Qualitative exploration of the experiences of renal dietitians and how they help patients with end stage kidney disease to understand the renal diet

Lambert, Kelly; Mansfield, Kylie J; Mullan, Judy

doi:10.1111/1747-0080.12443

Cited by 20 publications

(29 citation statements)

References 68 publications

(109 reference statements)

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“…Although satisfied with dietetic care, low patient motivation was a major barrier, and the authors conclude that patient‐centred models of nutrition care need to be further explored. This is consistent with recommendations from Lambert et al, who describe the emotionally and professionally challenging experiences of renal dietitians providing dietary advice to this patient group with low adherence to nutrition recommendations. These are common responses from health‐care professionals when client behaviour is not consistent with clinical practice guidelines or practitioner recommendations .…”

supporting

confidence: 90%

“…This includes the development and implementation of an evidence-based model of care 19 and service improvement from different stakeholder perspectives. 20,21 The Knowledge-to-Action Framework, 12 Theoretical Domains Framework 13 and Behaviour Change Wheel 22 were used to guide the implementation research by Mackay et al 19 to identify barriers and enablers, to improve nurses' knowledge by undertaking training, implement new procedures and create a database to monitor outcomes. The new model of care aligned practice with evidence-based guidelines and improved the prevalence of malnutrition.…”

mentioning

confidence: 99%

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Evidence‐based practice in nutrition and dietetics: Translating evidence into practice

Bauer

2019

Nutrition & Dietetics

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supporting

confidence: 90%

mentioning

confidence: 99%

Evidence‐based practice in nutrition and dietetics: Translating evidence into practice

Bauer

2019

Nutrition & Dietetics

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“…However, other methods such as written information, posters and nursing or medical education were also considered acceptable. Nutrition information from other health professionals has been identified as desirable by dietitians . This may provide an opportunity for dietitians to invest time in providing training to the entire multidisciplinary team and developing nutrition education resources to enable non‐dietitians to provide and reinforce basic nutrition messages with patients.…”

Section: Discussionmentioning

confidence: 99%

“…Nutrition information from other health professionals has been identified as desirable by dietitians. 29 This may provide an opportunity for dietitians to invest time in providing training to the entire multidisciplinary team and developing nutrition education resources to enable non-dietitians to provide and reinforce basic nutrition messages with patients. While often used in practice in response to inadequate dietetic staffing, group education was not a preferred method for receiving nutrition information in the haemodialysis population.…”

Section: Percentage Of Respondentsmentioning

confidence: 99%

Guidelines for review of patients on haemodialysis: Are we meeting patient needs?

Morgan

Jersey

Mason

et al. 2019

Nutrition & Dietetics

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Aim This study aimed to determine satisfaction with dietetic services, identify barriers and enablers to engaging with dietetic services and acceptable methods of delivering nutrition care to patients on haemodialysis. Methods A questionnaire was developed based on existing satisfaction surveys and key constructs from the Theoretical Domains Framework to understand patient behaviours around accessing dietetic services. Constructs were grouped according to the COM‐B model (Capability, Opportunity and Motivation) of the Behaviour Change Wheel to inform future interventions. Patients at three Brisbane haemodialysis units participated, with questionnaire administered via laptop (by dietetic assistants) or paper‐based version (by nurses). Results Sixty‐six patients completed the questionnaire (response rate 40%, 62 ± 14 years, 58% male). Most respondents (n = 63, 95%) reported seeing a dietitian since commencing haemodialysis. A quarter of respondents reported declining or not wanting to see the dietitian. Despite this, questions pertaining to service satisfaction were largely positive. Questions related to enablers and barriers to engaging with the dietitian revealed the domain of motivation as the main barrier with 41% (n = 26) participants not wanting to make dietary changes. The domains of capability and opportunity were not barriers. Patients preferred receiving nutrition information from dietitians, when they had a question or concern, rather than at predefined intervals. Telehealth was not acceptable to the majority of participants. Conclusions While patients were satisfied with dietetic care, their preferences for dietetic service delivery were not aligned with current evidence‐based guidelines, highlighting need for alternative models of care. Dietetic interventions need to be delivered in a way that addresses motivation.

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“…For optimal control of P absorption, regular careful review of the use and administration of P binders is essential. Children and their caregivers benefit from regular diet education sessions [103,104], with help from renal dietitians, as well as doctors and nurses, to understand the complexities of their renal diet [102,105,106].…”

Section: Evidence and Rationalementioning

confidence: 99%

The dietary management of calcium and phosphate in children with CKD stages 2-5 and on dialysis—clinical practice recommendation from the Pediatric Renal Nutrition Taskforce

et al. 2019

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In children with chronic kidney disease (CKD), optimal control of bone and mineral homeostasis is essential, not only for the prevention of debilitating skeletal complications and achieving adequate growth but also for preventing vascular calcification and cardiovascular disease. Complications of mineral bone disease (MBD) are common and contribute to the high morbidity and mortality seen in children with CKD. Although several studies describe the prevalence of abnormal calcium, phosphate, parathyroid hormone, and vitamin D levels as well as associated clinical and radiological complications and their medical management, little is known about the dietary requirements and management of calcium (Ca) and phosphate (P) in children with CKD. The Pediatric Renal Nutrition Taskforce (PRNT) is an international team of pediatric renal dietitians and pediatric nephrologists, who develop clinical practice recommendations (CPRs) for the nutritional management of various aspects of renal disease management in children. We present CPRs for the dietary intake of Ca and P in children with CKD stages 2-5 and on dialysis (CKD2-5D), describing the common Ca-and P-containing foods, the assessment of dietary Ca and P intake, requirements for Ca and P in healthy children and necessary modifications for children with CKD2-5D, and dietary management of hypo-and hypercalcemia and hyperphosphatemia. The statements have been graded, and statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs based on the clinical judgment of the treating physician and dietitian. These CPRs will be regularly audited and updated by the PRNT.

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Qualitative exploration of the experiences of renal dietitians and how they help patients with end stage kidney disease to understand the renal diet

Cited by 20 publications

References 68 publications

Evidence‐based practice in nutrition and dietetics: Translating evidence into practice

Evidence‐based practice in nutrition and dietetics: Translating evidence into practice

Guidelines for review of patients on haemodialysis: Are we meeting patient needs?

The dietary management of calcium and phosphate in children with CKD stages 2-5 and on dialysis—clinical practice recommendation from the Pediatric Renal Nutrition Taskforce

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