Physician Training for Patient-Centered Nutrition Counseling in a Lipid Intervention Trial

Ockene, Judith K.; Ockene, Ira S.; Quirk, Mark E.; Hébert, James R.; Saperia, Gordon M.; Luippold, Rose S.; Merriam, Philip A.; Ellis, Sarah

doi:10.1006/pmed.1995.1090

Cited by 116 publications

(69 citation statements)

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“…Lectures may be a good way of introducing new concepts to students but lectures alone might not enhance self-efficacy as its opportunities for practical and clinical experiences are limited [48]. In identifying teaching and learning methods that could promote self-efficacy as well as attitudes in nutrition care, Mogre et al [34] found the following to be important: role modelling by practicing physicians [49], role playing using either simulated or real patients [50][51][52][53], encouraging clinical bedside nutritional teaching [48], demonstrations and hands on practice sessions [49][50][51][52][54][55][56], viewing and discussion of videos and Web-based cases [51,57].…”

Section: Discussionmentioning

confidence: 99%

Future Doctors’ Nutrition-Related Knowledge, Attitudes and Self-Efficacy Regarding Nutrition Care in the General Practice Setting: A Cross-Sectional Survey

et al. 2017

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Background Doctors are in a good position to provide nutrition advice to patients. However, doctors and medical students find their nutrition education to be inadequate. We evaluated nutrition-related knowledge, attitudes and self-efficacy in a sample of future doctors. Furthermore, we investigated the association between nutrition-related knowledge, attitude and self-efficacy. We also compared nutrition-related knowledge, attitudes and self-efficacy with level of clinical training. Methods Following a cross-sectional design, the nutritionrelated knowledge, attitudes and self-efficacy of 207 undergraduate clinical-level medical students (referred to as future doctors) was measured using a questionnaire. Items of the questionnaire were derived from previously validated survey instruments. Descriptive statistics of mean and standard deviation was used to describe the data. Results Future doctors had a mean knowledge score of 64%. Their mean knowledge scores in the nutrition topics assessed were 41% for 'malnutrition in children', 59% for 'diabetes and obesity' and 73% for 'nutrients, energy and their deficiencies'. Future doctors' attitudes towards nutrition care were generally positive but were uncertain in the effectiveness of health education in changing the lifestyle of patients. They felt inadequate in their self-efficacy to provide nutrition care. Attitudes towards nutrition care correlated (r = 0.371, p < 0.001) positively with self-efficacy to provide nutrition care. Level of clinical training was associated to nutrition-related knowledge of the students. Conclusion Future doctors had positive attitudes towards nutrition care but showed important knowledge gaps and also felt inadequate in their confidence to provide nutrition care. Attitudes may be important in nutrition care self-efficacy.

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Section: Discussionmentioning

confidence: 99%

Future Doctors’ Nutrition-Related Knowledge, Attitudes and Self-Efficacy Regarding Nutrition Care in the General Practice Setting: A Cross-Sectional Survey

et al. 2017

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“…The 5As have been endorsed as a unifying framework for behavioral counseling in primary care. [4][5][6][7][8] The level of evidence is moderately strong for several health behaviors 5 and is growing for physical activity. base supporting use of the 5A guidelines, 5;12 health care clinicians have diffi culty with implementation.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Physical Activity Counseling in Primary Care Using Direct Observation of the 5As

Carroll

Antognoli

Flocke³

2011

The Annals of Family Medicine

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BACKGROUND The 5As (ask, advise, assess, assist, arrange) are recommended as a strategy for brief physical activity counseling in primary care. There is no reference standard for measurement, however, and patient participation is not well understood. This study's objectives were to (1) develop a coding scheme to measure the 5As using audio-recordings of primary care visits and (2) describe the degree to which patients and physicians accomplish the 5As. METHODSWe developed a coding scheme using previously published defi nitions of the 5As, direct-observation measures, and evaluation of audio-recorded discussions of physical activity. We applied the coding scheme to 361 audiorecorded visits by patients reporting low levels of physical activity and 28 physicians in northeast Ohio. RESULTSThe coding scheme achieved good inter-rater agreement for each of the 5As (κ = 0.62-1.0). A total of 135 visits included discussion of physical activity. Although ask tasks occurred in 91% of visits, it infrequently elicited suffi cient detail about current activity. Patient readiness to change physical activity (assess) was infrequently directly elicited by the physician (24%), but readiness was commonly expressed by the patient in response to an assessment of current level of physical activity (53%). Ambivalence was infrequently followed by physician assistance (49%).CONCLUSIONS Our newly developed measure showed that (1) physicians infrequently assess patient readiness to change, (2) patient expressions of ambivalence are common, and (3) specifi c mention of recommended guidelines for exercise is nearly absent. Future work should increase clinician skills in exploring ambivalence and readiness to change, as well as improve explicit mention of recommended guidelines for physical activity.

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“…3,[5][6][7] Unfortunately, there are few validated, functional supportive resources for screening, monitoring, and intervening for unhealthy behaviors. 4,8 Current research also indicates that successful practice interventions involve systematic processes using multiple members of the practice team, and not just relying on the physician alone.…”

Section: Discussionmentioning

confidence: 99%

Changing Organizational Constructs Into Functional Tools: An Assessment of the 5 A's in Primary Care Practices

Dosh

Holtrop²,

Torres³

et al. 2005

The Annals of Family Medicine

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Physician Training for Patient-Centered Nutrition Counseling in a Lipid Intervention Trial

Cited by 116 publications

References 0 publications

Future Doctors’ Nutrition-Related Knowledge, Attitudes and Self-Efficacy Regarding Nutrition Care in the General Practice Setting: A Cross-Sectional Survey

Future Doctors’ Nutrition-Related Knowledge, Attitudes and Self-Efficacy Regarding Nutrition Care in the General Practice Setting: A Cross-Sectional Survey

Evaluation of Physical Activity Counseling in Primary Care Using Direct Observation of the 5As

Changing Organizational Constructs Into Functional Tools: An Assessment of the 5 A's in Primary Care Practices

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