Search

Background: Patient‐centred care (PCC) is widely recognised as being important with respect to the delivery of quality health care. However, limited research has explored PCC in the dietetic context. In particular, dietitians' views of the barriers and enablers to delivering a patient‐centred approach have not been investigated. Therefore, the present study aimed to explore primary care dietitians' perspectives of the barriers and enablers to delivering PCC. Methods: The present study was situated in a constructivist–interpretivist paradigm and used qualitative methods. Both convenience and snowball sampling were used to recruit Australian Accredited Practising Dietitians (APD) who were working in primary care. Individual semi‐structured interviews explored dietitians' perspectives of the barriers and enablers to delivering PCC. Data were analysed thematically. Results: Twelve APDs were interviewed between March and April 2018. Seven themes were discovered: (i) challenges in defining PCC; (ii) valuing PCC; (iii) enacting PCC; (iv) requiring additional education in PCC; (v) evaluating one's own practice; (vi) workplace pressures and constraints; and (vii) keeping up with expectations. Conclusions: These findings suggest that: (i) the meaning of PCC in dietetics should be clarified to ensure it is being practiced consistently; (ii) undergraduate curricula require a greater emphasis on PCC so that dietitians graduate with the necessary knowledge and skills; (iii) there is a need for more professional development training to facilitate uptake of PCC in practice; and (iv) quantitative measurement of PCC using validated instruments is needed to evaluate PCC in the dietetic setting. Addressing some of these factors may assist dietitians to adopt these practices. [ABSTRACT FROM AUTHOR]

Background: The lack of a valid instrument to measure patient‐centred care (PCC) in dietetic practice makes it challenging to evaluate how patient‐centred dietitians are. The present study aimed to develop and psychometrically test a dietitian‐reported inventory to measure PCC in dietetic practice. Methods: The inventory was compiled based on a literature review of existing validated scales that measured the dimensions of PCC. Next, the inventory was distributed as a cross‐sectional survey to 180 Australian Accredited Practicing Dietitians who worked in primary care. Exploratory factor analysis was performed using principal factor analysis with Promax rotation. Cronbach's alpha (criteria ≥0.80), inter‐item correlations and corrected item‐total correlations (criteria 0.30–0.70) were computed to evaluate the internal consistency of each scale. Results: Five factors were extracted accounting for 56.9% of the variance. Most variables had strong loadings on only one factor. Factors were labelled as: shared decision‐making; holistic and individualised care; patient–dietitian communication; knowing the patient; and caring patient–dietitian relationships. Cronbach's alpha was 0.94 for the total inventory and ranged from 0.73 to 0.91 for the individual factors. Inter‐item correlations and corrected item‐total correlations mostly fell in the desired range. Conclusions: The present study offers a preliminary, conceptually grounded dietitian‐reported inventory, which is the first instrument developed and tested to measure PCC in dietetic practice. These findings illustrate the underlying factor structure of the inventory and support the reliability of the scales. With further testing, this inventory may provide useful to clinicians and researchers working to better understand and improve dietetic practice. [ABSTRACT FROM AUTHOR]

Abstract: Background: Patient‐centred care (PCC) is essential to quality healthcare. However, there is a paucity of research on PCC in dietetics, particularly regarding patients' experiences and perspectives of PCC. We aimed to enhance our understanding of PCC in dietetics by exploring patients' perceptions and experiences of PCC in individual dietetic consultations. Methods: The present study used qualitative methods, situated in a constructivist–interpretivist paradigm. Maximum variation purposive sampling was used to recruit English speaking adult participants who had participated in ≥1 dietetic consultations for nutrition care. Individual semi‐structured interviews explored participants' perceptions and experiences of PCC in dietetic consultations. Data were analysed thematically. Results: Eleven patients were interviewed between September and November 2016. Four overarching themes emerged: (i) fostering and maintaining caring relationships; (ii) delivering individualised care; (iii) enabling patient involvement; and (iv) taking control of one's own health. Conclusions: PCC is important to patients. Thus, there is opportunity for dietitians to enhance the care they provide by adopting patient‐centred practices. As the first study of its kind, these findings can inform future dietetic practice, education and research by contributing patients' perspectives of PCC. By understanding patients' unique needs and preferences, dietitians can better align their practice with a patient‐centred approach. Furthermore, these findings are useful for informing future dietetic research and education. [ABSTRACT FROM AUTHOR]

Background Patient-centred care ( PCC) is associated with significant improvements in patients' health outcomes and healthcare systems. There is an opportunity to better understand PCC in dietetics. Thus, the present integrative review aims to critically synthesise literature relating to PCC in dietetics. Methods A systematic literature search was conducted between February and March 2016. Studies were included if they (i) involved dietitians and/or patients who had participated in an individual dietetic consultation; (ii) related to one or more components of PCC; and (iii) were empirical full-text studies in English, involving adult participants, published between 1997 and 2016. Following title and abstract screening, full texts were retrieved and independently assessed for inclusion by two of the investigators. Two independent investigators conducted data extraction and quality assessment using the Mixed Methods Appraisal Tool. Study findings were analysed thematically using meta-synthesis. Twenty-seven studies met the inclusion criteria. Results Six themes were discovered inductively: (i) establishing a positive dietitian-patient relationship; (ii) displaying humanistic behaviours; (iii) using effective communication skills; (iv) individualising and adapting care; (v) redistributing power to the patient; and (vi) lacking time for PCC practices. The first three themes were closely related. Studies used a broad range of methodological designs. Limitations of the studies included a lack of reflexivity and a lack of representativeness of the study population. Conclusions It is apparent that dietitians require good communication skills and humanistic qualities to build positive relationships with patients. Patients strongly desire individualised nutrition care and greater involvement in care. Ensuring dietitians are able to incorporate patient-centred practises during care requires further research. [ABSTRACT FROM AUTHOR]