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'We work in silos': Exploring clinicians' perspectives on the dietary management of coronary heart disease and type 2 diabetes in an Australian public hospital and community health service.
- Source :
-
Nutrition & dietetics: the journal of the Dietitians Association of Australia [Nutr Diet] 2023 Jun; Vol. 80 (3), pp. 307-319. Date of Electronic Publication: 2022 Dec 11. - Publication Year :
- 2023
-
Abstract
- Aims: This study explored clinicians' perspectives on roles, practices and service delivery in the dietary management of coronary heart disease and type 2 diabetes in a public health service.<br />Methods: Semi-structured individual interviews were conducted with 57 clinicians (21 nurses, 19 doctors, 13 dietitians and 4 physiotherapists) involved in the care of relevant patients across hospital and post-acute community settings in a metropolitan health service in Australia. Interviews were audio-recorded, transcribed verbatim and analysed using inductive thematic analysis.<br />Results: A total of 3 themes with 10 subthemes were identified. (a) 'Treatment prioritisation': important role of nutrition in risk factor management; competing priorities with complex patients; weight loss as a priority; and dietitians individualise. (b) 'Diverse roles in providing diet advice': a tension between nutrients, restrictions and diet quality; patients seek and trust advice from non-dietitians; and providing nutrition information materials crosses professions. (c) 'Dietitian access': variable integration and resourcing; access governed by clinician discretion and perceived patient interest; and bespoke application of referral pathways.<br />Conclusions: Time and resource constraints, variable access and referral to dietitians, and inconsistent advice were key challenges in the dietary management of coronary heart disease and type 2 diabetes. Models of care may be improved with greater investment and integration of dietitians, including to provide professional support across disciplines and disease specialties.<br /> (© 2022 The Authors. Nutrition & Dietetics published by John Wiley & Sons Australia, Ltd on behalf of Dietitians Australia.)
Details
- Language :
- English
- ISSN :
- 1747-0080
- Volume :
- 80
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Nutrition & dietetics: the journal of the Dietitians Association of Australia
- Publication Type :
- Academic Journal
- Accession number :
- 36507592
- Full Text :
- https://doi.org/10.1111/1747-0080.12789