Back to Search
Start Over
A qualitative exploration of factors influencing medical staffs’ decision-making around nutrition prescription after colorectal surgery
- Source :
- BMC Health Services Research, BMC Health Services Research, Vol 19, Iss 1, Pp 1-11 (2019)
- Publication Year :
- 2019
- Publisher :
- BioMed Central, 2019.
-
Abstract
- Background Enhanced Recovery After Surgery (ERAS) guidelines recommend early oral feeding with nutritionally adequate diets after surgery. However, studies have demonstrated variations in practice and poor adherence to these recommendations among patients who have undergone colorectal surgery. Given doctors are responsible for prescribing patients’ diets after surgery, this study explored factors which influenced medical staffs’ decision-making regarding postoperative nutrition prescription to identify potential behaviour change interventions. Methods This qualitative study involved one-on-one, semi-structured interviews with medical staff involved in prescribing nutrition for patients following colorectal surgery across two tertiary teaching hospitals. Purposive sampling was used to recruit participants with varying years of clinical experience. The Theoretical Domains Framework (TDF) underpinned the development of a semi-structured interview guide. Interviews were audio recorded, with data transcribed verbatim before being thematically analysed. Emergent themes and sub-themes were discussed by all investigators to ensure consensus of interpretation. Results Twenty-one medical staff were interviewed, including nine consultants, three fellows, four surgical trainees and five junior medical doctors. Three overarching themes emerged from the data: (i) Prescription preferences are influenced by perceptions, experience and training; (ii) Modifying prescription practices to align with patient-related factors; and (iii) Peers influence prescription behaviours and attitudes towards nutrition. Conclusions Individual beliefs, patient-related factors and the social influence of peers (particularly seniors) appeared to strongly influence medical staffs’ decision-making regarding postoperative nutrition prescription. As such, a multi-faceted approach to behaviour change is required to target individual and organisational barriers to enacting evidence-based feeding recommendations. Electronic supplementary material The online version of this article (10.1186/s12913-019-4011-7) contains supplementary material, which is available to authorized users.
- Subjects :
- Adult
Male
medicine.medical_specialty
Consultants
education
Perioperative nutrition care
Clinical Decision-Making
Nutritional Status
Health informatics
Health administration
Nonprobability sampling
Interviews as Topic
03 medical and health sciences
0302 clinical medicine
Early oral feeding
Medical Staff, Hospital
Medicine
Humans
030212 general & internal medicine
Medical prescription
Practice Patterns, Physicians'
Hospitals, Teaching
Qualitative Research
Social influence
Postoperative nutrition care
business.industry
Nutritional Support
lcsh:Public aspects of medicine
030503 health policy & services
Health Policy
Nursing research
Public health
Australia
lcsh:RA1-1270
Middle Aged
Nutrition Assessment
Prescriptions
Family medicine
Practice Guidelines as Topic
Female
Guideline Adherence
0305 other medical science
business
Enhanced recovery after surgery
Colorectal Surgery
Qualitative research
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....5633cd33c915246f386a0cd02401d43e