Patient‐centred dietetic care from the perspectives of older malnourished patients

Hazzard, Emily; Barone, L; Mason, Michelle; Lambert, Kelly; McMahon, Anne

doi:10.1111/jhn.12478

Cited by 19 publications

(64 citation statements)

References 33 publications

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“…Participants were mainly female (n = 178; 98.9%), with a median age of 34 (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46) years. Participants reported working a median of 27.5 h in dietetic-related work each week and had a median of 8 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) years of experience as a dietitian. Almost half (n = 82; 46.6%) of the participants reported that they had undergone additional training, such as postgraduate certificates/diplomas (e.g.…”

Section: Demographic Characteristicsmentioning

confidence: 99%

Development and psychometric testing of an inventory to measure patient‐centred care in dietetic practice – dietitian version

Sladdin

Gillespie

Ball

et al. 2019

J Human Nutrition Diet

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Background The lack of a valid instrument to measure patient‐centred care (PCC) in dietetic practice makes it challenging to evaluate how patient‐centred dietitians are. The present study aimed to develop and psychometrically test a dietitian‐reported inventory to measure PCC in dietetic practice. Methods The inventory was compiled based on a literature review of existing validated scales that measured the dimensions of PCC. Next, the inventory was distributed as a cross‐sectional survey to 180 Australian Accredited Practicing Dietitians who worked in primary care. Exploratory factor analysis was performed using principal factor analysis with Promax rotation. Cronbach's alpha (criteria ≥0.80), inter‐item correlations and corrected item‐total correlations (criteria 0.30–0.70) were computed to evaluate the internal consistency of each scale. Results Five factors were extracted accounting for 56.9% of the variance. Most variables had strong loadings on only one factor. Factors were labelled as: shared decision‐making; holistic and individualised care; patient–dietitian communication; knowing the patient; and caring patient–dietitian relationships. Cronbach's alpha was 0.94 for the total inventory and ranged from 0.73 to 0.91 for the individual factors. Inter‐item correlations and corrected item‐total correlations mostly fell in the desired range. Conclusions The present study offers a preliminary, conceptually grounded dietitian‐reported inventory, which is the first instrument developed and tested to measure PCC in dietetic practice. These findings illustrate the underlying factor structure of the inventory and support the reliability of the scales. With further testing, this inventory may provide useful to clinicians and researchers working to better understand and improve dietetic practice.

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Section: Demographic Characteristicsmentioning

confidence: 99%

Development and psychometric testing of an inventory to measure patient‐centred care in dietetic practice – dietitian version

Sladdin

Gillespie

Ball

et al. 2019

J Human Nutrition Diet

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“…Although various stakeholders will have differing ideas about PCC, it is important to understand patients' preferences in this regard. A recent study explored malnourished patients' views of dietetic hospital care (27) ; however, no study has explored patients' perspectives of PCC in the dietetic primary care setting (26) . Thus, the present study aimed to explore patients' experiences and perspectives of PCC in individual dietetic consultations.…”

Section: Introductionmentioning

confidence: 99%

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

Sladdin

Chaboyer

Ball

2017

J Human Nutrition Diet

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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.

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“…Despite the limitations of manual thematic analysis, there have been few previous attempts to analyse large-survey, unstructured, free-text responses in health care, including cancer services, to inform clinical and health-care practice. 7,12,15,18,19 There are notable exceptions, 14,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] but these all represent one-off analyses (see Chapter 2).…”

Section: Current Limitations In the Usefulness Of Free-text Commentsmentioning

confidence: 99%

“…et al 32 Iversen et al 27 McLemore et al 29 Hazzard et al 25 34 York et al 33 Poole et al 30 Lian et al 28 Henrich et al 26 Fradgley et al 24 Cunningham et al 22,23 Number of studies Suggestions from the survey 21 Wiseman et al 14…”

Section: Waglandmentioning

confidence: 99%

“…et al 32 Iversen et al 27 McLemore et al 29 Hazzard et al 25 Attanasio et al 20 34 York et al 33 Poole et al 30 Lian et al 28 Henrich et al 26 Fradgley et al 24 Cunningham et al 22,23 Number of studies Suggestions from the survey A second 'dashboard-scoping' survey was sent out at the same time, which asked a similar range of stakeholders to tell us what they thought a good health-care dashboard should be like functionally and visually, and what good existing examples they could recommend to us. The later DCE data (see Chapter 7) make for an interesting comparison with this study.…”

Section: Waglandmentioning

confidence: 99%

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Automated analysis of free-text comments and dashboard representations in patient experience surveys: a multimethod co-design study

Rivas

Tkacz

Antao

et al. 2019

Health Serv Deliv Res

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Background Patient experience surveys (PESs) often include informative free-text comments, but with no way of systematically, efficiently and usefully analysing and reporting these. The National Cancer Patient Experience Survey (CPES), used to model the approach reported here, generates > 70,000 free-text comments annually. Main aim To improve the use and usefulness of PES free-text comments in driving health service changes that improve the patient experience. Secondary aims (1) To structure CPES free-text comments using rule-based information retrieval (IR) (‘text engineering’), drawing on health-care domain-specific gazetteers of terms, with in-built transferability to other surveys and conditions; (2) to display the results usefully for health-care professionals, in a digital toolkit dashboard display that drills down to the original free text; (3) to explore the usefulness of interdisciplinary mixed stakeholder co-design and consensus-forming approaches in technology development, ensuring that outputs have meaning for all; and (4) to explore the usefulness of Normalisation Process Theory (NPT) in structuring outputs for implementation and sustainability. Design A scoping review, rapid review and surveys with stakeholders in health care (patients, carers, health-care providers, commissioners, policy-makers and charities) explored clinical dashboard design/patient experience themes. The findings informed the rules for the draft rule-based IR [developed using half of the 2013 Wales CPES (WCPES) data set] and prototype toolkit dashboards summarising PES data. These were refined following mixed stakeholder, concept-mapping workshops and interviews, which were structured to enable consensus-forming ‘co-design’ work. IR validation used the second half of the WCPES, with comparison against its manual analysis; transferability was tested using further health-care data sets. A discrete choice experiment (DCE) explored which toolkit features were preferred by health-care professionals, with a simple cost–benefit analysis. Structured walk-throughs with NHS managers in Wessex, London and Leeds explored usability and general implementation into practice. Key outcomes A taxonomy of ranked PES themes, a checklist of key features recommended for digital clinical toolkits, rule-based IR validation and transferability scores, usability, and goal-oriented, cost–benefit and marketability results. The secondary outputs were a survey, scoping and rapid review findings, and concordance and discordance between stakeholders and methods. Results (1) The surveys, rapid review and workshops showed that stakeholders differed in their understandings of the patient experience and priorities for change, but that they reached consensus on a shortlist of 19 themes; six were considered to be core; (2) the scoping review and one survey explored the clinical toolkit design, emphasising that such toolkits should be quick and easy to use, and embedded in workflows; the workshop discussions, the DCE and the walk-throughs confirmed this and foregrounded other features to form the toolkit design checklist; and (3) the rule-based IR, developed using noun and verb phrases and lookup gazetteers, was 86% accurate on the WCPES, but needs modification to improve this and to be accurate with other data sets. The DCE and the walk-through suggest that the toolkit would be well accepted, with a favourable cost–benefit ratio, if implemented into practice with appropriate infrastructure support. Limitations Small participant numbers and sampling bias across component studies. The scoping review studies mostly used top-down approaches and focused on professional dashboards. The rapid review of themes had limited scope, with no second reviewer. The IR needs further refinement, especially for transferability. New governance restrictions further limit immediate use. Conclusions Using a multidisciplinary, mixed stakeholder, use of co-design, proof of concept was shown for an automated display of patient experience free-text comments in a way that could drive health-care improvements in real time. The approach is easily modified for transferable application. Future work Further exploration is needed of implementation into practice, transferable uses and technology development co-design approaches. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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Patient‐centred dietetic care from the perspectives of older malnourished patients

Abstract: The quality indicators of dietetic services identified in the present study may facilitate dietitians to provide evidence-based PCC for older malnourished patients.

Cited by 19 publications

References 33 publications

Development and psychometric testing of an inventory to measure patient‐centred care in dietetic practice – dietitian version

Development and psychometric testing of an inventory to measure patient‐centred care in dietetic practice – dietitian version

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

Automated analysis of free-text comments and dashboard representations in patient experience surveys: a multimethod co-design study

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