterinary practitioners, and in recent years, attention to communication competency and skills training has increased. To gain an up-to-date assessment of the current state of veterinary communication skills and training, we conducted a survey among veterinary practitioners in the United Kingdom and United States in 2012/2013. The questionnaire was used to assess the current state, relevance, and adequacy of veterinary communication skills among veterinary practitioners, to assess interest in further training, and to understand perceived challenges in communicating with clients. There was an overall response rate of 29.6% (1,774 of 6,000 recipients), with a higher response rate for UK-based practitioners (39.7%) than practitioners in the US (19.5%). Ninety-eight percent of respondents agreed that communication skills were as important as or more important than clinical knowledge. Forty-one percent of respondents had received formal veterinary communication skills training during veterinary school, and 47% had received training post-graduation. Thirty-five percent said their veterinary communication skills training during veterinary school prepared them well or very well for communicating with clients about the health of their pets, compared to 61% of those receiving post-graduate training. Forty percent said they would be interested in further veterinary communication skills training, with the preferred methods being simulated consultations and online training. While there has been increased emphasis on communication skills training during and after veterinary school, there is a need for more relevant and accessible training.
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Abstract
The need to support people to change diet-related behaviour is widely advocated and how to do this effectively in practice is an expanding area of research. Important factors to consider are how healthcare practitioners communicate with their patients and how that communication may affect diet-related behaviour change and subsequent outcomes. The aim of the present paper is to discuss communication skills for behaviour change (CSBC), focusing predominantly on registered dietitians who are required to communicate effectively and have an important role in supporting patients to change diet-related behaviour. The views of dietitians in relation to CSBC have been investigated and respondents have consistently reported that they perceive these skills to be of vital importance in practice. Patient views have reiterated the importance of good CSBC in one-to-one consultations. However, pre-qualification training of dietitians is thought to deliver practitioners who are competent at a minimum level. The need for ongoing continuous professional development (CPD) in relation to CSBC has been recognised but currently most CPD focuses on updating knowledge rather than improving these essential skills. Measuring CSBC in a consistent and objective manner is difficult and an assessment tool, DIET-COMMS, has been developed and validated for this purpose. DIET-COMMS can be used to support CSBC development, but concerns about logistical challenges and acceptability of implementing this in practice have been raised. Although a suitable assessment tool now exists there is a need to develop ways to facilitate assessment of CSBC in practice.
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21
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McMahon AT, Tay PC, Tapsell L, Williams P. Building bridges in dietary counselling: an exploratory study examining the usefulness of wellness and wellbeing concepts. J Hum Nutr Diet 2014; 29:75-85. [DOI: 10.1111/jhn.12282] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A.-T. McMahon
- Smart Foods Centre; School of Medicine; University of Wollongong; Wollongong NSW Australia
| | - P. C. Tay
- Smart Foods Centre; School of Medicine; University of Wollongong; Wollongong NSW Australia
| | - L. Tapsell
- Smart Foods Centre; School of Medicine; University of Wollongong; Wollongong NSW Australia
| | - P. Williams
- Smart Foods Centre; School of Medicine; University of Wollongong; Wollongong NSW Australia
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22
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Raaff C, Glazebrook C, Wharrad H. Dietitians' perceptions of communicating with preadolescent, overweight children in the consultation setting: the potential for e-resources. J Hum Nutr Diet 2014; 28:300-12. [PMID: 24898403 DOI: 10.1111/jhn.12247] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND There are calls to enhance existing child weight management interventions and to develop new treatment approaches. The potential for interactive electronic resources (e-resources) to support child-dietitian communication has yet to be explored. Towards developing such a tool, the present study aimed to understand dietetic attitudes and approaches to communicating with preadolescent overweight children in individual consultations to support behaviour change. METHODS A purposive sample of 18 dietitians, providing weight management advice to overweight 7-11-year-old children, took part in the study. Individual semi-structured telephone interviews were conducted. Data were transcribed and then analysed using inductive thematic analysis. Content analysis was used to interpret dietetic attitude towards e-resources. RESULTS Six overarching themes were identified describing dietitians' views: the complexity of treating childhood obesity, the strategic balance of dietetic communication focus between child and parent, the child's capacity to communicate affecting their contribution, dietetic approaches to verbal child communication and the features of resources that can support them, as well as dietetic expectations for resources. Independent inter-rater agreement for the themes was 76.9% and 73.1%, respectively. The majority of dietitians (n = 13) supported the concept of introducing an interactive multimedia e-resource into child weight management consultations. CONCLUSIONS Most dietitians sought to engage the preadolescent child in the consultation, using dietetic visual aids to complement verbal strategies and to serve as scaffolding for the conversation. There is scope for interactive e-resources to enhance communication, provided that they are flexibly tailored to meet the needs of the dietitian and the overweight child.
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Affiliation(s)
- C Raaff
- Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - C Glazebrook
- Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - H Wharrad
- Division of Nursing, School of Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK
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23
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Whitehead KA, Langley-Evans SC, Tischler VA, Swift JA. Assessing communication skills in dietetic consultations: the development of the reliable and valid DIET-COMMS tool. J Hum Nutr Diet 2013; 27 Suppl 2:321-32. [DOI: 10.1111/jhn.12136] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- K. A. Whitehead
- School of Biosciences; Division of Nutritional Sciences; Loughborough UK
| | | | - V. A. Tischler
- Institute of Mental Health; University of Nottingham; Nottingham UK
| | - J. A. Swift
- School of Biosciences; Division of Nutritional Sciences; Loughborough UK
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24
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Tinati T, Lawrence W, Ntani G, Black C, Cradock S, Jarman M, Pease A, Begum R, Inskip H, Cooper C, Baird J, Barker M. Implementation of new Healthy Conversation Skills to support lifestyle changes - what helps and what hinders? Experiences of Sure Start Children's Centre staff. HEALTH & SOCIAL CARE IN THE COMMUNITY 2012; 20:430-437. [PMID: 22452549 PMCID: PMC3679516 DOI: 10.1111/j.1365-2524.2012.01063.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Effective communication is necessary for good relationships between healthcare practitioners and clients. This study examined barriers and facilitators to implementing new communication skills. One hundred and ten Sure Start Children's Centre staff attended one of 13 follow-up workshops in Southampton, UK between May 2009 and February 2011 to reflect on the use of new skills following a training course in communication, reflection and problem-solving. Barriers and facilitators were assessed with an adapted Problematic Experiences of Therapy scale (PETS). Staff reported frequency of skill use, and described what made it more difficult or easier to use the skills. Complete data were available for 101 trainees. The PETS indicated that staff had confidence in using the skills, but felt that there were practical barriers to using them, such as lack of time. Skills were used less often when staff perceived parents not to be engaging with them (Spearman's correlation r(s) = -0.42, P < 0.001), when staff felt less confident to use the skills (r(s) = -0.37, P < 0.001) and when there were more practical barriers (r(s) = -0.37, P < 0.001). In support of findings from the PETS, content analysis of free text responses suggested that the main barrier was a perceived lack of time to implement new skills. Facilitators included seeing the benefits of using the skills, finding opportunities and having good relationships with parents. Understanding the range of barriers and facilitators to implementation is essential when developing training to facilitate ongoing support and sustain skill use. Special attention should be given to exploring trainees' perceptions of time, to be able to address this significant barrier to skill implementation. Staff training requires a multi-faceted approach to address the range of perceived barriers.
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Affiliation(s)
- Tannaze Tinati
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, UK.
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Hancock REE, Bonner G, Hollingdale R, Madden AM. 'If you listen to me properly, I feel good': a qualitative examination of patient experiences of dietetic consultations. J Hum Nutr Diet 2012; 25:275-84. [PMID: 22487006 DOI: 10.1111/j.1365-277x.2012.01244.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is considerable interest in healthcare research regarding communication skills and some debate surrounding the effectiveness of a patient-centred approach to care. Understanding patient experiences of consultations can help indicate how consultations can be modified to improve effectiveness. At present, there is little research exploring patient experience of dietetic consultations. The present study aimed to achieve a better understanding of patients' experiences of dietetic consultations using qualitative analysis. METHODS Patients undergoing consultations with a dietitian were invited to discuss their experience of the consultation with a research dietitian who was not involved in their care. Individual interviews and focus groups were conducted and analysed using the Framework approach. RESULTS Seventeen patients participated and described their experiences of consultations, which were varied and influenced by factors such as information given (resources, explanation, repetition, consistency); their dietitian's approach (prescriptive or nonprescriptive, use of behaviour change skills), behaviour (listening skills, body language) and appointment (expectations, involvement of the multidisciplinary team, length of time); and their own internal experience (confidence, guilt, frustration). Patients agreed that certain factors, such as good communication and rapport, receiving effective and reliable information and resources, and nonjudgmental, regular support, were important factors in creating a positive experience of their consultation. However, they differed in what they believed constituted these factors. CONCLUSIONS Patients like dietitians to adopt a patient-centred approach, which might be either patient- or practitioner-led, and to take account of what they wanted from consultations, adapting these to meet their individual requirements.
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Affiliation(s)
- R E E Hancock
- School of Health and Emergency Professions, University of Hertfordshire, Hatfield, UK
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Power BT, Lennie SC. Pre-registration dietetic students' attitudes to learning communication skills. J Hum Nutr Diet 2012; 25:189-97. [PMID: 22330052 DOI: 10.1111/j.1365-277x.2012.01226.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Communication is a core skill and a prerequisite for dietitians' clinical competence. It is generally acknowledged that communication skills can be taught and learned. There is a paucity of published work identifying dietetic students' attitudes towards learning communication skills, and understanding this is important. METHODS The present cross-sectional study aimed to address this issue using an adapted version of the Communication Skills Attitude Scale (CSAS), which was designed to capture information concerning positive and negative attitudes to learning communication skills. An online questionnaire was sent to all undergraduate and post-graduate dietetic programmes in the UK. RESULTS Of the students' solicited for enrolment in the study, 33.4% (n = 300) completed the questionnaire. A one-way analysis of variance showed attitudes to learning communication skills differed significantly between years of study on both subscales of the CSAS. Subsequent analyses indicated that first-year students' attitudes to learning communication skills were significantly more positive than those of fourth-year students (P = 0.042). Third-year students had significantly more positive attitudes to learning communication skills than fourth-year students (P = 0.028). Negative attitudes were also linked to the year of study with fourth-year students having significantly more negative attitudes than third-year students (P = 0.046). Sex, practice placement experience and parental occupation did not significantly influence attitudes to learning communication skills. CONCLUSIONS These findings indicate that efforts are required to maintain positive attitudes to learning communication skills. Further longitudinal studies are recommended in this respect.
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Affiliation(s)
- B T Power
- School of Pharmacy and Life Sciences, Robert Gordon University, St Andrew Street, Aberdeen, UK
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