A comparison of Dutch family doctors' and patients' perspectives on nutrition communication

A Survey of Medical Students’ Use of Nutrition Resources and Perceived Competency in Providing Basic Nutrition Education

Purpose. The aims of this study were to assess where medical students obtain their nutrition information and their self-perceived level of competency in providing basic nutrition education to patients. Methods. A survey was distributed to all first through fourth year medical students at Case Western Reserve University (n=657). For statistical analysis, data was expressed as percentages of total responses and binomial regression was used to answer the study hypotheses. Results. The survey response rate was 47%. Forty-two percent of respondents selected a majority of professional nutrition resources (n=132) as their most commonly used nutrition resources, 38% selected a majority of consumer resources (n=119), and 20% selected “I do not use nutrition resources” (n=61). The most popular nutrition resource selected was consumer websites. Seventy percent of respondents reported feeling competent in their ability to provide basic nutrition education to patients (n=219). Conclusion. Medical students seem to feel competent in their ability to give basic nutrition education to patients, but they may be obtaining nutrition information from unreliable consumer-based resources. To help increase the provision of sound nutritional guidance, medical students should be taught to use reliable nutrition resources, as well as the value of referring patients to registered dietitians.

Nutrition and physical activity guidance practices in general practice: a critical review

OBJECTIVE

The aim of this critical review is to provide insight into the main outcomes of research on communication about nutrition and/or physical activity between GPs and patients for prevention or treatment of overweight and obesity.

METHODS

Relevant studies were identified by a computerized search of multiple electronic databases (MEDLINE, PsycINFO) for all available papers between 1 January 1995 and 1 January 2012. In addition, two independent reviewers judged all studies on ten quality criteria.

RESULTS

In total, 41 studies were retrieved. More studies were found about the guidance of obese patients than of overweight patients. The most common weight guidance practice was discussion of weight. The range of communication strategies for nutrition showed to be more diverse than for physical activity. Twelve studies were considered as high-quality studies, 18 were having medium quality, and 11 were seen as low quality.

CONCLUSION

We reflected on the fact that the content of advice about nutrition and physical activity was quite general. GPs' provision of combined lifestyle advice to overweight and obese patients seems to be rather low.

PRACTICE IMPLICATIONS

Observational research is needed to unravel the quality of the advice given by GPs to overweight and obese patients.

Attitudes and expectations of gastroenterology outpatients about the importance of diet and possible relationship to their symptoms

OBJECTIVES

To evaluate gastroenterology outpatients' attitudes to the importance of diet and its relationship to their symptoms, as well as their expectations of dietary advice from health professionals.

DESIGN

Prospective clinical audit.

SETTING

Gastroenterology outpatient department of St George's Healthcare NHS Trust.

PATIENTS

Two hundred and twenty-five patients, aged between 18 and 70 years met the inclusion criteria.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Participants' responses to a structured questionnaire.

RESULTS

Sixty-nine per cent of participants felt their diet played an important role in their condition. Factors significantly associated with a positive dietary attitude included younger age (40.6 years vs 46.0 years, p<0.01), regularity of dietary pattern (108 vs 35, p<0.01), number of symptoms (4.6 vs 2.5, p<0.01), severity of gastrointestinal symptoms (2.3 vs 1.5, p<0.01), history of weight loss (34% vs 20.3%, p<0.05) and history of dietary advice (71.1% vs 33.3%, p<0.01). Sixty-eight per cent (68%) of participants were interested in receiving dietary advice, though only 36% expected to receive it. No differences were found for any comparisons based on average body mass index.

CONCLUSION

The majority of gastroenterology outpatients view diet as playing an important role in their condition, particularly those who have more severe symptoms and those who have received dietary advice. Although a large proportion of patients are interested in receiving dietary advice, few expect to receive it in clinics. Further research is required to explore the reasons why, and to assess the confidence of health professionals in providing nutritional advice.

Nutrition beyond drugs and devices: a review of the approaches to enhance the capacity of nutrition care provision by general practitioners

The prevention and management of chronic disease is a key priority for primary care services. Nutrition-related care is an integral feature of several best practice guidelines for management of chronic disease in the general practice setting. This paper critically reviews the international literature to enhance the nutrition knowledge, skills and overall capacity of GPs to provide nutrition care using examples from nutrition in medical education, continuing medical education, GP-centred and practice-setting approaches. The medical nutrition education approach provides an opportunity for linear translation between desired nutrition competencies and curriculum learning objectives, while that of continuing medical education allows for tailored nutrition education to increase nutrition competencies once a learning need is identified. The GP-centred approach focuses on the determinants of nutrition care provision by GPs as strategies for enhancing nutrition care delivery, whereas the practice setting approach aims to increase the nutrition-related exposure to patients through avenues independent of the GP. In the Australian and New Zealand context, the potential appropriateness of these approaches requires judicious consideration, as it is unlikely that one approach will comprehensively address this topic. Ongoing multifaceted evaluation of each approach is needed to ensure enhancement of GPs' capacity to provide nutrition care by increasing nutrition knowledge and skills, and improving patient health outcomes.