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Parchment A, Lawrence W, Rahman E, Townsend N, Wainwright E, Wainwright D. How useful is the Making Every Contact Count Healthy Conversation Skills approach for supporting people with musculoskeletal conditions? J Public Health (Oxf) 2022; 30:2389-2405. [PMID: 35530417 PMCID: PMC9067897 DOI: 10.1007/s10389-022-01718-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/16/2022] [Indexed: 11/29/2022] Open
Abstract
Aim To explore the current use and perceptions of the Wessex model of Making Every Contact Count (MECC), incorporating Healthy Conversation Skills (HCS), focussing specifically on physiotherapists supporting people living with musculoskeletal conditions. Methods A mixed method, sequential explanatory design was employed. This article reports the first phase of the study, in which an online questionnaire was administered, consisting of items relating to perceived acceptability, appropriateness, feasibility, sustainability, and uptake of MECC HCS. Barriers and facilitators to MECC HCS delivery were additionally explored and mapped to the Theoretical Domains Framework. Results Seventy-one professionals responded, including 15 physiotherapists supporting people with MSK conditions. Across professional groups, MECC HCS was found to be highly acceptable, appropriate, and feasible. A significant interaction between perceived sustainability of MECC HCS and the location in which professionals worked was observed. Physiotherapists reported using their MECC HCS at least daily; however, there were discrepancies between the number of their patients they believed could benefit from behaviour change intervention, and the number to whom they reported actually delivering MECC HCS. Perceived barriers and facilitators to MECC HCS implementation mapped mostly to ‘Environmental Context and Resources’ on the Theoretical Domains Framework. Conclusions The Wessex model of MECC is a promising brief or very brief intervention for physiotherapists supporting individuals with musculoskeletal conditions. Barriers associated with the sustainability of the intervention within organisations must be addressed in order to enhance future implementation. Further rollout of this intervention may be beneficial for meeting the goals of the NHS and Public Health England in prevention of chronic MSK conditions and promotion of musculoskeletal health.
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Affiliation(s)
- Amelia Parchment
- Department for Health, University of Bath, Bath, England BA2 7AY UK
| | - Wendy Lawrence
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England SO16 6YD UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, England SO16 6YD UK
| | - Em Rahman
- Public Health Workforce Development, Southern House, Health Education England, Winchester, England SO21 2RU UK
| | - Nick Townsend
- Department for Health, University of Bath, Bath, England BA2 7AY UK
| | - Elaine Wainwright
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - David Wainwright
- Department for Health, University of Bath, Bath, England BA2 7AY UK
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Making Every Contact Count and Healthy Conversation Skills as very brief or brief behaviour change interventions: a scoping review. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01653-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Abstract
Aim
To identify and map the available evidence regarding the implementation of Making Every Contact Count and/or Healthy Conversation Skills for both staff delivering and service users receiving the brief or very brief intervention/s.
Methods
A scoping review approach was used to rapidly map and provide an overview of the relevant literature, identify gaps in knowledge, and inform further, related research. Articles investigating experiences, perceptions and impact of Making Every Contact Count and/or Healthy Conversation Skills were included. Quantitative, qualitative, and mixed methods studies were eligible for inclusion, as were reviews and reports.
Results
Twenty-two articles were included in total. Healthy Conversation Skills training was found to be acceptable, and had a positive impact on staff confidence and competence in supporting behaviour change, across studies. Some positive effects of intervention exposure on the sedentary behaviour and dietary quality of service users were evidenced. Changes in confidence following Making Every Contact Count training were varied, as was perceived acceptability of the intervention for staff. Two studies highlighted positive impacts of the intervention on service user health; however, statistical significance was not reported. The perceived barriers and facilitators of implementation for both interventions mapped mostly to ‘Environmental Context and Resources’ on the Theoretical Domains Framework.
Conclusion
Healthy Conversation Skills is an acceptable and effective behaviour change intervention that could provide a consistent approach to Making Every Contact Count training and evaluation. Further research is warranted to evaluate this approach for more staff and service user groups.
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Exploring healthcare professionals' views of the acceptability of delivering interventions to promote healthy infant feeding practices within primary care: a qualitative interview study. Public Health Nutr 2021; 24:2889-2899. [PMID: 33317663 PMCID: PMC9884767 DOI: 10.1017/s1368980020004954] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Early-life nutrition plays a key role in establishing healthy lifestyles and preventing chronic disease. This study aimed to (1) explore healthcare professionals' (HCP) opinions on the acceptability of and factors influencing the delivery of interventions to promote healthy infant feeding behaviours within primary care and (2) identify proposed barriers/enablers to delivering such interventions during vaccination visits, to inform the development of a childhood obesity prevention intervention. DESIGN A qualitative study design was employed using semi-structured telephone interviews. Data were analysed using qualitative content analysis; findings were also mapped to the Theoretical Framework of Acceptability (TFA). SETTING Primary care in Ireland. PARTICIPANTS Twenty-one primary care-based HCP: five practice nurses, seven general practitioners, three public health nurses, three community dietitians and three community medical officers. RESULTS The acceptability of delivering interventions to promote healthy infant feeding within primary care is influenced by the availability of resources, HCP's roles and priorities, and factors relating to communication and relationships between HCP and parents. Proposed barriers and enablers to delivering interventions within vaccination visits include time constraints v. opportunistic access, existing relationships and trust between parents and practice nurses, and potential communication issues. Barriers/enablers mapped to TFA constructs of Affective Attitude, Perceived Effectiveness and Self-Efficacy. CONCLUSIONS This study provides a valuable insight into HCP perspectives of delivering prevention-focused infant feeding interventions within primary care settings. While promising, factors such as coordination and clarity of HCP roles and resource allocation need to be addressed to ensure acceptability of interventions to HCP involved in delivery.
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Abdin S, Heath G, Welch RK. Health professionals' views and experiences of discussing weight with children and their families: A systematic review of qualitative research. Child Care Health Dev 2021; 47:562-574. [PMID: 33565647 DOI: 10.1111/cch.12854] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/23/2020] [Accepted: 02/03/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Healthcare professionals are ideally placed to discuss weight management with children and families to treat and prevent childhood obesity. The aim of this review was to collect and synthesize primary research evidence relating to health professional's views and experiences of discussing weight with children and their families. METHODS Systematic searches were conducted using the following databases: MEDLINE (OVID), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE (OVID), PsycINFO (OVID) and Healthcare Management Information Consortium (HMIC). Twenty-six full text qualitative studies published in English Language journals since inception to October 2019 were included. Papers were quality assessed and synthesized using an inductive thematic analysis approach. RESULTS Data analysis generated five themes: sensitivity of the issue, family-professional relationships, whole systems approach, professional competency and sociocultural context. CONCLUSION Supporting behaviour change through discussion of healthy weight with children and families is an important part of the health professional's role. Tailored information for professionals, including resources and training, facilitates them to confidently talk to children and families about weight prioritized within interventions. The success of such interventions requires commitment from a range of professionals to ensure healthy weight is tackled through a whole system approach.
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Affiliation(s)
- Shanara Abdin
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, Bristol, UK.,Public Health and Wellbeing, City of Wolverhampton Council, Wolverhampton, UK
| | - Gemma Heath
- Department of Psychology, University of Wolverhampton, Wolverhampton, UK
| | - Richard K Welch
- Public Health and Wellbeing, City of Wolverhampton Council, Wolverhampton, UK
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When primary care providers and smokers meet: a systematic review and metasynthesis. NPJ Prim Care Respir Med 2021; 31:31. [PMID: 34075057 PMCID: PMC8169673 DOI: 10.1038/s41533-021-00245-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/07/2021] [Indexed: 01/08/2023] Open
Abstract
Primary Care Providers (PCPs) often deal with patients on daily clinical practice without knowing anything about their smoking status and willingness to quit. The aim of this metasynthesis is to explore the PCPs and patients who are smokers perspectives regarding the issue of smoking cessation within primary care settings. It relies on the model of meta-ethnography and follows thematic synthesis procedures. Twenty-two studies are included, reporting on the view of 580 participants. Three main themes emerge: (i) What lacks, (ii) Some expectations but no request, and (iii) How to address the issue and induce patients' motivation. Our results reveal a global feeling of a lack of legitimacy among PCPs when it comes to addressing the issue of tobacco and smoking cessation with their patients, even though they have developed creative strategies based on what is at the core of their practice, that is proximity, continuity, long-term and trustworthy relationship.
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Ryan K, Murphy LE, Linehan C, Dockray S. Theory in practice: identifying theory-based techniques in health coaches' tailored feedback during a weight loss intervention. Psychol Health 2020; 35:1384-1406. [PMID: 32362140 DOI: 10.1080/08870446.2020.1748629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: A taxonomy of ninety-three functionally different behaviour change techniques (BCTs) has been identified. However, it is not fully clear how these and other theory-based techniques are applied in the day-to-day practice of people delivering health behaviour change interventions. This study examines feedback provided by expert health coaches in a behavioural weight-loss intervention, to describe; a) what theory-based techniques are used in sessions, b) which techniques are used most frequently, c) what occurs in sessions, beyond existing theory-based techniques. Main Outcome Measures: Theory-based techniques (BCTs/tailoring strategies); relational/content-based techniques. Design: 10 tailored feedback videos from two health coaches were coded using a hybrid thematic analysis approach. Theory-based techniques were coded deductively; content not matching definitions of theory-based techniques but that addressed a determinant of behaviour change were coded inductively and relational codes were connected into themes. Results: Seventeen BCTs were coded M = 20.88 times (range:1-109). Eight tailoring techniques were coded M = 25.25 times (range:1-91). Relational themes included; 'Autonomous interpersonal coaching style,' 'Supportive accountability,' and 'Coach as expert'. Additional behavioural techniques were also identified. Conclusion: This work highlights what and how theory-based techniques are implemented in a weight-loss intervention, drawing attention to the role of tailoring techniques and health coaches in supporting behaviour change.
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Affiliation(s)
- Kathleen Ryan
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Lisa Ellen Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Conor Linehan
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Samantha Dockray
- School of Applied Psychology, University College Cork, Cork, Ireland
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Keyworth C, Epton T, Goldthorpe J, Calam R, Armitage CJ. 'It's difficult, I think it's complicated': Health care professionals' barriers and enablers to providing opportunistic behaviour change interventions during routine medical consultations. Br J Health Psychol 2019; 24:571-592. [PMID: 30977291 PMCID: PMC6766974 DOI: 10.1111/bjhp.12368] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 02/15/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Internationally, public health strategies encourage health care professionals to deliver opportunistic behaviour change interventions. The present study: (1) examines the barriers and enablers to delivering interventions during routine consultations, and (2) provides recommendations for the design of interventions to increase delivery of opportunistic behaviour change interventions. DESIGN Qualitative interview study. METHODS Twenty-eight semi-structured interviews were conducted with patient-facing health care professionals. The Behaviour Change Wheel informed a framework analysis in which findings were mapped onto the Theoretical Domains Framework (TDF). Intervention functions and behaviour change techniques (BCTs) targeting each TDF domain were identified. RESULTS Health care professionals understood the importance of opportunistic behaviour change interventions (beliefs about consequences), but were sceptical about their capabilities to facilitate behaviour change with patients (beliefs about capabilities). Some clinicians were unwilling to discuss behaviours perceived as unrelated to the patient's visit (social/professional role and identity). Discipline-specific tasks were prioritized, and delivering interventions was perceived as psychologically burdensome. One-to-one contact was favoured over busy hospital settings (environmental context and resources). Seven intervention functions (training, restriction, environmental restructuring, enablement, education, persuasion, and modelling) and eight BCT groupings (antecedents, associations, comparison of outcomes, covert learning, feedback and monitoring, natural consequences, reward and threat, and self-belief) were identified. CONCLUSIONS Across disciplines, health care professionals see the value of opportunistic behaviour change interventions. Barriers related to workload, the clinical environment, competence, and perceptions of the health care professional role must be addressed, using appropriate intervention functions and BCTs, in order to support health care professionals to increase the delivery of interventions in routine practice. Statement of contribution What is already known on this subject? Brief, opportunistic interventions can be a cost effective way of addressing population health problems. Public health policies compel health care professionals to deliver behaviour change interventions opportunistically. Health care professionals do not always deliver interventions opportunistically during routine medical consultations; however the barriers and enablers are currently unclear. What does this study add? This is the first study to examine cross-disciplinary barriers and enablers to delivering opportunistic behaviour change interventions. Across diverse professional groups, working in different medical professions, participants saw the value of delivering opportunistic behaviour change interventions. Targeting key theoretical domains that are shared across professional groups may be useful for increasing the delivery of opportunistic behaviour change interventions.
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Affiliation(s)
- Chris Keyworth
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, UK
| | - Tracy Epton
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, UK
| | - Joanna Goldthorpe
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, UK
| | - Rachel Calam
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, UK
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre and Manchester University NHS Foundation Trust (MFT), and NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, UK
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Clarke R, Heath G, Pattison H, Farrow C. Weight-management in children living with asthma: a qualitative study of the experiences of paediatric healthcare professionals. J Asthma 2018; 56:1274-1281. [PMID: 30444152 DOI: 10.1080/02770903.2018.1536146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Weight loss has been found to improve the symptoms of asthma in children who are overweight. However, many paediatric weight management programmes do not address the challenges associated with living with asthma. The aim of this study was to explore the views and experiences of paediatric healthcare professionals concerning weight management advice and support offered to families of children living with asthma. Methods: In-depth individual interviews with 10 healthcare professionals who work with a paediatric asthma population (n = 4 Respiratory Consultants, 3 Respiratory Nurses, 3 General Paediatricians). Data were analysed using a Framework approach. Results: Healthcare professionals highlighted that families' perceptions of weight, their approach to physical activity and nutrition, the family's social context and perceptions of asthma and asthma treatment all influence weight management in children living with asthma. Initiating weight management conversations and referring to weight management support were perceived as challenging. It was thought that tailoring weight management to the needs of children living with asthma and locating support within the community were important to the success of a family-centred intervention. Conclusions: The results highlight the added complexity of responding to excessive weight in a paediatric population with asthma. Training and referral guidance for healthcare professionals may help overcome weight management support challenges. Addressing family beliefs about the factors influencing paediatric asthma and exploring families' motivations for behaviour change may enhance engagement with weight management.
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Affiliation(s)
- Rebecca Clarke
- Department of Psychology, Aston University , Birmingham , UK
| | - Gemma Heath
- Department of Psychology, Aston University , Birmingham , UK.,Department of Psychology, Birmingham Children's Hospital , Birmingham , UK
| | - Helen Pattison
- Department of Psychology, Aston University , Birmingham , UK
| | - Claire Farrow
- Department of Psychology, Aston University , Birmingham , UK
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Keyworth C, Epton T, Goldthorpe J, Calam R, Armitage CJ. Are healthcare professionals delivering opportunistic behaviour change interventions? A multi-professional survey of engagement with public health policy. Implement Sci 2018; 13:122. [PMID: 30241557 PMCID: PMC6151030 DOI: 10.1186/s13012-018-0814-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND "Making Every Contact Count" (MECC), a public health policy in the UK, compels healthcare professionals to deliver opportunistic health behaviour change interventions to patients during routine medical consultations. Professionals' awareness of, and engagement with, the policy is unclear. This study examined (1) awareness of the MECC policy, and (2) the prevalence of MECC-related practice in relation to (a) perceived patient benefit, (b) how often healthcare professionals deliver interventions during routine consultations, and (c) the time spent on this activity. METHODS Cross-sectional national survey was administered in 2017 of 1387 healthcare professionals working in the UK's National Health Service (NHS). Descriptive statistics were used to assess awareness and practice consistent with the MECC policy. Chi-square was used to gauge the potential representativeness of our sample compared to NHS employment data. RESULTS 31.4% of healthcare professionals reported having heard of the policy; nevertheless, healthcare professionals perceived a need to provide patients with opportunistic behaviour change interventions in 55.9% (32,946/58,906) of consultations. However, healthcare professionals did not deliver interventions on 50.0% of occasions in which they perceived a need. Where behaviour change interventions were delivered to patients, this constituted 35.3% of the appointment time. CONCLUSIONS Policy makers must address the gap between the proportion of patients that healthcare professionals perceive would benefit from opportunistic behaviour change interventions and those receiving them (an estimated 50.0%; 16,473 additional patients could have benefited). Future research should consider how healthcare professionals identify patients who might benefit from opportunistic behaviour change interventions and developing training for efficient delivery of interventions.
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Affiliation(s)
- Chris Keyworth
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building-Room G3, Oxford Road, Manchester, M13 9PL, UK.
| | - Tracy Epton
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK
| | - Joanna Goldthorpe
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK
| | - Rachel Calam
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
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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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McLean S, Charlesworth L, May S, Pollard N. Healthcare students' perceptions about their role, confidence and competence to deliver brief public health interventions and advice. BMC MEDICAL EDUCATION 2018; 18:114. [PMID: 29793485 PMCID: PMC5968571 DOI: 10.1186/s12909-018-1224-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 05/14/2018] [Indexed: 05/15/2023]
Abstract
BACKGROUND Public health improvement has long been an important focus for the United Kingdom Department of Health. The Allied Health Professions (AHP) Federation has 84,000 members, such a large number of AHP professionals should play a role in public health initiatives, but it is not clear if they or the AHP students who will be the future healthcare workforce feel themselves equipped to do so. Our aim was to understand the perceptions of AHP students about their role in delivering public health advice. METHODS AHP students were recruited in one teaching university from different departments. Participants were final year AHP students who had completed all clinical placements related to their course. All students were emailed an invitation to participate, and those interested were asked to contact the researchers to participate in one of several focus groups. Data were recorded, transcribed, and analysed using framework analysis by two independent researchers. RESULTS Nineteen students were recruited and participated in four focus groups. The main themes produced by the data analysis were: understanding of public health issues, perceptions of their role in this, challenges and opportunities to develop a public health role, and preparation for a public health role. CONCLUSIONS AHP students felt that they had a role in public health advice-giving, but barriers to providing this advice included their own lack of confidence and knowledge, time, and the environment of the clinical placement. They considered that there should be more teaching on public health issues, and that these should feature in both the curriculum and on clinical placement.
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Affiliation(s)
- Sionnadh McLean
- Faculty of Health and Wellbeing, Sheffield Hallam University, Robert Winston Building, Sheffield, S10 2BP UK
| | - Laura Charlesworth
- Faculty of Health and Wellbeing, Sheffield Hallam University, Robert Winston Building, Sheffield, S10 2BP UK
| | - Stephen May
- Faculty of Health and Wellbeing, Sheffield Hallam University, Robert Winston Building, Sheffield, S10 2BP UK
| | - Nick Pollard
- Faculty of Health and Wellbeing, Sheffield Hallam University, Robert Winston Building, Sheffield, S10 2BP UK
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Elwell L, Powell J, Wordsworth S, Cummins C. Challenges of implementing routine health behavior change support in a children's hospital setting. PATIENT EDUCATION AND COUNSELING 2014; 96:113-119. [PMID: 24801412 DOI: 10.1016/j.pec.2014.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 03/17/2014] [Accepted: 04/05/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Evidence indicates that health behavior change initiatives are often not implemented successfully. This qualitative study aims to understand the barriers and facilitators to implementation of health behavior change brief advice into routine practice in an acute children's hospital setting. METHODS Semi-structured interviews were conducted with health professionals working at a UK children's hospital (n=33). Participants were purposively sampled to incorporate a range of specialties, job roles and training. RESULTS An inductive thematic framework analysis identified two emergent themes. These capture the challenges of implementing routine health behavior change support in a children's hospital setting: (1) 'health professional knowledge, beliefs and behaviors' and (2) 'patient and family related challenges'. CONCLUSION This study enhances findings from previous research by outlining the challenges pediatric health professionals face in relation to supporting health behavior change. Challenges include failure to assume responsibility, low confidence, prioritization of the health provider relationship with patients and families, health provider and patient knowledge, and low patient and family motivation. PRACTICE IMPLICATIONS Skills-based behavior change training is needed for pediatric health professionals to effectively support health behavior change.
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Affiliation(s)
- Laura Elwell
- Research and Development, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, England, UK.
| | - Jane Powell
- Children and Families Division, Birmingham Community Healthcare NHS Trust, Birmingham, England, UK
| | | | - Carole Cummins
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, UK
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