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We aimed to explore both the dietary-related behavior change techniques (BCTs) adults with type 2 diabetes (T2D) described to enact themselves and the BCTs they perceived their dietitians to enact within consultations. Qualitative study involving semistructured telephone interviews with adults who consulted with a dietitian after their T2D diagnosis. Participants shared their experience of dietary behavior change and interactions with dietitians. Telephone-based interviews from an Australian university setting. Twenty-one adults (12 females and 9 males) aged 36–75 years were self-selected and invited by email. Dietary behavior changes reportedly enacted after a T2D diagnosis by participants and their dietitians. Transcripts were analyzed through thematic content analysis according to the BCT taxonomy. Participants described several BCTs such as problem-solving and self-monitoring (behavior), which helped their dietary behavior change. Participants perceived their dietitians to use BCTs, including goal setting (outcome), self-monitoring (behavior), and instruction on how to perform the behavior. These participants who had consulted with a dietitian reported additional techniques than those prescribed in the consultation process. Adults with T2D undertake a variety of BCTs to support dietary behavior change. Dietitians can draw on behavior change taxonomies to support behavior change in clients. [ABSTRACT FROM AUTHOR]

To identify the views of GPs and general practice staff regarding barriers and enablers to implementation of obesity guideline recommendations in general practice. Twenty general practitioners (GPs) and 18 practice staff from inner-eastern Melbourne, Australia, participated in semi-structured telephone interviews. The interview schedule was informed by the Theoretical Domains Framework (TDF). Interviews were audio-recorded, transcribed verbatim and underwent thematic analysis. Participants lacked familiarity with and knowledge of the NHMRC obesity guidelines. Barriers and enablers were predominantly related to five theoretical domains: (1) environmental context and resources, (2) knowledge, (3) emotion, (4) beliefs about consequences, and (5) motivation and goals. Time pressures in consultations, costs for the patient, reluctance to add to patient burden particularly in those with comorbidities such as mental health issues, lack of awareness about services to refer patients to and GPs' fear of embarrassing patients and losing them were significant barriers. Enablers included having a strong doctor–patient relationship and a sense of responsibility to the patient to address weight. Obesity guidelines and policy makers need to better engage with issues of multimorbidity, socioeconomic disadvantage and workforce issues if recommendations are to be widely adopted in general practice. Tasksharing, teamwork and technology are potential solutions to some of the barriers. Patient perspectives and approaches to being able to overcome stigma and legitimise obesity management in primary care consultations could also assist. [ABSTRACT FROM AUTHOR]

Gabapentinoid medications are increasingly being used in chronic pain management, yet very little is known about the experiences of those using them. The aim of this study was to address this gap in the literature by qualitatively exploring the lived experiences of patients using gabapentinoids for chronic pain. Semi-structured interviews were conducted with 12 adults prescribed a gabapentinoid medication – either pregabalin or gabapentin – for chronic pain in Australia. Interviews were conducted in May 2022 via telephone or online video chat. Audio recordings of the interviews were transcribed verbatim, and data were analysed using reflexive thematic analysis. The Medication Adherence Model was used as a framework for synthesising the data and organising themes. For participants in this study, the initial decision to use gabapentinoids for chronic pain was driven by a level of desperation for pain relief, a perceived lack of pain management alternatives, and a belief that the medication was safer and easier to access than opioids. However, once using gabapentinoids, experiences varied considerably with some viewing the medication as effective and safe, and others viewing it as useless or harmful. Some participants expressed concern that they were not adequately informed by their prescribers about the risks of gabapentinoid use. These findings emphasise the importance of patient-provider communication and taking a patient-centred approach to gabapentinoid prescribing and de-prescribing. Future qualitative research in this area should involve primary care providers to gain a better understanding of factors driving increased gabapentinoid prescribing in chronic pain management as well as barriers to patient education. [ABSTRACT FROM AUTHOR]

Objective: Little is known about how family are involved in cancer treatment decision-making. This study aimed to qualitatively explore Australian oncology clinicians', patients', and family members' attitudes towards, and experiences of, family involvement in decision-making.Methods: Semi-structured interviews were conducted with 30 cancer patients, 33 family members, 10 oncology nurses and 11 oncologists. Framework analysis methods were used.Results: Three main themes were uncovered: (i) how family are involved in the decision-making process: specific behaviours of family across 5 (extended) decision-making stages; (ii) attitudes towards family involvement in the decision-making process: balancing patient authority with the rights of the family; and (iii) factors influencing family involvement: patient, family, cultural, relationship, and decision.Conclusion: This study highlighted many specific behaviours of family throughout the decision-making process, the complex participant attitudes toward retaining patient authority whilst including the family, and insight into influencing factors. These findings will inform a conceptual framework describing family involvement in decision-making.Practice Implications: Clinicians could ascertain participant preferences and remain open to the varying forms of family involvement in decision-making. Given the important role of family in the decision-making process, family inclusive consultation strategies are needed. [ABSTRACT FROM AUTHOR]

Abstract: Women''s same-sex attraction is rarely raised within general practice consultations, despite a common desire for its inclusion. Same-sex attracted women are significantly more likely than heterosexual women to suffer a range of health inequalities, making disclosure of sexual orientation often clinically relevant. This research explored the influences on disclosure from the perspectives of GPs and their regular same-sex attracted female patients. We conducted in-depth semi-structured interviews between mid 2005 and late 2006 with 33 same-sex attracted Australian women, 27 GPs and 1 psychiatrist, including 24 patient–GP pairs. Analysis revealed three disclosure patterns by same-sex attracted women with their preferred GPs, which we labelled open (telling), passive (waiting to be asked) and private (not telling). The three main influences on disclosure patterns were women''s sexual identity experience, the risk of disclosure perceived by women and GPs, and the quality of the patient–doctor relationship. We developed the Identity Disclosure model to explain the interactions between these three influences. The more important a woman''s sexual identity, the more likely she was to prefer an open disclosure approach, while a lower level of identity importance led to a passive or private approach. Risk and relationship then counterbalanced the disclosure decision. A high level of perceived risk for women or GPs would reduce women''s openness, or GPs'' willingness to facilitate disclosure. Reciprocal knowing within the relationship would attenuate risk and increase openness. Reciprocity had the capacity to increase GPs'' shared responsibility for disclosure, which was desired by many women. We suggest that the Identity Disclosure model will facilitate GPs'' understanding of the complex influences on disclosure, and ultimately transform their consultations with same-sex attracted women beyond the habitual silence to a new level of sensitivity. [Copyright &y& Elsevier]

Consumption of steroids and other performance and image-enhancing drugs (PIEDs) is thought to be on the rise in Australia. Along with the benefits experienced by consumers come a range of health risks. This article draws on interviews conducted for an Australian research project on men who inject PIEDs to consider the ways in which information about managing these risks can be provided, the sources of information men use and value, and the professional relationships most effective for securing the best outcomes for them. As we will show, the men in our project expressed a very strong desire for reliable, credible information about risks and how to manage them, but also described often having to rely on information gleaned from sources of questionable reliability such as online forums and friends and acquaintances. Among the sources of information, advice and monitoring they expressed a desire to access were general medical practitioners (GPs), but high-quality interactions with GPs were, they argued, rarely possible. Using the recent work of Isabelle Stengers, particularly the notions of connoisseurship and symbiosis, we argue that new modes of engagement need to be developed that might allow men who consume PIEDs to access the information and support they need, including through their GPs. Following Stengers, we characterise the men in our project as 'connoisseurs' of PIEDs, and we consider what might be at stake and made possible were GPs and PIED connoisseurs to enter into more collaborative relationships to manage PIED-related health issues. In conducting our analysis, we argue for greater recognition of the complexities GPs face when encountering people engaged in illegal forms of consumption and call for new symbiotic models of engagement beyond both zero tolerance-style refusals to help and narrowly focused harm reduction approaches. • Men who inject PIEDs seek quality advice from general medical practitioners (GPs). • Such advice is rarely available as GPs are reluctant to discuss PIED use. • Using the work of Stengers, these men can be described as 'connoisseurs' of PIEDs. • Connoisseurs articulate their own interests when seeking information from GPs. • Connoisseur/GP relationships can be 'symbiotic' if addressing overlapping interests. [ABSTRACT FROM AUTHOR]