Building bridges in dietary counselling: an exploratory study examining the usefulness of wellness and wellbeing concepts

The personal dimension of allied health professional identity: A scoping review in health sciences literature / Die persönliche Dimension der beruflichen Identität von Gesundheitsfachkräften: ein Scoping-Review in der gesundheitswissenschaftlichen Literatur

Introduction

With a shift in healthcare from diagnosis-centered to human- and interprofessional-centered work, allied health professionals (AHPs) may encounter dilemmas in daily work because of discrepancies between values of learned professional protocols and their personal values, the latter being a component of the personal dimension. The personal dimension can be defined as a set of personal components that have a substantial impact on professional identity. In this study, we aim to improve the understanding of the role played by the personal dimension, by answering the following research question: What is known about the personal dimension of the professional identity of AHPs in (allied) health literature?

Methods

In the scoping review, databases, CINAHL, ERIC, Medline, PubMed, and PsychINFO were searched for studies focusing on what is regarded as ‘the personal dimension of professional identity’ of AHPs in the health literature; 81 out of 815 articles were included and analyzed in this scoping review. A varying degree of attention for the personal dimension within the various allied health professions was observed.

Result

After analysis, we introduce the concept of four aspects in the personal dimension of AHPs. We explain how these aspects overlap to some degree and feed into each other. The first aspect encompasses characteristics like gender, age, nationality, and ethnicity. The second aspect consists of the life experiences of the professional. The third involves character traits related to resilience and virtues. The fourth aspect, worldview, is formed by the first three aspects and consists of the core beliefs and values of AHPs, paired with personal norms.

Discussion

These four aspects are visualized in a conceptual model that aims to make AHPs more aware of their own personal dimension, as well as the personal dimension of their colleagues intra- and interprofessionally. It is recommended that more research be carried out to examine how the personal dimension affects allied health practice.

Challenges and Perspectives in Nutritional Counselling and Nursing: A Narrative Review

Nutritional counselling has been recognised as the first line approach in the management of numerous chronic diseases. Though usually carried out by dietitians, nutritional counselling may be used by nurses, or other healthcare professionals to improve nutritional status and meet healthcare goals. Healthcare professionals require training and education to facilitate a patient centred approach to effective counselling. Advances in digital technology have the potential to improve access to nutritional counselling for some patients such as those in primary care. However, caution is required to ensure that valuable interpersonal relationships are not lost, as these form the cornerstone of effective nutritional counselling. The aim of this narrative review is to explore aspects of effective nutritional counselling, including advances in e-counselling and areas where nursing input in nutritional counselling might enhance overall nutritional care.

Dietitians' perspectives of the barriers and enablers to delivering patient-centred care

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.

Patients' perceptions and experiences of patient-centred care in dietetic consultations

BACKGROUND

Patient-centred care (PCC) is essential to quality healthcare. However, there is a paucity of research on PCC in dietetics, particularly regarding patients' experiences and perspectives of PCC. We aimed to enhance our understanding of PCC in dietetics by exploring patients' perceptions and experiences of PCC in individual dietetic consultations.

METHODS

The present study used qualitative methods, situated in a constructivist-interpretivist paradigm. Maximum variation purposive sampling was used to recruit English speaking adult participants who had participated in ≥1 dietetic consultations for nutrition care. Individual semi-structured interviews explored participants' perceptions and experiences of PCC in dietetic consultations. Data were analysed thematically.

RESULTS

Eleven patients were interviewed between September and November 2016. Four overarching themes emerged: (i) fostering and maintaining caring relationships; (ii) delivering individualised care; (iii) enabling patient involvement; and (iv) taking control of one's own health.

CONCLUSIONS

PCC is important to patients. Thus, there is opportunity for dietitians to enhance the care they provide by adopting patient-centred practices. As the first study of its kind, these findings can inform future dietetic practice, education and research by contributing patients' perspectives of PCC. By understanding patients' unique needs and preferences, dietitians can better align their practice with a patient-centred approach. Furthermore, these findings are useful for informing future dietetic research and education.

Patient-centred care to improve dietetic practice: an integrative review

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.