Understanding weight management experiences from patient perspectives: qualitative exploration in general practice

Norman, K.; Burrows, Lisette; Chepulis, Lynne; Keenan, Rāwiri; Lawrenson, Ross

doi:10.1186/s12875-023-01998-7

Cited by 2 publications

(3 citation statements)

References 34 publications

(44 reference statements)

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“…Facilitators of collective action identified by providers included close teamwork within provider organisations, trusting relationships between coaches and SUs and wider choices of TDR products. This is in line with other literature around the importance of trust in the relationship between provider and SU [ 25 ]. A range of barriers were identified by providers for SUs compliance and continuation with the programme, associated with personal characteristics, environment, skills and preferences.…”

Section: Discussionsupporting

confidence: 92%

Commercial provider staff experiences of the NHS low calorie diet programme pilot: a qualitative exploration of key barriers and facilitators

Jones,

Brown,

Watson

et al. 2024

BMC Health Serv Res

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Background The National Health Service Type 2 Diabetes Path to Remission programme in England (known as the NHS Low Calorie Diet programme when piloted) was established to support people living with excess weight and Type 2 Diabetes to lose weight and improve their glycaemic control. A mixed method evaluation was commissioned to provide an enhanced understanding of the long-term cost effectiveness of the pilot programme, its implementation, equity and transferability across broad and diverse populations. This study provided key insights on implementation and equity from the service providers’ perspective. Methods Thirteen focus groups were conducted with commercial providers of the programme, during the initial pilot rollout. Participants were purposively sampled across all provider organisations and staff roles involved in implementing and delivering the programme. Normalisation Process Theory (NPT) was used to design the topic schedule, with the addition of topics on equity and person-centredness. Data were thematically analysed using NPT constructs with additional inductively created codes. Codes were summarised, and analytical themes generated. Results The programme was found to fulfil the requirements for normalisation from the providers’ perspective. However, barriers were identified in engaging GP practices and receiving sufficient referrals, as well as supporting service users through challenges to remain compliant. There was variation in communication and training between provider sites. Areas for learning and improvement included adapting systems and processes and closing the gap where needs of service users are not fully met. Conclusions The evaluation of the pilot programme demonstrated that it was workable when supported by effective primary care engagement, comprehensive training, and effective internal and external communication. However, limitations were identified in relation to programme specifications e.g. eligibility criteria, service specification and local commissioning decisions e.g. pattern of roll out, incentivisation of general practice. A person-centred approach to care is fundamental and should include cultural adaptation(s), and the assessment and signposting to additional support and services where required.

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Section: Discussionsupporting

confidence: 92%

Commercial provider staff experiences of the NHS low calorie diet programme pilot: a qualitative exploration of key barriers and facilitators

Jones,

Brown,

Watson

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

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“…While these findings align with previous rural patient (Norman et al. , 2022 ; 2023 ) and GP perspective literature that highlights the complexities of effective weight management in rural settings (Norman et al. , 2022 ), this study extends this to the often overlooked rural nurse experience.…”

Section: Discussionsupporting

confidence: 86%

“…, 2022 ; Norman et al. , 2023 ) with only some of these solely focused on rural experiences. In addition, weight management strategies conducted with a Māori or Pacific cultural worldview outside the general practice context have also identified barriers (Bell et al.…”

Section: Introductionmentioning

confidence: 99%

‘They’re all individuals, none of them are on the same boat’: barriers to weight management in general practice from the rural nurse perspective

Norman

Burrows

Chepulis

et al. 2023

Prim Health Care Res Dev

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Aim: To explore nurses’ experiences with, and barriers to, obesity healthcare in rural general practice. Background: Obesity is a significant health risk worldwide, which can lead to many other physical and psychosocial health issues that contribute to a poor quality of life. Primary care is considered the most suitable context to deliver obesity management healthcare across the world, including New Zealand, which reportedly has 34% of all adults (and 51% Indigenous Māori) classed as obese. Nurses in primary care have a significant role in the multidisciplinary team and deliver obesity healthcare in general practice contexts. Yet, there is little focus on the nurse perspective of weight management, specifically in rural areas where medical staff and resources are limited, and obesity rates are high. Methods: This was a qualitative research design. Semi-structured interviews with 10 rural nurses from indigenous and non-indigenous health providers were analyzed guided by Braun and Clarke (2006) approach to thematic analysis. Findings: Three themes were identified: limitations of a nurse role; patient-level barriers; and cultural barriers. Nurses reported experiencing significant barriers to delivering effective weight management in their practice due to factors outside the scope of their practice such as patient-level factors, social determinants of health, rural locality restrictions, and limitations to their role. While this study highlights that practice nurses are versatile with an invaluable skill repertoire, it also demonstrates the near impossibility for rural nurses to meet their rural patient’s complex weight management needs, as there are many social determinants of health, sociocultural, and rural locality factors acting as barriers to effective weight management. Nurses experienced a lack of systemic support in the form of time, resources, funding, and effective weight management referral options. Future investigation should look to address the unique rural weight management healthcare needs that experience many barriers.

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Understanding weight management experiences from patient perspectives: qualitative exploration in general practice

Cited by 2 publications

References 34 publications

Commercial provider staff experiences of the NHS low calorie diet programme pilot: a qualitative exploration of key barriers and facilitators

Commercial provider staff experiences of the NHS low calorie diet programme pilot: a qualitative exploration of key barriers and facilitators

‘They’re all individuals, none of them are on the same boat’: barriers to weight management in general practice from the rural nurse perspective

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