Exploring stakeholder experiences of dietetic service and care delivery: A systematic qualitative review

Elliott, Andrea; Gibson, Simone

doi:10.1111/jhn.13063

Cited by 7 publications

(7 citation statements)

References 83 publications

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“…Novel topics that engage community curiosity have been shown to have a wide range of effects on the brain, including increasing motivation, eliciting exploratory behavior, and promoting learning 79,80 . In this pilot study, past experiences with health care providers left participants feeling unsatisfied with the repetitive and standardized content provided which is consistent with current evidence 81 . Participants believed that their baseline level of nutrition knowledge exceeded the basic topics often covered by national dietary guidelines.…”

Section: Discussionsupporting

confidence: 57%

“…79,80 In this pilot study, past experiences with health care providers left participants feeling unsatisfied with the repetitive and standardized content provided which is consistent with current evidence. 81 Participants believed that their baseline level of nutrition knowledge exceeded the basic topics often covered by national dietary guidelines. These women were self-assured with their health literacy skills, demonstrating a proficient understanding of basic nutrition principles and advanced cooking skills, which afforded them the capacity to engage with innovative concepts around diet and inflammation.…”

Section: Discussionmentioning

confidence: 99%

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Investigating the efficacy and feasibility of using a whole-of-diet approach to lower circulating levels of C-reactive protein in postmenopausal women: a mixed methods pilot study

et al. 2023

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Objective: Chronic inflammation is associated with obesity and is an underlying pathophysiology for cardiovascular disease (CVD) development in postmenopausal women. This study aims to determine feasibility and efficacy of an anti-inflammatory dietary intervention to lower levels of C-reactive protein in weight stable postmenopausal women with abdominal obesity.Methods: This mixed-methods pilot study used a single arm pre-post design. Thirteen women followed a 4-week anti-inflammatory, dietary intervention, optimizing consumption of healthy fats, low glycemic index wholegrains, and dietary antioxidants. Quantitative outcomes included change in inflammatory and metabolic markers. Focus groups were undertaken and thematically analyzed to explore participants lived experience of following the diet.Results: There was no significant change in plasma high-sensitivity C-reactive, protein. Despite discouraging weight loss, median (Q1-Q3) body weight decreased by −0.7 (−1.3 to 0 kg, P = 0.02). This was accompanied by reductions in plasma insulin (0.90 [−0.05 to 2.20] mmol/L), Homeostatic Model Assessment of Insulin Resistance (0.29 [−0.03 to 0.59]), and low-density lipoprotein:high-density lipoprotein ratio (0.18 [−0.01 to 0.40]) (P ≤ 0.023 for all). Thematic analysis revealed that postmenopausal women have a desire to improve meaningful markers of health status that do not focus on weight. Women were highly engaged with learning about emerging and innovative nutrition topics, favoring a detailed and comprehensive nutrition education style that challenged their proficient health literacy and cooking skills.Conclusions: Weight-neutral dietary interventions targeting inflammation can improve metabolic markers and may be a viable strategy for CVD risk reduction in postmenopausal women. To determine effects on inflammatory status, a fully powered and longer-term randomized controlled trial is required.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Investigating the efficacy and feasibility of using a whole-of-diet approach to lower circulating levels of C-reactive protein in postmenopausal women: a mixed methods pilot study

et al. 2023

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“…Patients who have obesity may need specialist support from treating teams, from continence specialists, respiratory physicians, wound care nurses, clinical psychology, and occupational health and safety representatives [ 60 ]. Health services need to ensure they have appropriate governance frameworks, leadership, policy, clinical pathways, and equipment [ 56 , 60 , 61 ] in place that support the best care of patients who have obesity as well as treating teams that are empathetic and are able to provide personalized care [ 56 , 60 , 62 ]. As a starting point, this may require an exploration of nutrition risks identified for patients in the hospital setting.…”

Section: Discussionmentioning

confidence: 99%

Exploring Overnutrition, Overweight, and Obesity in the Hospital Setting—A Point Prevalence Study

et al. 2023

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Malnutrition is an international healthcare concern associated with poor patient outcomes, increased length of stay, and healthcare costs. Although malnutrition includes both under and overnutrition, there is a large body of evidence that describes the impacts of undernutrition with limited data on overnutrition in hospitalized patients. Obesity itself is a modifiable risk factor associated with hospital-associated complications. However, there is limited reporting of the prevalence of obesity in hospitals. This one-day cross-sectional study (n = 513) captures the prevalence of both under and overnutrition in a hospitalized population and explores dietetic care provided compared to the Nutrition Care Process Model for hospitalized patients who have obesity. The main findings were: (1) the largest proportion of patients were in the overweight and obese classifications (57.3%, n = 294/513); 5.3% of these patients had severe obesity (class III); (2) patients who were overweight and obese had lower malnutrition risk profiles as well as the prevalence of malnutrition; (3) 24.1% of patients who had obesity (n = 34/141) were receiving dietetic intervention; (4) 70.6% (n = 24/34) did not have a nutrition diagnosis that followed the Nutrition Care Process Model. Study results provide valuable clinical insight into the prevalence of overnutrition and opportunities to improve nutrition care for this vulnerable patient group.

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“…1 A recent systematic review identified opportunities to improve dietetics care delivered in primary care settings. 2 Quality improvement strategies are implemented within dietetics services to enhance the quality and safety of care such that care achieves optimal health outcomes. 1 A systematic review evaluating quality improvement strategies used by primary care dietitians described 10 strategies across the 12 included studies.…”

Section: Introductionmentioning

confidence: 99%

“…Quality care leads to the efficient use of resources by optimising the cost of health care and making resources available for other areas of societal need, such as social services and infrastructure 1 . A recent systematic review identified opportunities to improve dietetics care delivered in primary care settings 2 …”

Section: Introductionmentioning

confidence: 99%

Developing the EQUIPED approach to quality management using multi‐grounded theory

Kirkegaard

Mitchell

Ball

et al. 2022

Nutrition & Dietetics

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Aim This study aimed to develop a theoretical approach to quality management for dietetics services operating in primary care settings in Australia. Methods Multi‐grounded theory was used to develop a theoretical approach to quality management across three phases. A preliminary approach was developed in the first phase using empirical data outlining quality management activities employed by primary care dietetics services. In the second phase, the preliminary approach was matched to theoretical data captured from the Australian National Safety and Quality in Primary and Community Healthcare Standards, the Quality in Nutrition Care Model for Dietitians, and complex adaptive systems theory. Central concepts were defined and described in the final phase. Results Seventeen small (n = 7) and medium‐large (n = 10) dietetics services from all Australian states and territories, except Tasmania, participated. The theoretical approach to quality management comprised 107 rules organised into six attractors (culture, integrated care, evidence‐based care, safe environment and care, client partnerships and personalised care) and 10 governance elements. Rules had one or more foci that aimed to: improve quality within the service (internally focused), improve care by influencing other healthcare professionals (externally focused), improve the client relationship (client‐focused), or monitor and respond to external systems (system‐focused). Conclusions The theoretical approach developed in this study produced a set of rules that primary care dietetics services can use to inform quality management activities. The use of multi‐grounded theory should be investigated in other healthcare disciplines and settings to address quality.

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Exploring stakeholder experiences of dietetic service and care delivery: A systematic qualitative review

Cited by 7 publications

References 83 publications

Investigating the efficacy and feasibility of using a whole-of-diet approach to lower circulating levels of C-reactive protein in postmenopausal women: a mixed methods pilot study

Investigating the efficacy and feasibility of using a whole-of-diet approach to lower circulating levels of C-reactive protein in postmenopausal women: a mixed methods pilot study

Exploring Overnutrition, Overweight, and Obesity in the Hospital Setting—A Point Prevalence Study

Developing the EQUIPED approach to quality management using multi‐grounded theory

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